Terrible Tinnitus; Suspecting Ototoxicity from Polydexa (Neomycin and Polymyxin B)

Hello everyone, I'm so desperate right now.. I need help for my case, I couldn't find enough case close to mine on internet.

Let me explain briefly how it happened;

During coronavirus lockdown I got really mild ringing and pressure in my right ear, it was probably because of an allergy or stress and it was getting better, doctor gave me appointment for a week later and the day I went to doctor it was almost non existent. I went to a doctor and he said I might have fluid in right ear gave me 3 different medication and I started using them without question, on 4th day of medication I started hearing really intense high frequency hissing noise in both ears and then intense ringing in left ear developed, I stopped using these medications immediately. Drugs that doctor gave me were; Antihistamine, Otrivine care and Polydexa ear (through nose while lying on bed) which I later find out that it contains Neomycin and Polymyxin B that are highly ototoxic. I believe it got into my eustachian tube and reached to middle ear, and entered to inner ear. Do you think this is possible?

I'm having really bad tinnitus since then, it's been 3 weeks, Ringing in the left ear and Static noise all around my head which makes me feel sick, it's more than a noise, it gives me a really weird sensation/feeling and Morse code like sound coming behind tinnitus. Right now I'm hearing 3-4 different sounds at once.

I'm 27 years old male, sound engineer/musician. I feel like my life is ruined. And it's so weird that this happened while I was doing fasting, and quit alcohol and smoking for 3 months now. I was in my best shape and healthiest state ever. I'm suspecting it's from Polydexa (Neomycin and Polymyxin B)

Do you think it will get better for me? Or no chance? Anyone had tinnitus from such drugs? I can't live like that, it's weird I can tolerate the ringing sound but static is so bizarre also having 3-4 different types of tinnitus at once? Do you guys experience this? Please I need help I'm so desperate right now. Will it stay like that forever? Any advice? What should I do?

 

Anytime ototoxicity is suspected, I would consider steroids as soon as possible to mitigate as much of the damage as you can. It may be too late for oral steroids but intratympanic may still be possible. See an Otologist asap, and try to get an extended audiogram because ototoxicity shows up in extended high frequencies first.

And in the meantime take NAC, and as many anti oxidants as you can.

 

Thank you for the reply! I found about NAC a week ago and started using it, I will contact doctor about steroids. Does it also help with tinnitus? Or it's only for preventing hearing loss? Noise in my left ears seems to increase in last week, should I also take oral steroids right now?

 

Ototoxicity, if that's what you have, is hearing loss. Sometimes you need an extended audiogram (8kHz-16kHz) to see it because it tends to affect the base (highest frequencies) first.

I'm not sure if oral steroids will do much 3 weeks out but it is probably worth a try. See if you can get seen on emergency somewhere that can do an extended audiogram, especially.

 

Thanks for the information, so if there isn't any hearing loss but only tinnitus does that also mean ototoxicity? I had extended frequency test couple days ago, all seems fine till 8 kHz, there is only 10 dB loss at 10 kHz and 15 dB loss at 12 kHz in both ears, doctor said that's normal.

 

This makes it less likely imo to have (at least significant) ototoxicity.

You mentioned quitting alcohol recently. Alcohol potentiates GABA so you may have been masking existing tinnitus that you were developing. Since you are a sound engineer and musician, you may even have a noise induced cause (for instance) that you hid with alcohol. Noise induced can cause damage to the synapses first which don't show up on a audiogram (also known as "cochlear synaptopathy"). Speech in noise difficult can be a sign of this but only if the synaptopathy is in important speech frequencies.

Make sure you rule out more esoteric stuff lile TMJ if you can too. Hope yours improves. For most people, if you baby your ears in the acute stage, their tinnitus improves.

 

Thank you so much for all the information and help, really appreciate it!

That make sense, even tho I always think I didn't listened at loud levels, I did listen for long periods without resting my ears, hopefully it will fade away within time at least to an unnoticeable level. Last question do you think there is also chance that it will fade if it's from the medicine getting into cochlea?

I started taking Ginkgo biloba, NAC, D + C + E + Zinc. Also thinking about adding Curcumin pills but don't want to over do supplements.

 

It could definitely fade (though it takes time). Early anti-oxidants have evidence for increasing those odds.

Hope yours gets better soon.

 

@FGG

It looks like he stopped drinking alcohol about two months prior to the onset of his tinnitus, however @Jack23 please correct me if I'm wrong with that timeline. Would tinnitus that was masked by potentiated GABA from alcohol show up after roughly two months time? I'd assume it would be more immediate especially if any level of withdrawal is involved. I ask because I have a similar timeline and am curious if that could be a potential reason. Thanks!

 

That's a good point and I would expect that some degree of tinnitus would have shown up before then even if it got worse. GABA receptors and their internal regulation are highly variable, though so who knows?

Are you on any other meds, @Jack23?

 

During lockdown which was around 2 months, I haven't noticed anything, only close to the end of second month I had mild ringing in the right ear and very low hissing noise only noticeable mornings which made me visit doctor but I really regret that, I only took vitamins, C + D + E + Zinc and Omega 3 in these 2 months.

Drugs that doctor prescribed were: Clarinase (Antihistamin), Otrivin Care, Polydexa and Ginkgo Biloba. After 4 days of using these, my ears got way worse

Because of medications it's hard to pin point the exact cause I'm not sure if it was going to evolve into current state without using these medications. Initial start be even from Alcohol or stress then ototoxicity made it worse.

Right now I'm using Ginko and NAC for their anti oxidant effect, B complex and other basic vitamins.

 

Yes it appeared after 2 months when I stopped drinking. Not sure if they are related but GABA masking theory definitely makes sense. I am wondering, if it's related to neurotransmitters, does that mean there is nothing to do with hearing loss? As my test results came normal for my age according to my doctor.

 

Hearing loss due to antibiotic ototoxicity is usually very obvious on an especially extended audiogram. Early hearing loss due to other causes may not be obvious on an audiogram. Read about "cochlear synaptopathy" aka "hidden hearing loss."

GABA can not mask hearing loss but can suppress tinnitus (though long term GABA potentiation can lead to worse tinnitus due to receptor down regulation/tolerance).

 

Is there anyway to recover (regulation/tolerance) of GABA from long term alcohol or antidepressant use?

 

For most people, the receptors seem to recover but it takes a long time (sometimes years). Often, the tinnitus seems to improve at this point too.

Some anti depressants are poorly studied and there isn't a lot of data, though.

 

I also have Neomycin induced tinnitus.

How long does one have to take Prednisone to be considered long term? I've taken it a few times and I am worried about long term side effects. I've taken it 6 times in the last year and half. Two weeks at a time.

 

Prednisone is often given to treat acute ototoxicity. It shouldn't make anything (in your ears at least) worse unless you get blood pressure spikes from it.

 

What does your tinnitus sound like? Is it constant beep? Or hissing?

 

Hey everyone,

I am wondering how many people here got their tinnitus from ototoxic medication?
Also what's characteristics of your tinnitus?
Did it ever get better within time?

I got it from using Polydexa, mine is 7/24 hissing noise both ears + Solid ringing noise in left ear.

 

My ototoxicity (Azithromycin) induced tinnitus was initially and briefly mild, then severe for a few months, then settled to moderate and has not budged in over a year (and does not fluctuate) so I suspect that level is permanent for me.

My bothersome tinnitus is high pitched and tonal. It *sounds* bilateral but will get a bit louder if i lay on my left side (and not my right).

I have another "crickets" tone that might bother me if the pure tone wasn't so much more annoying.

Recently, I got a severely loud and distressing 3rd tone (high pitched but less so than my regular tinnitus) randomly with no known reason (no noise and no ototoxin) but I took steroids within 3 hours and it responded extremely well. In fact, I can only hear it in silence with plugged ears. Still have the other two though.

 

Which steroid brand did you take for your new tinnitus sound? I'm wondering should I get injections to my ears. My tinnitus is still 2 months old, I heard it might help up to 3 months. My doctor hasn't mentioned me anything about steroids after I told him my tinnitus got intense from antibiotics.

 

I used Prednisone that I happened to have around. It was generic Prednisone. I doubt oral steroids would do much a few months out but you never know. I'm really not sure how far out Intratympanic steroids can help antibiotic ototoxcity. I would have probably tried it personally if I could have gotten a doctor to do it at the time.

 

Just came back from doctor, I asked him about steroids, he also said that when they suspect ototoxicity they give steroid injections but he doesn't think that I had ototoxicity, because I don't have hearing loss in test results but my ears are ringing badly. Instead of injections to ear he prescribed me injection to hip. Do you think that will have any effect?

 

For evidence of ototoxicity, sometimes you need an extended audiogram (from 8000hz to 16000hz). Is that something you have access to? If you can get that and show hearing loss in the upper ranges, you can probably convince your ENT to do an intratympanic injection.

 

Isn't Polydexa ear drops? (not systemic medication)

 

@Jack23, I had forgotten that you had an extended audiogram. It would definitely be highly unusual not to have any evidence of hearing loss on extended audiogram with antibiotic ototoxicity if that was the cause.

Does your ENT want to do a further work up?

 

Hi @Jack23 I got it from antidrpressant medication. You're just 1 month in? It's still too early to know what your outcome will be. Use the search bar at the top of the page and search for antibiotics etc. You will find all the cases similar to yours.

Don't let people's stories scare you. When people post they often don't mention their full medical history, so you can never know exactly their circumstances and everyone's outcome will be different.

Search for my posts, I'm not cured but it's much quieter now.

The first month is a nightmare, wondering if you can ever have a good life again, work normally etc. but It gets better.

 

Yes, my doctor directed me to use it through nose for eustachian tubes. I wasn't aware of ototoxicity...

 

My test was 500 Hz to 12,000 Hz. There was hearing loss starting from 8,000 Hz and more towards 12,000 Hz. I will ask for 16,000 Hz test.

 

Why did your doctor say you didn't have hearing loss on the extended audiogram if you did? If you have loss at 8000 Hz, you don't need to get one up to 16000 Hz to show hearing loss.

Can you post your audiogram?