Tinnitus Therapy from The American Academy

The American Academy of Otolaryngology has established Guidelines for the Treatment of Tinnitus. These guidelines are readily available. They are clear as to how Tinnitus should be treated. Nothing in the guidelines says patients should “learn to live with it.” Unfortunately, when I speak at meetings of the American Tinnitus Association, the patients attending the meetings have often not been treated according to the American Academy Guidelines! The American Academy of Audiologists have Guidelines as to how to measure Tinnitus. These are clearly stated. Yet, only a few patients I see have had audiology evaluation based on these guidelines! This is really a mystery to me. There are guidelines for treating tonsillitis, allergic sinusitis, enlarged adenoids, and so on. These are regularly referred to by practicing physicians. None of these guidelines say that patients with these conditions should just learn to learn to live with it! If you have tinnitus, you may want to familiarize yourself with these guidelines to assist in your tinnitus therapy. My book: The Whole Person Tinnitus Relief Program is based on these Clinical Practice Guidelines and is written so that patients can read and follow these recommendations. The book is free at www.drgrossantinnitus.com These guidelines were formulated by a large group of Tinnitus specialists and are published in the medical journal: Otolaryngol Head Neck Surg. 2014 Oct;151(2 Suppl):S1-S40. doi: 10.1177/0194599814545325. Clinical practice guideline: tinnitus. The authors: Tunkel DE1, Bauer CA2, Sun GH3, Rosenfeld RM4, Chandrasekhar SS5, Cunningham ER Jr6, Archer SM7, Blakley BW8, Carter JM9, Granieri EC10, Henry JA11, Hollingsworth D12, Khan FA13, Mitchell S14, Monfared A15, Newman CW16, Omole FS17, Phillips CD18, Robinson...

Clearing Your Ears

Did you know that your ears are connected to your throat? Your middle ear is a sealed chamber containing tiny bones that transmit sounds to the nerves in your inner ear. When the pressure outside your body changes (like when you drive up a high mountain, or like when the cabin pressure in an airplane changes), a valve in your eustachian tubes opens, and the pressure is equalized. Many people reccomend swallowing or blowing while holding your nose to clear your ears if you have trouble…That’s because your sinuses are connected to your eustachian tube. When your sinuses are blocked, or irritated, your eustachian tubes can become blocked as well. This is why sinus medication can help you clear your ears. I promise this is true; it is not that I don’t know my nose from my ear! Antihistamines (Chlophenarimine, Entex, ternafdine (Seldane) )will help, and you should take these with you if you have to fly with a cold or allergies. If you have a lot of trouble clearing your ears all the time, try this: Practice! Divers LEARN to clear their ears with practice; we are simply conscious of the part of our body that opens the Eustacian tubes, like other people are conscious of their fingers. Try to clear your ears a few times every now and again by blowing gently while holding your nose. Go ahead and try the old standbys, chewing gum and holding your nose and blowing. These usually work if you keep at it. FOR THE DIVER: Same for you, only more important since failure to clear your ears could result in...

Dizziness and Vertigo

Dizziness and Vertigo Dizziness, Vertigo, and Their CausesDizziness and Vertigo are terms that are sometimes used interchangeably by lay persons, but they terms have clearly different meanings for doctors.Vertigo is the sensation of moving – either you feel like you are moving or the room feels like it is moving. This often occurs when the fluid in the inner ear – called the labyrinth – is affected. Dizziness, on the other hand, is any sensation of unsteadiness, or feeling faint, or difficulty in walking, and can have many causes. Physicians sometimes have to work hard to get the patient to properly convey what they are feeling. you can be dizzy from getting up out of bed too fast. Here the blood hasn’t had a chance to catch up with your brain. any part of the balance circuit may not be getting enough blood. This can make you dizzy and faint. Any blow to the head, even a severe whiplash can cause some swelling in the circuits and make balancing a problem. We can do a test called Electronystagmography and tell if the neck is a causal factor or if it is Benign Positional Vertigo.   BalanceKeeping one’s balance is a highly complex activity.Balance consists of four elements. Your eyes can tell you which way is up. In the inner ear are three water tubes called semicircular canals. (Picture of ear at http://www.teleport.com/~Veda/gallery. html) They go in 3 different directions. Think of them as a carpenter’s ruler with a bubble. The bubble goes up when you tilt your head. One canal or bubble system is for forward and back, one...

Tinnitus

Tinnitus Do you have Tinnitus (ringing in the ears)? Ringing in the ears is a subjective symptom, a sound heard by the patient that cannot be recorded by today’s instruments, much like pain. If it is very loud it can distract from sleep and thinking. It can be caused by Meniere’s disease – an increase in fluid pressure in the inner ear. It is treated by reducing that presage. High blood pressure may cause tinnitus, and lowering the pressure is effective. Loud noise and associated hearing loss is a causal factor too. Large doses of aspirin and certain aspirin products may bring it on. Avoid these if they are the cause. Stress is not a cause, but once tinnitus becomes annoying the person feels stressed. TreatmentFor tinnitus that fails other treatment, Vitamin B6 ( Pyridoxine) 100 milligrams twice a day is worth trying for 3 months. I personally have had little success with Niacin in doses large enough to cause a flush, but it may be worth trying. I was first to publish about the use of muscle biofeedback in the 70’s for tinnitus. It is successful because when the muscles are relaxed, you stop making it worse by tension and anxiety. You cannot feel anxiety when the muscles are fully relaxed! This is done by the patient at home as follows: sit comfortably in a chair with a large mirror in front of you. Practice relaxation by breathing in at the count of 4 and out at the count of 6. As you exhale, let a signal go through your to relax. Look at your face – you...

Eustachian Tube Blockage

Eustachian Tube BlockageDo you have Eustachian Tube Blockage? In order to hear, we have an ear drum that vibrates with the sound and 3 little bones located in the middle ear that move back and forth in order to transmit the sound to the inner ear where the nerves are. In order for the ear drum and the bones to move properly, the middle ear space has have a pressure equal to that of the air outside the ear. But if you change altitude, the pressure outside changes and you have to adjust the middle ear pressure. This is done through the Eustachian tube (ET), which connects the middle ear to the nose and the outside. When people blow the nose too hard, this can close the ET. Any nasal congestion, swelling can do this. A growth in the back of the nose can press on this opening too. This is why we are concerned when the ET is blocked on one side without an obvious cause, we must look for the cause. Inhaled toxins can injure the ET system too. With blockage, patients are aware that they can’t hear as well; this is because the closure of the ET causes a vacuum to form in the middle ear that prevents the normal vibration of the ear drum. If this closure persists, the body tries to fill this vacuum and the normal air containing cells of the mastoid bone change to mucous making cells and give a condition called Serous Otitis Media or fluid filling the middle ear. When the ET is blocked, a nasal decongestant such a Zephrex...

Outer Ear Infections (External Otitis)

Outer Ear Infections (External Otitis)The human ear is not designed for California living -swimming, daily shampoo, hot tub, scuba diving. The human ear needs wax (cerumen) to protect against the ravages of soap and water. Unfortunately we are taught with religious fervor to scrub the ears with soap and water. WRONG. Or use alcohol ear drops. WRONG. You need the wax. What happens is that once the wax is out of the ear canal you have the equivalent of dishpan hands of the ear canal. The ears itch and you scratch it in your sleep, then it gets infected. So, avoid this by filling the ear canal with baby oil before shower or washing the hair. This prevents irritation caused by soap and water and helps keep the ear canal properly oiled. If itching does start, taking one of the over the counter antihistamines such as Chlortimeton or Benadryl at night may stop the itch and prevent you from scratching the ear in your...