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Q: Causes of tinnitus
asked by: DoctorQuestion on January 8th, 2009
I have done quite a bit of loud music listening over the years. I've attended several concerts where I left with my ears ringing and I've done a lot of loud headphone listening over the years. However, it has been a few years since I have done much of either (with the exception of a bit of headphone and stereo listening.) In recent weeks however, I have noticed that the ringing and whistling in my ears that I have occasionally noticed over the past 1-2 yrs has gotten perceptibly worse. The only potential reason I can think of is that I have been taking small dosages of Vicodin recreationally over the past 2 yrs. I take it sometimes multiple times a week, usually in the 200-300mg range at night and never more than 500mg in a day. I am wondering if it is probable that this is the reason for what I feel to be a worsening ringing/whistling in my ears in recent weeks or if it is possible that damage I did to my ears awhile back is causing problems all this time later. Thank you.


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Dr. Goce Aleksovski , MD
replied on January 9th, 2009
Ear, Nose and Throat Disorders Answer A5296
Current medical status: I am currently experiencing some relatively low volume ringing and slight whistling in both of my ears. I believe it could be Tinnitus. I had experienced the noise primarily in my left ear until a few weeks ago when I felt that I noticed the noise worsening in my right ear. It's making it difficult to sleep at night and is at times bothersome during the day as well.
Current medical treatment: I've been to one doctor (not an ENT or specialist) and had him look at whether it could be a result of ear wax buildup. I thought this might have been the case because about 16 months ago I had a physical and was told that I had quite a bit of ear wax buildup. This doctor, however, said there was no buildup to speak of.




It is hard to say without a physical examination and tests, what is exactly causing your tinnitus (continual ringing/whistling sensation occurring in one or both ears). Possible causes might be: ear wax (cerumen obturans impaction), noise induced hearing loss, high (or rarely low) blood pressure, heart murmur, anemia, auditory tube dysfunction, sinusitis, cholesteatoma, psychological disorders, certain medications (such as opiates, aspirin, quinine, streptomycine,…), etc. It might be recommended that you visit an audiologist who might do simple hearing tests to diagnose if there is any noise induced hearing loss that you are suspecting (as a result of loud noise exposure in the past)-these simple tests could also be done by your family doctor if s/he has the very basic equipment: tuning forks, audiometer, Politzer balloon and an otoscope. This way your health-care-provider will see if there is any hearing loss or not, as well as whether there is something wrong with the ear structures. Moreover, they might want to do a whole body physical examination and simple blood tests, in order to exclude other possible causes listed above. If they exclude the basic causes of tinnitus, they might refer you to an ENT specialist. In the end, if nothing is found, it could be assumed that the probable cause of your condition might be the opiates usage.







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