Author Topic: Worried  (Read 5221 times)

SomeSomething

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Worried
« on: September 07, 2016, 10:21:33 am »
First of all about me - 24 year old male, trying to live a healthy lifestyle. Sports have always been part of my life, been a semi-pro football player in my teenage years, now I'm into gym workouts. Nothing big, just for fun.
I'm also a big music lover, had a lot of parties in my youth years, nowadays I'm always clubbing with ear protection, no measurable hearing loss. In fact, I did that Online audiogram on my mdr-7506 headphones and could hear the almost silent (0 / -5db ) tones (in 100% audio volume)

So, about my tinnitus(es) and what worries me. They were probably part of me for the last few years, but started to bother me since the past summer. It was the pulsatile tinnitus in my right ear that sent me to several ENT's and neurologists. They ran some blood tests, visual observation, doppler of my arteries - nothing found. The neurologist did the standard balance tests for stability, nystagmus, vertigo & etc - nothing found.
Although the dentists found some evidence of nocturnal bruxism, problematic wisdom teeth (they grow straight, but they're not fully erupted - growing with a very slow pace) and jaw misaligment. Sometimes I hear the clicking sounds, especially when I chew food.
Pulsatile tinnitus keeps bother me mostly at night and when lying down. It actually responded well with Eleuthero supplement, a famous adaptogenic herb (don't know it its ok to share the brand, so I won't - maybe on PM).
And what is strange - I never get it through my weightlift workouts.
My left year gets some strange hissing sounds at about 16-17 khz, very high pitched, not that annoying, but sometimes my hypochondria kicks in and I start to think of scary things like acoustic neuroma, tumors & etc.

So let's summarize:
Doppler of my arteries - OK
Blood tests - Fine
Some evidence of nocturnal bruxism, possible connection to wisdom teeth and TMJ
The neurologists did the basic battery of tests - smiling, blowing, all the sensory tests with my feet, belly, all the vertigo and nystagmus tests. Nothing significant and troublesome found.
Low blood pressure - 110/70 or even 100/70 (if that matters)

They never did any kind of imaging - no CT, no MRI, as they didn't seemed to be concerned. So what are the chances that my hissing or PT be caused, by lets say, acoustic neuroma? Wouldn't that mess with my workouts, as I've never experienced any balance issues during/after hard day at the gym or at the stadium (even doing some exercises that actually require good balance skills). And not to mention my regular 10-12km daily walking/climbing trips or intensive cardio workouts. Pretty sure that would affect them if it was there..

So this is my hypochondria speaking. Should I go further testing, or shall I accept the things as they are..

tonyc

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Re: Worried
« Reply #1 on: September 07, 2016, 12:03:28 pm »
Check this link:

https://www.tinnitusformula.com/library/pulsatile-tinnitus-2/

Pulsatile tinnitus usually originates within the blood vessels inside the head or neck region when disturbed blood flow occurs. This results from either increased blood flow or a narrowing of the opening of the blood vessel, both of which result in turbulent blood flow that can be heard in the ears. In this regard, it is totally different from and independent of continuous tinnitus which results from damage to the cochlea and/or hearing nerve. It is very possible to have both pulsatile and continuous tinnitus together. People who have both of these generally say the pulsatile component is the more bothersome.

The following section describes some of the more common causes of pulsatile tinnitus and relevant therapies.



1 – Benign Intracranial Hypertension (BIH). This is a condition where there is increased pressure of the cerebrospinal fluid that bathes the brain. The majority of these patients are young females who are generally overweight. Other symptoms of BIH may include hearing loss, ear fullness, dizziness, headaches and visual disturbances. Management of this condition includes weight loss and administration of a diuretic. Most patients improve dramatically with weight reduction alone.

2 – Glomus Tumor. This is a benign vascular tumor usually located in the ear or just below the ear at the skull base. It consists of a mass of intertwined blood vessels. Hearing loss is also a common symptom. Young patients are usually treated surgically, to remove the tumor, while older patients may need no treatment since they are very slow growing.

3 – Atherosclerotic Carotid Artery Disease. Atherosclerosis is the narrowing of the artery due to cholesterol build-up on the artery wall. This reduces the opening resulting in turbulent blood flow that produces pulsatile tinnitus. This usually occurs in older patients with a history of hypertension, elevated cholesterol, diabetes, angina and smoking. The condition can usually be controlled through medication.

4 – Intracranial Vascular Lesions. These include aneurism and arteriovenous malformations, which is an abnormal connection between an artery and a vein.The blood flows directly from a high pressure artery to a lower pressure vein without going through the capillaries. Either aneurism or arteriovenous malformation can lead to bleeding in the brain and can be extremely dangerous. Therapies include surgery and embolizing (closing off) the blood vessels.

5 – Middle Ear Effusion. The middle ear is normally an air-filled space. If fluid accumulates in the middle ear due to infection, inflammation or Eustachian tube dysfunction, pulsatile tinnitus can result. It is sometime accompanied by decreased hearing, a feeling of fullness, and may also include pain. This is most often treated with antibiotics, decongestants, nasal sprays, etc. or sometimes surgery.

6 – Venous Hum. Patients who are pregnant, anemic, or have thyroid problems, may develop increased blood flow through the jugular vein, the largest vein in the neck. The jugular vein traverses the middle ear and any turbulent flow in the vein can be heard in the middle ear as a “hum” which may or may not fluctuate with the pulse. Correction of the underlying problem generally results in improvement or resolution.

7 – Hypertension. There are reports of patients with high blood pressure whose pulsatile tinnitus started after they began taking blood pressure medication. Tinnitus subsided in most after four to six weeks. For the remainder, a change to another medication resolved the issue. Others developed tinnitus from elevated blood pressure and it resolved after medication reduced the pressure.

8 – Twisted Arteries. Twisted arteries in the head and neck cause turbulent blood flow leading to pulsatile tinnitus. It generally does not require treatment.

These are the primary causes of pulsatile tinnitus but not an exhaustive listing.

9 – Other Causes. Other causes can include Arnold-Chiari malformation where an elongation of the cerebellum is pushed down through the opening of the base of the skull, blocking the flow of cerebrospinal fluid. Muscle spasm in the soft palate can cause a clicking sound which is rapid (60-200 beats per minute), repetitive and intermittent. This is associated with multiple sclerosis, small vessel disease, tumor or degenerative neurological disorders. The small muscle attached to the stapes bone in the middle ear can spasm which produces a crackling or rumbling noise. There are other, mostly rare, causes of pulsatile tinnitus as well as those mentioned here.

If pulsatile tinnitus is caused by turbulent flow in arteries, pressure applied to the upper neck on the side of the tinnitus should alter or reduce it. If it is venous in origin, the Valsalva maneuver may improve it. This is performed by forcibly exhaling against closed lips and pinched nose, forcing air into the middle ear, provided the Eustachian tube is open. Neither of these is a fool-proof way of identifying or arches-tinnitus-formulaalleviating the problem but positive results may lead to a better diagnosis by a physician.

Arches Tinnitus Formula® is helpful in many cases of pulsatile tinnitus. The mechanism of action is Ginkgo biloba extract reduces the viscosity of the blood and arterial pressure which in turn reduces the throbbing or pulsing effect. People with pulsatile tinnitus should always undergo a thorough evaluation to ensure that serious consequences, such as stroke, will be prevented.
08/2010, first vertigo episode and tinnitus, 9mm AN found in left ear. Wait and Watch.
01/2016,  AN increased to 13mm.
03/2016, Middle Fossa at House with Drs. Brackmann/Schwartz/Stefan. Entire tumor removed, no facial issues, hearing preserved.
09/2021, MRI showed no regrowth.