ISSHL Case, Severe Tinnitus >60 dB

[Alexandras]

Unfortunately I became the member of tinnitus community as well. I got some good insights from browsing Tinnitus Talk so decided to share my case too.

14 July suddenly felt dizzy simply sitting in the front of PC. I tried to stand up, but I was feeling like heavily drunk. In the past I had some anxiety attacks so thought maybe this is it, so just took a bromazepam pill and went to lay down. In the next 5 minutes the horrible, very loud high frequency pitch came to my left ear. After one hour I felt aural fullness, as if my ear was filled with cotton. I barely could hear anything with it. Unfortunately probably due to the bromazepam I was feeling quite calm and did not panic when it was a right time to panic and call the ambulance for the emergency. I felt asleep because of the drug.

In the morning the aural fullness sensation has disappeared and I could hear quite well. Except the horrible tinnitus was so loud as if someone just turned on the high frequency generator right to my ear, and I felt my balance is still affected. The audiogram showed that I lost 20 dB in 4000 Hz, 50 dB in 6000 Hz and basically deaf above 7000 Hz. In a few hours I was already in the hospital under the IV dexamethasone, vasodilators and mildronate. I also have received HBOT therapy, 3x60 min. Despite the effort, after one week there was no any improvement so I went for survival therapy, 5xIT dexamethasone. After the first injection I got +10 dB, however, the other injections did not bring any improvement. The last injection will be made in the end of this week, so... some hope remains...

I also took 60 mg prednisone for two weeks, plus high doses of various vitamins, magnesium, zinc , etc. From the beginning of this week I decided to take a risk and also began to use a high dose of all relevant antioxidants such as curcumin, resveratrol, alpha lipoic acid, NAC, you name it. Actually I spent a lot of money on my blood test to check the various deficiencies, however, all good, no problem, no allergies, does not even show the inflammation (the blood test in the hospital before the drugs). The hypothesis - stress induced free radicals caused a local inflammation as the result of spontaneous vasoconstriction in the cochlea.

Being anxious person, who enjoyed, who focused and worked usually in total silence, who always sleep with ear plugs, I had no choice only to take this as a special torture/challenge for me. I decided to agree with the hypothesis that further stress, anxiety and depression may result in the strengthening of tinnitus (if it is even possible) or becoming chronic (I still believe I will win this fight) so I decided in addition to take a small dosage of tranquilizer (bromazepame), neuroleptic (small dosage of sulpiride) and melatonin every day. Plus high dose of all known antioxidants I have read had any slightest success in the clinical trials. Plus two bottles of beer, good quality I am aware of effects and risks mixing alcohol in all this, however.

I am constantly using the masking sound, the only one which helps me - this I found very strange. I looked through many of them with no success, but that one somehow works brilliantly.

As from alternative treatments, I was positively surprised that it seems that the Tinnitus Mix from the crazy inventor was able to create so called residual inhibition of my tinnitus. Will give it a shot. At least he is not asking hundreds of dollars for his sound file like other pseudo scientific companies.

I am not sure if something left which I should try (CBT, acceptance therapies, meditation and the rest does not work on me), but if anyone has some ideas, please share. At least in my case the reason of tinnitus was very clear, cochlear hair cells were damaged and probably died - (hopefully not... hopefully only disabled...) - during the inflammation so the auditory nerves lost their signal and now generate it on its own.

 

[Dave111]

Awfull man. Is this maybe Meniere's disease?

 

[Alexandras]

Meniere's typically comes with very strong vertigo, not simply dizziness, and usually the low frequencies are lost, not high ones. So not likely. Unless, of course, it will happen again after some time. I will have MRI after a month, but not sure if somebody will be able to see something.

 

[GregCA]

Can you post your audiogram in here? (blank out any personal info)

 

[Alexandras]

The audiogram done the next morning after the onset.

In addition, now I started to notice that my tinnitus somehow feels not so annoying/maybe slightly better in the mornings, yet during the day it strengthens again and become hardly bearable in the evening. It reacts to the sounds, I guess, so it is so called reactive tinnitus ? However, it is hard to say, maybe it is related to my mood or anxiety level. I am using 10 mg melatonin for sleep, so such high dosage helps me to sleep quite decently for 5-6 hours.

I maybe can feel that it is more sensitive to the harsh sounds as well, so probably very mild hyperacusis is presented as well. I am still using the masking sounds, yet thinking about trying to do completely opposite - put an ear plug and allow the total silence for the damaged ear.

 

[Alexandras]

It seems that I can activate the residual inhibition effect by generating 8000 Hz pitch sound loud enough - very interesting! And it seems that my idea to leave the damaged ear in the total silence is not good at all:

"Roberts' 2007 paper discusses a theory that treating patients early in the onset of their tinnitus may be important for long-term benefits to be seen.[56] Roberts suggests that we should assess whether continuous exposure to masker noise, tuned to the tinnitus pitch range, "can induce a lasting residual inhibition, particularly in new tinnitus cases". He cites two earlier studies [51][52] in which cats were exposed to damaging levels of noise. After this, one group of cats was kept in a quiet environment. Another group was kept in an "enriched acoustic environment" in which the cats were continuously played a sound, effectively like masking noise, that matched the pitch range of their expected hearing loss. After a number of weeks, the cats in the quiet environment showed classic symptoms: noise-induced hearing loss, distortion of their brains' physical "pitch map" (a plastic change in the auditory cortex), and neural signs of tinnitus (over-active groups of neurons, in the auditory cortex, firing synchronously – called hypersynchrony). The cats that had been kept in the enriched acoustic environment, however, showed much less hearing loss, no map distortion and no neural signs of tinnitus. Therefore, there is strong evidence that simply by playing pitch-matched sound to these cats, in the early weeks of recovery, the development of 11 tinnitus was stopped; and, perhaps more remarkably, hearing loss was considerably reduced too"

http://www.residualinhibition.com/residual-inhibition.pdf

 

[Alexandras]

The first month has passed. The tinnitus got the second tone sometimes, the new tone is beeping like Morse code. The loudness has not changed - at least I think so.

What is interesting, that somehow suddenly I felt much more calm about it. Like my perception of it has changed. It is here, it still annoys me, but not so much as in the beginning, I am able now to think about something else too, what was impossible recently.

Maybe sulpiride + melatonin is working for me, I am following the routine like in this paper: https://www.researchgate.net/public...ulating_the_Auditolimbic_Dopaminergic_Pathway. Or maybe something else. Who knows.

In addition, I am still taking a lot of supplements: NAC, nicotinamide riboside, lipoinic acid, carnitine, etc.

I also apply so called constrained sound therapy, i.e. I am constantly listening so music or movies or something with that bad ear, using a single headphone. Use it or lose it principle. The one study found some benefit, other not, so again, everything is so relative, no science here.

 

[StayCalm]

@Alexandras How are you doing now? My situation is pretty similar to yours, but I'm about a couple months behind you. I'm still very much struggling with SSHL, and it's been hard to get any advice on how to cope in the early months.