Dr. Akshay. B. K.
Otolaryngology (E.N.T)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have a whooshing sound in my ear (tinnitus). It reduces when I fast. It is better when I am awake but gets worse when I lie down, and it takes two hours in the morning to reduce it. It started with an ear infection. Fasting and intermittent fasting have helped decrease it by 98 %. Kindly suggest diet and lifestyle changes to improve the condition. Also, what tests do I have to get done? Kindly guide.
Hello,
Welcome to icliniq.com.
You might be suffering from serous otitis media as there is a positional variation of sounds. Have you undergone a pure tone audiogram or impedance audiogram?
Patient's Query
Hello doctor,
Thank you for the response. I could not get the tests done. Can you suggest me how to reduce it in the meantime? Can I do gargling or inhale hot steam? Can I go for diet or lifestyle changes? Why does this sound reduce with intermittent fasting? Kindly advise.
Hello,
Welcome back to icliniq.com.
There can be two diagnoses. Either serous otitis media or tinnitus. I suggest the below treatment plan: 1. Steam inhalation for five to ten minutes daily. 2. Tablet Amoxicillin and Clavulanic Acid 625 mg twice daily. 3. Tablet Pantoprazole 40 mg once in the morning on an empty stomach. 4. Tablet Montelukast and levocetrizine at night. 5. Xylometazoline nasal drops thrice daily. Avoid citrus fruits, bananas, and yogurt for a few days. Since how many days is the whooshing sound there? Also, is there a decrease in hearing? As you are above 60 years, a pure tone audiogram will be helpful. I hope this helps. Thank you.
Patient's Query
Hello doctor,
I have done steam inhalation and gargling as per your advice. I have a runny nose, also. Kindly advise what a pure tone audiogram would help and what it will show. My ear infection started four weeks back. My doctor suggested ear drops initially and, after five days, suggested antibiotics. Yesterday, I went to the emergency department to get urgent care for my ear in the ENT room, and the doctor used the otoscope attached to the wall and said that my ear and eardrum were clear. He said there was no liquid behind the ear drum or no infections, but he could see wax. Also, he said that the ear infection would gradually reduce. Is there any device other than an otoscope better for checking the ear? Can I go for any diet or lifestyle changes? Is my acid reflux problem worsening my condition? Should I consult a TMJ expert? Also, I cannot always fast to reduce my whooshing sounds.
Hello,
Welcome back to icliniq.com.
SOM (serous otitis media) is a condition in which fluid accumulates behind the ear drum due to eustachian tube dysfunction. As you have got your ears checked, SOM can be ruled out. A pure tone audiogram will show a graph of whether your hearing mechanism is intact or there is a problem in the conduction of sounds in the neural pathways. Considering your age, some amount of hearing loss is expected, which causes tinnitus. Therefore, I suggest you go for a hearing aid. Also, impedance audiometry will let us know the status of the middle ear and the functioning of the eustachian tube. As your doctor suggested, your condition is due to a previous infection. The sound might be due to eustachian tube dysfunction. Therefore, Xylometazoline nasal drops thrice daily and steam inhalation for five to ten minutes daily should help. Also, you should avoid loud sounds, use earphones, and practice meditation. Also, you can use multivitamins like Alpha lipoic Acid 200 mg, Chromium Picolinate 200 mcg, Cyanocobalamine 1500 mcg, and Elemental Zinc 12 mg. Acid reflux does not cause such symptoms. Also, TMJ discomfort does not cause ear infections and causes difficulty in chewing. Fasting also is not related to ear pain. I hope this helps. Thank you.
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Otolaryngology (E.N.T)
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