Hearing and Balance Archive Questions

Below are Dr. Eisenman’s answers to Hearing and Balance questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.



Now displaying records 1 to 15 of 58.

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Q : 1 06/10/2010	I was diagnosed with Meinere's disease about six years ago and have recently been treated with steroid injections. My case has been severe over the years and I even had shunts put in my ear and they worked for only three years. My hope is to cure this frequent problem. Is there a supplement I could take or medication to help with this severe problem? The mainstay of medical treatment for Meniere's disease is a low-sodium diet and diuretic (like the Triamterene you are taking). The low-sodium diet is very important, probably more so than the medication. Aside from that, I don't know of any effective medications. If the current regimen, and surgeries, have not worked to control your vertigo, consideration should be given to other options, such as gentamicin injection, vestibular nerve section or labyrinthectomy.
Q : 2 05/25/2010	I have recently experienced a sudden loss of hearing in my right ear - specifically above 4khz. The specialist I have seen has attempted to treat it with an oral steroid (prednisone) and a direct injection into the ear itself. There has been no change. What other treatment options do I have? The cause of this is still unknown. Sudden sensorineural hearing loss is a frightening and poorly understood problem. The standard of care is treatment with oral steroids. There are some data to suggest that timely treatment with injected steroids may also be helpful, either as a complementary or alternative treatment approach. There are no other known, clinically proven effective treatments of which I am aware.
Q : 3 04/28/2010	I wanted to see if I was a candidate for your practice. I have tinnitus and loss of hearing in my right ear (since 1990s). I also have Pos-vertigo and constant fluid problem with my ears. Those are problems we commonly evaluate and treat. We would be glad to see you in our practice for a complete evaluation.
Q : 4 04/09/2010	I have had insomnia and stress for a few months. Ear ringing seems to have occurred in the last week or so. I was taking Lorazepam and stopped because I thought it might have been a side-effect or symptoms of withdrawal. I think all the sleepless nights are affecting the nerves in my ears because I have noticed my hearing decreasing. Can these nerves heal themselves as I return to a normal sleeping pattern? I am scared that the ringing and noise-sensitivity will be a permanent thing. Stress, fatigue and anxiety can commonly make tinnitus into a problem. Usually, when the inciting problem gets better so does the tinnitus.
Q : 5 03/29/2010	What kind of a doctor should I go to for my tinnitus sound and pain problems? Tinnitus is best evaluated by an ENT physician. A hearing test will be necessary. As for pain evaluation and treatment, it depends on where the pain is, and what the likely cause is. Often an internist, general practitioner or neurologist is a good place to start.
Q : 6 03/02/2010	I have been suffering from tinnitus for over 3 years. I have tried several approaches including acupuncture and OTC remedies with no luck. What should I do next? Tinnitus habituation therapy, is one of the many available treatment options and is a very helpful approach for people with refractory, intrusive, chronic tinnitus.
Q : 7 02/26/2010	Is there any surgery to relieve tinnitus? I have a sister who has had this illness for more than 3 years. She has been tested, but no identifiable problem has been found. I read that zinc is a vitamin our body is missing, could you please tell me if this is true and how much an adult should take per day? There are many different types and causes of tinnitus. Pulse synchronous tinnitus most often has an identifiable and treatable cause, often with surgery, though not always. The more common tinnitus, i.e. where a person hears a constant tone, is usually associated with hearing loss, though not always. If it is, then measures to improve hearing are often helpful. There are no definitive studies demonstrating any single medication to be helpful or any vitamin deficiency to be responsible for that type of tinnitus.
Q : 8 02/24/2010	My mother, age 87, is losing balance and falling backward, without experiencing dizziness, vertigo or loss of consciousness. This used to be a rare occurrence, but it is becoming more frequent (once per week). Could this be an issue that would lie within your purview? She may have weakness in the vestibular system contributing to the imbalance, which is in our purview. Imbalance in the elderly is very often due to multiple causes, including decreased vision, weakness in the inner ear balance system, decreased sensation from the feet and legs and decreased strength and reaction time. When that is the case, in addition to optimizing those functions to the greatest extent possible, use of a cane or walker is indicated to help prevent falls.
Q : 9 01/25/2010	I was diagnosed with Meniere's disease in 2001 at the Shea Clinic in Memphis. The doctor was puzzled that my hearing test in the affected ear was 100 percent accurate. Is it possible to have Meniere's disease and not have hearing loss? I elected not to have ear surgery and since then have only had a few vertigo spells. As far as I know, I still do not have any noticeable hearing loss. To make the diagnosis of Meniere's disease definitively, one needs to see hearing loss at least at some point. That doesn't mean that you can't have Meniere's disease if you don't have the hearing loss, but it does decrease the certainty of the diagnosis. A more common cause of episodic spells of vertigo without hearing loss would be vestibular migraines, even if you don't have concurrent migraine headaches.
Q : 10 12/22/2009	I had knee replacement on November 2, and on November 6, I had a total loss of hearing in my left ear. I have now regained 10% of my hearing. I have been diagnosed with sudden hearing loss, but find it hard to believe that it was not related to my surgery/hospitalization. Have you ever heard of a case like this? Sudden hearing loss can occur after general anesthesia, though it is uncommon. Idiopathic sudden hearing loss is more common, and that could be the case in your situation too. Treatment is usually with oral steroids, and sometimes with steroids injected into the ear as well.
Q : 11 11/23/2009	My father is 78-years-old and received a Baha implant seven years ago. I am concerned because despite his diligence with cleaning and care he has a small area that attempts to grow over the edge of his external snap about every 18 months. He has trimmed the area and he does well with this until the site become sore again due to new overgrowth. Now, he is told that he needs the outer snap replaced and a larger external snap installed to eliminate this issue. I am wondering if abutment is common and something you see frequently? Are there other solutions less traumatic that could be tried before general surgery? Skin overgrowth is the most common complication after Baha surgery, occurring in about 10% of patients. When minimal, it can sometimes be treated in the office, though it often requires surgical revision.
Q : 12 10/01/2009	I was just talking to a woman who has a Baha Implant. I'm a cochlear implant candidate. Is there much difference between the Baha and cochlear implants? They are very different devices. A Baha is appropriate for somebody with conductive hearing loss who can't wear hearing aids for some reason (e.g. no ear canal, chronic ear discharge), or somebody with unaidable hearing loss in one ear and good hearing in the other ear. Cochlear implants are for people with unaidable (or insufficiently aided) hearing loss in both ears. The Baha is implanted in the skull behind the ear, and works by vibrating the bone to transmit sound. A cochlear implant is implanted into the inner ear (cochlea), and electrically stimulates the nerve endings directly.
Q : 13 09/25/2009	Can tinnitus ever be caused by a head injury? Yes, we do see tinnitus after head injury. This is often associated with hearing loss, but not always.
Q : 14 08/19/2009	I had an ENT give me the tympanometry test. He diagnosed me with Eustachian Tube Dysfunction. There was no fluid in my ear, but I did have slight high frequency hearing loss. When my symptoms didn't go away, my family doctor sent me to a dentist who did an x-ray and quickly diagnosed me with TMJ and said my sinuses were blocked as well. I am worried that this could be something more serious like a tumor since I have been repeatedly misdiagnosed in the past. TMJ dysfunction is a common cause of tinnitus. When a person has asymmetric hearing loss or tinnitus in only one ear we have a greater concern about a tumor as a possible cause.
Q : 15 07/21/2009	I experienced vertigo for the first time 7 years ago. Along with the vertigo, I have nausea and a headache. Over the past seven years I get the vertigo maybe twice a year. This year I notice that I keep getting the vertigo not as severely as I have in the past, but more often. In addition to the vertigo, I also notice that I get bad motion sickness, fullness in my ears and I am sensitive to flickering lights and videogames. I can usually tell when I am going to the vertigo because I get very tired and this strange feeling in my head along with a slight headache. I am worried because it is happening more often and would like to know if there's anything I can do for it. The symptoms you describe are strongly suggestive of vestibular migraine. These are episodes of vertigo due to migraine, and can occur even without an associated migraine headache at the same time. Treatment of vestibular migraine is usually with avoidance of migraine triggers, and sometimes with migraine prophylactic medications- i.e. medications taken on a regular basis to prevent the episodes from occuring. A neurologist with expertise in migraine could be a could person to see for this problem.

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