Tinnitus Since 4/17/2020 Due to Abuse with Headphones

Good night to everyone in the community. First of all, I would like to thank all the collaborators of the forum, certainly this initiative is helping and will help many who are experiencing the same problem as us.

My name is Leandro, I am 22 years old, I live in Brazil and I am a medical student in his last year.

My tinnitus started last Friday in a very low tone, almost static, I noticed in the night when I went to sleep, I even thought it was my PC speaker that was interfering but even turning it off the noise did not stop. Saturday during the day I didn't notice the noise, only at night I could see that something was happening. I researched a little about it because I already suspected an acoustic trauma since I always use headphones to listen to music and play and always at a very high volume (a big mistake). On Sunday the noise was noticeable during the day but it still wasn't very uncomfortable. From Monday, I could hear him all the time, the anxiety worsened and made the noise even louder. In my case, it is a noise that I only perceive in my left ear, in an extremely high pitched tone (from my 14000Hz tests) and constant, with slight fluctuations in volume. The noise was making me extremely anxious but the more I learn about it the more peaceful I become. As for sleep, I can sleep with the TV on (something I was used to doing). I don't have symptoms of hyperacusis and I didn't notice any hearing loss either.

As I am a student, I searched the Scielo and PubMED database for possible preventive treatments immediately because I know the risk of irreversibility of the condition. Anyway, I got in touch with one of my professors who is an otolaryngologist and he attended me in his office on Wednesday (04/22). After verifying that the otoscopy and the rest of the physical examination was ok, he came to the same conclusions as me. Prescribed me prednisolone 40 ~ 60mg / day for 5 days and pentoxifylline for 1 to 2 weeks, in addition to asking me for an audiometry if the symptoms did not improve within 1 month, no blood tests were requested. As a professor, he also asked me to investigate more about it since the content, even in the scientific community, is very scarce in terms of tinnitus. After a more detailed research on the different types of treatments (all without much scientific support and more related to evidence-based medicine) I decided to keep the prednisolone for 1 week (until the next Wednesday) and finish with this box of pentoxifylline.

In the case of pentoxifylline the mechanism is the same as other drugs such as Ginkgo Biloba 761, increasing the blood supply to the cochlea in order to try to speed up recovery. I haven't noticed any improvement yet, not least because I'm only on the third day of treatment but I'm hopeful seeing the reports from the forum because I thought it would be something permanent if I stayed for more than 72 hours with the symptoms given the pathophysiology of the diseases related to damage to the auditory hair cells , which in theory regenerate every 48 hours (but we all know that in practice there are many more variables involved, such as the neuromodulation of the auditory channels). I decided not to opt for antidepressant drugs, benzodiazepines, anticonvulsants or calcium channel blockers for now.

After reading some other articles, I decided to start supplementing with magnesium and a multivitamin that contains the B and D complex, these I started today and will update if it has any effect going forward. Until yesterday I was still using headphones at very low volume but now I stopped using them altogether, in fact, I am using a pair of in-ear twins turned off to protect my ears only.

At the most I will post updates about my evolution, if anyone has any tips on what can be changed or added to improve the prognosis of my case I would be extremely grateful.

Thank you all.

 

Very interesting you are a medical student. Share your knowledge with us going forward!!

 

Certainly everything I discover about possible treatments I will publish here for you.

 

Seeing as our situations are somewhat similar, I'm very interested to see if the use of Prednison will improve your situation.

Unfortunately my physician wouldn't prescribe it to me, so I'll never know.

I wish you all the best and hope to read more of your findings!

 

Check out my success story, there's many treatments I tried. Your injury is still super new so I think you can make a very good recovery.

https://www.tinnitustalk.com/thread...—-possible-but-not-without-some-effort.40728/

 

Thank you, I'll read it.

 

1903/5000

Updating about my case:

In the last two days I noticed a slight improvement in the tinnitus, it is lower and less bothering me even at bedtime.

I went to another otolaryngologist today, a friend of my family. Again a completely normal physical exam, I told a little about my story and he asked me to anticipate the audiometry that my other doctor had already requested. I did it at the same time with the clinic's speech therapist and the exam was completely normal, without hearing loss, with only a slight change in the pressure curves of the inner ear, she even commented to me that it could be some dysfunction of the Eustachian tubes that could be obstructed disrupting the communication between the rhinopharynx and the inner ear.

I went back to the doctor's office and he asked me for a fibronasolaringoscopy that is done together with fibronasopharyngoscopy (a video fiber to be able to see inside the cavities). He performed the procedure himself immediately and found some changes, a slight / moderate deviation of the nasal septum, nasal turbinate hypertrophy and obstruction of the pharyngeal ostium of the right auditory tube (I thought it was funny because my tinnitus is in the left ear). The obstruction seems to have been caused by a cellular hyperplasia, the hypothesis is that it has an allergic etiology causing this abnormal cell multiplication.

In addition, the treatment I was undergoing with corticosteroids and pentoxifylline was continued until this Wednesday. Ginkgo Biloba 80mg 12 / 12h and Noex (Budesonide) 50mcg were added 2 jets in each nostril of 12 / 12h for 2 months. It was also requested to wash with 0.9% saline in abundance in the morning and at night in both nostrils before using Noex.

After 2 months of treatment, if there is no improvement in the condition, he asked for a return. I'll update you if the treatment in question had any effect.

Fraternal hug.

 

Update:

I finished using corticosteroids and pentoxifylline, I'm still using Noex and ginkgo biloba. I noticed a 90% improvement in tinnitus, I only listen in quiet environments and sometimes I spend hours without even noticing it, I believe it is evolving towards a cure. One of the things that helped me the most was using 0.9% saline to wash the rhinopharynx 3x a day (at high pressure and aspirating it into the throat) in addition to the valsalva maneuver after this washing procedure which helps in unblocking of the eustachian tubes. I started using loratadine 10mg yesterday and I will keep it for a week due to the possibility that the allergic condition may have caused the obstruction. I hope my next message is to say that I am cured of this disease.

Edit: I hope my case is a reflection and can help some of the members who may think that their problem comes from problems related to cochlea and hearing loss and that in fact it can be something as simple as an obstruction due to allergy or sinusitis.

 

Final update: I'm cured!

After a few days of my last post my tinnitus had worsened a lot, I heard it again extremely loudly and it was affecting me deeply. I started to feel a little dizzy so I looked for a neurologist in order to look at the problem under a new view from another specialist.

After a long conversation about my problem and its evolution he reported that it could be an inflammatory condition of the acoustic nerve (usually caused by reactivation of the herpes virus) or it could be a psychosomatic problem due to stress. A MRI of the skull and ears was then requested, in addition to several other blood tests to assess the possibility of a metabolic or infectious condition. He also asked me to suspend Ginkgo biloba as he did not consider it a vascular cause. He prescribed betahistine for dizziness. On the night I did the MRI, my tinnitus increased considerably (most likely due to the loud noise that the machine makes), I was ill for about 3 days, the dizziness improved but the tinnitus remained. My exams were ready and as I expected everything was normal.

The fact that he mentioned the possibility of an inflammatory condition led me to use a non-steroidal anti-inflammatory in a desperate attempt at improvement and, to my surprise, I had a surprising improvement. I used ibuprofen 600mg 3x a day for 5 days and it was the best 5 days I had in over a month. After 5 days I stopped using it to reassess myself and after 1 day my tinnitus started again, not too loud but it made me afraid. So, I decided to use ibuprofen for another 5 days at 600mg 3x and, after the 5 days I did a kind of "weaning" (1- 2x a day / 2- 2x a day / 3 - 1x a day / 4- 1x a day) day / 5- 1x a day), totaling 15 days of treatment. It is important to note that ibuprofen itself is a drug that can trigger tinnitus, so I suggest talking to your doctor to assess the risk x benefit of its use. I am almost 10 days without using any oral medication (just keeping budesonide for nasal turbinate hypertrophy) and I can say that I am practically cured! Rarely the moments I hear in totally silent environments some kind of very low tinnitus, most of the time I feel like it's even in my head because after so long without hearing the silence hearing it made me even a little uncomfortable or maybe scared of a return of tinnitus.

About ear protection, in my experience I had a very mild hyperacusis I think it is not valid, I even tried it at first but I think that inhibiting external sounds is not the best way, our mind is very powerful and because we are overprotective we ended up developing an exaggerated fear of loud sounds and this can be an even bigger problem in your quality of life. Of course, all of us with this condition should avoid exposure to high volumes such as concerts and headphones (mainly intra-earphones) as much as possible, but the constant use of ear protectors can end up leading to a more harmful than beneficial neuromodulation, being necessary to be evaluated if the case.

Just concluding about the pathophysiology of my tinnitus, after all the medical opinions I believe it was indeed induced by high volume of the headphones for long periods. The acoustic trauma caused an injury to the cochlear and auditory tube control cells, which promoted an inflammatory process both in the inner ear and in the meatus of the eustachian tubes, which meant that my body could no longer match the pressure between the inner ear and the nasopharynx worsening tinnitus. The clearing of the meatus with saline + budesonide together with the inhibition of the inflammatory process with ibuprofen reached the mechanisms discussed here, although hair cells generally do not regenerate they can reorganize and neuromodulation make your hearing perfectly normal again. The fact that I used prednisolone (corticosteroids with a potent anti-inflammatory power) early after the trauma must also have had a strong relevance in the good prognosis.

My message to other members with tinnitus due to acute acoustic trauma (<2 years) is that they do not give up seeking treatment and do not leave it for later, it is a condition that must be addressed early as soon as possible!