Expert: Harriet B Jacobster, Au.D. - 6/5/2009

Question
I began noticing a hissing sound in my left ear about two months ago; it felt as if my right ear was not hearing as well as the left, though, and that there is wax in there.  I've been to an audiologist who says I have intermediate hearing loss in both ears (advised hearing aids, I'm not ready for that yet!) He says the right and left ears are the same and there's no obstruction in my right ear (but it still feels like there is).  I have no other signs of acoustic neuroma and he didn't suggest it was even a remote possibility.  I'm 57, in excellent health except for hypertension which is well controlled (117/75) by medication.  I was taking 50MG toprol and am now taking 25MG toprol and 2.5 MG vascor.  I've been on the Vascor for about three weeks and I'm definitely getting off it (seeing my Dr. next week), but meanwhile there's a new sound in my left ear, a constant low level tone that goes up and down in minor thirds and it's DRIVING ME NUTS.  Is this the vascor?  Do you know about TRT counseling and is it available in the US?  The audiologist said my ear drums are perfect and attributed the hissing to hearing loss, but I'm uncertain of this.  Should I have an MRI?  I know there are several complicated questions in this paragraph and apologize but I really need some answers.  Thank you!

Answer
Hi JC,
It is good that you consulted an audiologist.  But that is only the first step.  The next step is to consult an ENT.  Any change in hearing or auditory status needs to be thoroughly evaluated.  There are just too many causes of tinnitus - medications, vascular, immune dysfunctions - that to say you don't have the signs of an acoustic neuroma is only the beginning.  It is true that you may never find the source of your tinnitus, but it does deserve a full investigation.

To be sure, both Toprol and Vascor have Tinnitus listed as side affects.  If this is the case, your physician may be able to adjust the dosages.  But, this is not always possible and if it is a choice between controlling your blood pressure and "putting up" with the tinnitus, I believe the choice is obvious.

Once a treatable medical condition has been ruled out, you can then treat the effects of the tinnitus.  I refer you to this site for the American Tinnitus Association: ata.org. You will find a wealth of information there.  Also, for TRT (yes, it is very much available in this country), try: http://www.tinnitus-pjj.com/  This is the home page of Dr. Jastreboff, the developer of TRT who happens to teach at Emory University in Atlanta, Georgia.

Hope this helps.
Harriet B. Jacobster, AuD
Board Certified in Audiology