I am Dr. J M Hans, ENT Specialist. Tinnitus has many causes. But what I want to discuss here is tinnitus is a part of the meniere's disease. We must understand that the inner ear has 2 parts. The cochlea which is responsible for hearing and the labyrinth and vestibular which is responsible for equilibria. Now meniere's disease typically has many symptoms like fluctuating hearing loss, tinnitus, and vertigo. But this is not always presented by the patient. There is a part of meniere's disease in the early stages. It may come as either imbalance or dizziness or may be the cochlear component of the disease with tinnitus. So, we have to pick up this disease at prodromal stage. Later on, it may start with unilateral that means it may start at one side but later on it may become bilateral. Usually, it becomes a bilateral disorder.
It is very important that we pick up this disease during the prodromal stage which generally remains for the first year. It is this period when we need to understand that it may not be idiopathic tinnitus which is known like drug induce, noise induce or head injury induce. We have to make out that first attack of meniere's can or is presenting like tinnitus. There are different ways of diagnosing this. One is audiometry. We might find some hearing loss, maybe in the lower frequency, higher frequency or in the middle frequency. But there is another very important stage during this stage which we called short increment sensitivity index which needs to be done. This may indicate an onset of meniere's disease at a later time. The causes of meniere's are many and particularly in the present era, high salt intake, high-stress levels, hereditary, high estrogen levels particularly during pregnancy or in menopausal age.
It can also occur in men. It is very important to find out the causes. Apart from this, the very important thing is an autoimmune disorder. We have tests to rule out autoimmune disorder and to see another organ in the body whether they are affected or not. The treatment for meniere's is to prevent these causative agents like the salt intake has to be reduced, the stress level has to be reduced. Medicines are given to increase blood circulation. Another medicine to reduce the fluid content of endolymphatic space which actually has gone high in these cases. Last but not least, things which block the debris. It not only gives the allergic component but also inflammation in the ear. If it is the chronic case, the tinnitus may not come out but vertigo and the hearing loss may improve definitely. The hearing loss may or may not improve. The tinnitus also improves 70-80% of the time if treated and diagnosed in the early stages in a period of time. If not, then tinnitus has the way we treated the other cases, we treat tinnitus that way.