Expert: Harriet B Jacobster, Au.D. - 11/17/2008

Question
On Jan 2005 I had this 4 hr headach. During this headach the pain on the right side of my head increased and then I started hearing hissing in my right ear. I went to an ENT and they did an audio exam and said I have excellent hearing but there isn't anything that can be done except mask therapy.I was 43 at the time and in good health. I job 35 miles a week and eat mostly fish&seafood.I work in a clean room so most of the time the noise is masked at work. it's when it's quiet out or when I go to bed that I really notice it. The fact that it happened acutely does that point to vascular as opposed to tumor? What should be my next move?

Answer
Hi Eugene,
Tinnitus is a sign that there is neural damage of some type...usually.  The fact that you have "excellent" hearing does not necessarily rule out the possibility of neural damage being the cause of the tinnitus. It just means that all the possible tests have not been done.  Did the ENT do an MRI?  I would seriously considering having a complete workup with an audiologist and neurologist which should contain Otoacoustic Emissions and Auditory Brainstem Responses.  Both of these will give better information on the neural integrity of the auditory pathway.  I would also suggest an MRI, probably with contrast, to rule out any lesions. Once the cause is found, or a tumor ruled out, you can check out the American Tinnitus Association at http://ata.org/ for the latest news on Tinnitus Treatment.
Hope this helps.
Harriet B. Jacobster, AuD
Board Certified in Audiology