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 am a 59-year-old male. My height is 5.61 ft, and my weight is 171.96 lb . Just three days ago, I realized that I hear a low-intensity sound constantly in my right ear, like the sound when air is released from high pressure to low pressure. The PTA does indicate moderate hearing loss. I do have moderate sinus issues, which I tend to feel more during a rainy season or when there are weather variations, and I am rather more sensitive to cold and cough. Will brahmari pranayama be useful to handle this? What are the other recommendations to get over this problem completely? Is it likely that this sound will stop by itself after a few days? I use a thyroid medication of 100 mcg for past 15 years. I started using Ginkoba tablet for tinnitus and steam inhalation. I am doing brahmari pranayama too, which tends to provide relief.
Hello,
Welcome to icliniq.com.
As I can see, your pure-tone audiometry (PTA) test shows moderate sensorineural hearing loss and tinnitus is quite common in this condition. Sensorineural hearing loss in old age is a common occurrence. As you have already started steam inhalation and brahmari pranayama, they will be definitely helpful. I would give a few more suggestions. 1) Many times, we have seen the tinnitus goes off when a person starts using an appropriate hearing aid, so please undergo a hearing aid trial and get one. 2) There is something known as tinnitus masking therapy. It can be done with a device similar to a hearing aid, or a simple solution would be making yourself adjust to that sound by concentrating on surrounding sounds; for example, whenever you sleep or when you are in a quiet place, concentrate your mind on some sound like that of a person or a piece of light music can also be played. This way of constantly training wanes off tinnitus gradually. Definitely, Ginkoba has some effect, and you can use it for a month or so. I hope I have answered all your questions. If there are any further questions, please write back to me. Thank you.
Patient's Query
Hello doctor,
Thank you so much for a quick reply which certainly was useful. I have a few more questions and comments as below. It is rather long. Please read them at your convenience. 1. I have also attached my sinus X-ray. Could you please have a look at that and let me know if I have an enhanced sinus problem? And if yes, could you please elaborate on the magnitude or severity of this problem, and is it playing a role in tinnitus? 2. As you have indicated, I am very much aligned with getting a hearing aid. I have experienced hearing loss even before feeling tinnitus and before doing the PTA test, as I missed out on pieces of conversations over the phone or during a meeting, or in a one-to-one conversation when a person speaks softly (or if there is background noise). 3. However, is one PTA test enough before I actually go ahead with the process of acquiring hearing aids? Should I do a repeat PTA (is it needed?), and are there other hearing-related tests that need to be done before finalizing the hearing aid? 4. I was told that impedance audiometry might help to have a better understanding of this issue. Do you feel the same? 5. I also feel mild to moderate pain in the right ear along with blocking of the nose and heaviness in the forehead on the right side. This pain and blocking get relieved for some time and come back again. It is a cyclic process. Is it a connected problem, and does it need independent attention? 6. Brahmari has been helpful. It tends to relieve the pressure in the ears and provides a general comfort level. In addition, I am also doing a little deep breathing and Anulom-Vilom, hoping that this combination will help. 7. Are there evidence of homeopathy medicine being useful in tinnitus? 8. Due to my profession, my work is all about reading, preparing notes, writing technical papers, solving engineering problems, teaching, and training. All this requires a lot of focus, and hence tinnitus has been rather disturbing, though I am learning to cope with it. 9. Are there evidence that tinnitus goes away by itself or by the use of hearing aids? My aim is to put in all the good practices, along with hearing aids and proper medication, to get out of this problem completely and so that life gets back to the same old. 10. At 59 years of age, I am physically quite active. I go for a brisk morning walk of 35 minutes almost every day at the rate of 1 km in about 10 minutes. 11. However, I have a bad medical history of Hodgkin's lymphoma around 19 years back, which was healed with chemotherapy and radiation, severe dengue around five years back, hyper anxiety and very high restlessness two years back, Covid-19 last year (heavy lung infection, required admission in hospital for 15 days with oxygen support), and finally herpes zoster this year. However, I fought all these problems with full determination and absolute confidence in the doctors and their treatment plans. 12. I am seeking a solution that will enable me to come out of tinnitus completely. I wanted to give a clear picture so that you are able to provide me with precise guidance. Thank you again for being very prompt and so very helpful.
Hello,
Welcome back to icliniq.com.
Your sinus X-ray appears pretty much normal to me. Actually, your PTA (pure tone audiometry) clearly shows there is sensorineural hearing loss, so there is no need for impedance audiometry. If there was a conductive or mixed hearing loss, I would have advised impedance. Regarding your nose obstruction and pain, I would advise a CT (computerized tomography) scan to have a detailed review rather than a sinus X-ray. Usually, we do not recommend any homeopathic drugs as most of those drugs will have steroids. There is evidence to show that hearing aids do relieve tinnitus; if not completely, at least the intensity reduces. Active exercise is a must and well appreciated. I am sorry to hear about the problems you have undergone. Your sensorineural hearing loss may be a side effect of chemotherapy and radiotherapy as well. I am glad that you have successfully coped with all these situations. Finally, I would say tinnitus is a long-standing problem, and you have a lot of online support groups who are suffering from tinnitus. Maybe if you go through their experience, you will find a lot of solutions to your problems. Please feel free to contact me anytime. Thanks and regards.
Patient's Query
Hello doctor,
Thank you so much for your response. I have the answer to most of my concerns. Just a few more queries as below. 1) Shall I continue with Ginkoba tablets? As of now, I have been recommended two tablets a day, morning and at night, after food.
Hello,
Welcome back to icliniq.com.
Yes, you can continue your Ginkoba tablets post your 10 days of current course for another 10 days or so. I would advise (consult with a specialist and take the medication with their consent) one more tablet called Tinnicar (caroverine). You can use this twice daily for 10 days. It seems to give some better results in tinnitus. All these supplements are just supportive medications, so adding or deleting one or two components does not practically make much of a difference. Based on your words, I can see you are maintaining a very active lifestyle, and you do walk daily on a regular basis. It has many benefits; first, it helps in keeping your heart strong, and second, it releases many positive chemicals in your brain, and it definitely increases antioxidants in your body, which help in healing. So I would say any form of aerobic exercise is always beneficial. But there is no documented evidence showing a relation between tinnitus and walking. Do get your hearing aids as it will help you a lot in your profession. To prevent your frequent nose issues, I would suggest a few things. 1) Take steam inhalation at least twice a day. 2) Reduce consumption of citrus fruits, curds, and bananas. 3) Use a simple face mask whenever you are out of your home. I hope I have answered all your questions.
Patient's Query
Hello doctor,
1) As you have recommended, I will continue with morning walking as it has many benefits. 2) You mentioned a tablet called Tinnicar. Is it a widely recommended tablet and are there evidences to show that it does help in reducing the tinnitus sound (makes this sound milder and reduces the number of times you get it)? 3) I had a look at the description of Tinnicar, and it says it works by suppressing the activity of a chemical called glutamate, which is responsible for the tinnitus. So can you please give me some insight into this statement so that a non-medical person like me is able to understand its functioning and its impact on tinnitus management? 4) Can Tinnicar be taken along with Ginkoba, and if required, can Tinnicar be continued beyond 10 days? 5) Would you recommend or would you propose any other tablet for Vitamin B12 supplement? 6) Can I take one tablet of Becozinc daily after breakfast on a regular basis? 7) Can I take one tablet of Tayo 60K every week for 6 to 8 weeks? 8) I tend to feel mild pain in the right ear and as if mild to moderate pressure is building up in this ear. This is intermittent. It goes away and again comes back. Why is it so? 9) Based on my PTA, is hearing loss the root cause of tinnitus in my case? Can it be said with high confidence? 10) How using a hearing aid will help me to reduce (or eliminate) tinnitus sounds?
Hello,
Welcome back to icliniq.com.
I understand you are taking vitamin D, vitamin B, and all other multivitamins. Tinnicar (Caroverine) can be taken with Ginkoba. To answer all your further queries like the action of hearing aid and the mode of action of Tinnicar, please consult an ENT (otorhinolaryngologist) surgeon in person.
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Otolaryngology (E.N.T)
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