Tinnitus is the ringing in the ears in the absence of any external sound and the ringing heard is not related to any external source. Tinnitus is a symptom due to underlying ear disease.

Epidemiology

Worldwide 10%-15% of the population suffer from tinnitus and those suffering from ear-related problems are 85% of the population.

How do we know whether it is subjective or objective tinnitus?

Subjective tinnitus is the sound which only the patient hears and objective tinnitus is the sound which others can hear as well along with the patient. Ninety-five percent of the people suffer from subjective tinnitus due to problems in the inner, middle, and outer ear whereas rest 5% suffer from objective tinnitus which is due to any structural defect in the ear, neuromuscular condition, or a tumor in the head, neck, and brain.

Causes

Prolonged exposure to loud sound for a long duration can cause permanent damage to the ear, whereas exposure to a sound for short duration may restore hearing back.
Middle ear infection.
Injury to ear.
Age-related hearing loss: Hearing gets hampered with age which starts around 60 years of age. Hearing loss can lead to tinnitus.
Meniere s disease: It is an inner ear disease; tinnitus is an early symptom
Earwax: Normally earwax protects ear canal from dirt. When it accumulates, wax gets built up causing blockage leading to hearing loss.
Emotional stress Diseases of the heart
Drugs, such as aspirin, antidepressants, quinine, cancer medications, and diuretics.
Temporomandibular joint disorder
Acoustic neuroma
How to deal with it?

First, treat the underlying cause.A patient suffering from tinnitus should be counseled every 15 days. It reduces the stress onto those who are suffering from tinnitus and will boost up the patient.Tinnitus maskers/hearing aid is helpful in ignoring tinnitus frequency. Maintain your cardiovascular health with regular exercise, yoga, meditation, and medicines which control blood pressure. All these factors can help prevent tinnitus.

Can tinnitus be fatal?

It can vary from mild to severe which can cause distress such as interference with sleep and normal day to day routine activities. It can affect patient psychologically so much that patient goes into depression and can commit suicide.

How to evaluate tinnitus?

It can include an audiogram (hearing test), measurement of acoustic parameters and some of the imaging studies to be performed.

A pure tone hearing test is to be performed to find out the cause. Acoustic measurement of tinnitus includes measuring several parameters like frequency, the range of frequency, bandwidth, and loudness in dB above hearing threshold.
Residual inhibition helps indicate how useful tinnitus maskers would be.
Imaging studies like magnetic resonance angiography and Transcranial Doppler are to be performed to find out the underlying cause.

Tinnitus - What Causes It?

Nasal allergies are very common and as a result, not taken seriously by most people. In most cases you patiently withstand the coughing and sneezing, which might last for an entire day and in the process might inadvertently damage your health by choosing to ignore it for the time being. Here are some of the commonly experienced nasal allergies and what you should do to get relief from them.

1. Runny or stuffy nose: The best option is to just avoid allergy triggers. For example, if pollen is your allergen, then avoid going out during the times pollen count when it is reported to be high. Or, if animals make you sneeze, then make sure to have your hands washed and clothes changed after playing with them. Do not over use decongestant sprays at all. If these symptoms persist for more than half a week, then it's time to seek your doctor's advice.
1. Uncontrollable Sneezing: Again, the best option is to avoid; but in many cases, it becomes difficult for you to avoid the allergen. In those cases, try antihistamine. If that doesn't work, then you can also go for a nasal steroid spray, but again, make sure to not overuse it.
2. Post Nasal Drip: Usually, you unconsciously swallow your mucus. But, if the mucus quantity increases, it becomes thicker and results in post-nasal drip. It isn't much common, but you can practically feel the mucus dripping into your throat from the back of the nose. It can result in a lumpy feeling in the throat and can cause irritation. You can try drinking more fluids and using a nasal spray to reduce the mucus quantity. If that doesn't work, then it's time to seek advice from your doctor.
3. Eyes that itch: Watery eyes that itch are annoying companions of nose allergy and though they might not be a serious hazard for the eyes, you cannot ignore them. Try wearing sunglasses when you go out into a reportedly high-pollen-count weather. It might be a better option to forego contact lenses; they can escalate the entire eye-itching problem. If it becomes too itchy, you can place a cold washcloth over your eyes.

Testing an Allergy
Allergy testing is commonly done by by skin prick test, in order to diagnose the allergens. Once, the allergens are diagnosed, immunotherapy can be started, which will help in improving the symptoms of and in many cases, it provides complete cure.

Allergic Issues of the Nose

BAHA Implant
Bone Anchored Hearing Aid (BAHA) is a device surgically implanted to help people suffering from a loss of hearing. Most conventional hearing aids transmit sound through air conduction. The BAHA device is suitable for conductive or mild-moderate mixed hearing loss.

Problems with hearing in the middle or outer ears can be helped with the BAHA device. The sound waves received by the BAHA device bypass the middle ear and get delivered straight to the functioning cochlea in both ears.

A BAHA device comprises of two parts:
a) The processor 
b) A fixture which is surgically implanted behind the ear in the bone.

The implant is embedded in the bone. The processor, which remains outside, is attached to the implant. There is a microphone on the processor that picks up sounds. The sounds are passed on to the implant. The implant vibrates which triggers the Cochlear. You can consider wearing a BAHA implant if other conventional hearing aids do not work for you. BAHA implants are also given to people with collapsed or irritated ear canals.

Cochlear Implant Surgery

A complex, small electronic device that helps hearing in people with severe hearing loss or deafness is used in the Cochlear Implant Surgery. The cochlear implant comprises of an external piece behind the ear and another piece that is surgically implanted under the skin. A cochlear implant comprises of four parts:
1. A microphone which picks up sounds from the surroundings
2. A speech processor which chooses and arranges the sounds the microphone picks up
3. A receiver/stimulator and transmitter that picks up signals from the speech processor and changes them into electric impulses
4. An electrode ray, a bunch of electrodes, receives impulses the stimulator sends and transmits them to different areas of the auditory nerves.
The implant does not cure deafness; it only gives you a useful portrayal of sounds in the environment and considerable aid in understanding speech.

The surgery is done in the following way:
i. The area around the site of the implant is shaved or cleaned
ii. The patient's vital signs are monitored through cables, patches and monitors attached to him or her
iii. General anaesthesia is administered through IV or through a face mask
iv. After the device is implanted, the patient is taken to the recovery room for the anaesthesia effect to lessen.

BAHA Implant and Cochlear Implant Surgery

Why nose bleeding can be serious?

A majority of people experience nosebleeds at least once in their lifetimes, whether from excessive picking of the nose or a pretty hard fall. Most nosebleeds go away soon but it can get very serious if you are not careful.

Nosebleeds can be broadly classified into two types:

1. Anterior nosebleeds, which happen from the front of the nose, are quite normal and get better quickly.

2. Posterior nosebleeds happen from deep within the nose and get very serious if proper care is not provided. However, such cases are rare and happen only in extreme trauma.

What to do when a nosebleed strikes?

- to stop the bleeding, tilt your head upwards and apply ice on the bridge of the nose. This helps in stopping the blood flow quickly. You can also stuff cotton in your nostrils while doing it.

- blow your nose in order to clear the clots in the nose as they can prolong bleeding.

When does a nosebleed get serious?

- when the measures to stop the bleeding don't work. You are at risk to lose blood if you don't get medical help.

- if you have regular nosebleeds then consult your doctor immediately as it could be a symptom of an underlying health condition.

- a nosebleed can also become serious if you are having medicines that thin blood as it could make the nosebleed more severe.

- if you suffer from a blood clotting disorder.

- if the nosebleed is a caused by a trauma like a fall or an accident and you are having difficulty in stopping the bleeding, get immediate medical help.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: Ways to Prevent and Stop Nose Bleeding

Why Nose Bleeding Can Be Serious?

The tonsils are soft tissue masses which are located at the back of your throat, usually at the pharynx. The tonsils are masses which are part of the lymphatic system that helps fight infections. However, tonsils can themselves become inflamed and cause a lot of pain. Tonsillectomy is a procedure to remove the tonsils and relieve pain.

Why is tonsillectomy performed?
A few decades back, tonsillectomy was a routine surgery performed to relieve any pain within the tonsils. This method of treatment however has changed over the past few decades as pain medications for inflammation have improved vastly. However, tonsillitis is still performed in many cases wherein it tends to cause acute problems. Some of the cases it is applicable in are:

Chronic bad breath problems caused by recurrent inflammation of the tonsils
Recurrent sore throats caused by tonsillitis
It is also done along with dental surgery for correcting teeth with imperfect positioning
Abscess formation in the mouth
Upper airway being obstructed due to inflammation, thus causing difficulty with sleeping, snoring, or causing sleep apnea (irregular breathing during sleep)
Ear infections being regularly caused by inflammation of the tonsils
Other reasons why it may be recommended
Tonsillectomy may be also be recommended when there are no indications of problems but tonsillitis and other infections keep cropping up too regularly. This affects children and can make them sick or keep them in pain regularly. Some of these other indications are mentioned below:

Tonsil infections and inflammations happening too frequently within a year
Tonsillitis is caused by bacterial infection wherein the antibiotics aren t effective
Formation of pus in the form of an abscess within or around the tonsils which keep forming even after repeated drainage or administering antibiotics
Possible complications and risks
Like any other form of surgery, tonsillectomy has certain risks associated with it as well. However, these are very rare. Some of these risks and complications are mentioned as follows  

Swelling of the mouth: The tongue and the soft palate or the roof of the mouth may swell, resulting in breathing difficulties an few hours after the surgery.
Infection: As is the case with any surgery, infections may occur in rare cases, which may require further treatment.
Adverse reactions to anesthetics: Many patients exhibit an adverse reaction to anesthetics and may develop symptoms such as a headache, nausea, muscle soreness and frequent vomiting.
Bleeding during surgery or healing: Although it is rare, bleeding during and after surgery has been reported after all sorts of procedures and it may occur with tonsillectomy as well. If you wish to discuss about any specific problem, you can consult an ENT specialist.

Tonsillectomy - When Should You Go For It?

Most people listen to music or their favourite videos while on the move, and they spend a considerable amount of time plugging in the headphones or earphones. If you are concerned about the pros and cons of the headphones and earphones, or rather which one is better, you will have to consider various aspects. These include noise isolation, frequency response, noise cancellation and comfort of wearing.

Earphones are devices which are worn on the pinna or the internal part of the ear. This device is also referred to as earbuds, in-ears, canal phones, buds, in-ear headphones, IEMs.

Headphones are equipment worn on or around the ear. These are not considered as handy as the earphones and are also known as ear speakers. Let s evaluate the pros and cons of these two devices and choose the one that is better.

Frequency response curve: This helps in assessing how much distortion is brought about by the devices which relate to the clarity. They should be able to respond equally well to all the pitches without transmitting any frequency more loudly than another. This suggests that the frequency you are receiving should be exactly similar to what has been fed in regardless of the frequency ranges. Typically, the earphones have bad frequency response while the headphones tend to have better frequency response. If you are primarily concerned about the noise distortion, then you should opt for headphones.
Noise isolation: By this, it is understood how well does the gear help in isolating other noises than what you are trying to listen. Generally, higher noise isolation is preferred unless you are willing to hear the sounds of the ambience. Better isolation also ensures that your audio would not bother others surrounding you. A rightly fitted pair of earphones would be able to give you the best noise isolation whereas good over-ear headphones would not be able to seal the sound from going out.
Noise cancellation: Noise cancellation is entirely different from the noise isolation. In the process of noise isolation, the atmospheric sounds which intrude in are reproduced and inverted. This is an excellent feature especially when you are travelling through public transportation or walking down the street. When it comes to earphones, the noise cancellation feature is are not as effective as headphones unless you buy any of the high end pieces. But the headphones are far better in cancelling the noises that are constantly playing in the backdrop.
Judging from all these aspects, the headphones tend to be a better purchase than the earphones, and they are also much more comfortable. Still, it boils down to personal preference at the end. If you wish to discuss about any specific problem, you can consult a general physician.

Earphones Vs Headphones - Which Is Better?

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