Tinnitus and vertigo

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Tinnitus and Vertigo: Understanding the Link

Tinnitus (ringing or buzzing in the ears) and vertigo (spinning dizziness) often occur together because both are related to inner ear problems. The inner ear plays a key role in both hearing and balance, so disturbances in this region can cause both tinnitus and vertigo.

Causes of Tinnitus and Vertigo

Ménière’s Disease
- A chronic inner ear disorder causing:
  - Vertigo: Episodes lasting minutes to hours.
  - Tinnitus: Low-pitched ringing or buzzing.
  - Hearing loss: Often fluctuating and in the lower frequencies.
  - Ear fullness: A sensation of pressure in the ear.
Labyrinthitis and Vestibular Neuritis
- Infections or inflammation of the inner ear or vestibular nerve can cause:
  - Vertigo: Sudden onset, lasting days to weeks.
  - Tinnitus: Often temporary but may persist.
  - Hearing loss: Common in labyrinthitis (less so with vestibular neuritis).
Acoustic Neuroma (Vestibular Schwannoma)
- A benign tumor on the vestibular nerve leading to:
  - Gradual hearing loss in one ear.
  - Tinnitus: Often constant in the affected ear.
  - Vertigo or imbalance as the tumor grows.
Ototoxic Medications
- Certain drugs (e.g., aminoglycoside antibiotics, chemotherapy agents) can damage inner ear structures.
  - Tinnitus: May develop early.
  - Vertigo and balance problems: Appear with long-term use.
Perilymph Fistula
- A tear between the inner and middle ear causing:
  - Vertigo: Triggered by exertion or pressure changes.
  - Tinnitus: May accompany hearing loss.

Symptoms to Expect

Tinnitus:
- Ringing, buzzing, hissing, or roaring sounds in one or both ears.
- Can be intermittent or constant.
Vertigo:
- Sensation of spinning or tilting, often worsening with head movements.
- Episodes can last minutes, hours, or days, depending on the cause.

Managing Tinnitus and Vertigo

Medications
- Betahistine: Often used for Ménière’s disease to reduce vertigo and tinnitus.
- Vestibular suppressants: Like meclizine or diazepam to control dizziness.
- Diuretics: Can reduce fluid buildup in Ménière’s disease, alleviating symptoms.
Vestibular Rehabilitation Therapy (VRT)
- Helps retrain the brain to manage balance issues.
Sound Therapy for Tinnitus
- White noise machines or tinnitus maskers can reduce the perception of tinnitus.
Hearing Aids
- Amplify external sounds, which can mask tinnitus. Useful if hearing loss accompanies tinnitus.
Lifestyle Adjustments
- Avoid caffeine, alcohol, and salt, which can worsen tinnitus and vertigo.
- Manage stress, as it can trigger or worsen both symptoms.
Surgical Options
- In cases of acoustic neuroma or perilymph fistula, surgery may be necessary.

When to Seek Medical Attention

Sudden tinnitus and vertigo: May indicate inner ear infections or Ménière’s disease.
Persistent symptoms: Could signal an acoustic neuroma or other serious inner ear condition.
Neurological symptoms (e.g., slurred speech, numbness, or weakness) with vertigo require emergency care to rule out stroke.

Addressing the root cause (such as Ménière’s disease or an infection) is key to managing tinnitus and vertigo effectively. Regular follow-ups with an ENT specialist are recommended for persistent or worsening symptoms.

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