Patient: Last August, I went to a KTV and the sound inside was so loud that my ears hurt, but I put up with it because I wanted to save face, and then I came out with tinnitus in my left ear and pain in my ears. After various treatments for tinnitus, there is no obvious effect but I have adapted to it. (However, when I go to a quiet place to rest for a while, the pain disappears, and I usually have no earache in a quiet environment.) Now my life is seriously affected, and I am afraid to go out and participate in social activities. At first I thought I would get better after resting for a while, and I tried to avoid all kinds of sounds, but now I have rested for almost half a year, but there is no significant improvement. In August and October of last year, I had a complete hearing examination (including acoustic impedance, pure tone audiometry and brainstem evoked potentials) and CT of the involved bones twice. The treatment was mainly for tinnitus, and I have been taking Michelin, Mineralon, Vitamin B1, etc. for almost a month, and I have had two infusions of Gennadol. Dr. Wang, have you seen this kind of patient before? How should I treat my acrophobia and how long will it take for my ear pain to return to normal? Is there any research on acoustophobia at the General Hospital, or is there a more effective treatment for it? I wish I could live a normal life! Thank you, Dr. Wang. Wang Hongtian, Department of Otolaryngology, Beijing 301 Hospital: Acoustophobia is a serious hearing allergy and can be treated with special elastic ear plugs. We have these ear plugs here. Patient: Dr. Wang is still caring about our patients and replying to us at almost 11 o’clock at night, I am very grateful! I have worn the elastic earplugs bought in general stores, but I feel that they make my ears hurt, stuffy inside my ears, and a little buzzing. I feel like the earplugs only keep the sound out, but they don’t raise the threshold of hearing pain, and it still hurts when I take them out. Thank you! Wang Hongtian, Department of Otolaryngology, Beijing 301 Hospital: Theoretically speaking, elastic earplugs should work. Or try with cotton. Patient: Thank you, Dr. Wang, for your answer. Also, after reading your article “Tinnitus is not scary, just stick to the practice”, I would like to ask you a few questions related to tinnitus. 1. Does tinnitus practice therapy need to be done under the guidance of a doctor? 2. Is there a “critical period” for tinnitus treatment? Some people say that tinnitus is usually better with infusion in the first few days; the first 3-6 months of tinnitus is the best time for treatment, and you should insist on medication, acupuncture, etc., and only start to try to practice therapy after half a year of treatment fails. What does Dr. Wang think about these two statements? 3. Which place can I go to to configure a masking sound consistent with the sound of tinnitus? There is no tertiary care hospital near us, and I have searched the internet for a long time without finding it. I look forward to a reply, and I am very grateful. Wang Hongtian, Department of Otolaryngology, Beijing 301 Hospital: 1. It will be better under the guidance of a doctor, and those who can comprehend the theory of tinnitus habit therapy by themselves will be fine. 2.We use the treatment plan of sudden deafness for acute tinnitus (tinnitus within 3 months), so please pay attention to the indications of tinnitus habit therapy. 3.Our hospital has. Patient: I had tinnitus in my left ear, but in the past few days, I have been experiencing intermittent tinnitus near my left head that does not stop, and the sound is small enough to be heard in a quiet environment. It turns out that the left tinnitus is still present. On New Year’s Day, I had a complete hearing test (including acoustic impedance, pure tone audiometry, brainstem evoked potential, otoacoustic emission, cochlea electrogram, etc.) and CT of the bones involved, and my hearing was very good. But no MRI was done, the doctor said to rule out organic pathology and to just learn to adapt. In the last few days, after the appearance of new sounds, I went for acoustic impedance and pure tone audiometry, which showed that my hearing was still very good. The doctor didn’t let other tests be done, but just told him to go back and learn to adapt. 1.The doctor said that evoked potentials are more accurate than MRI and can detect smaller tumors etc., so there is no need to do MRI, is that right? 2. Do you think I need an MRI now to rule out organic lesions? 3. I have acoustophobia, and MRI is said to be very loud, so I am afraid I can’t stand it. Can I bring elastic earplugs if I have it done? Once again, I would like to thank Dr. Wang. Wang Hongtian, Department of Otolaryngology, Beijing 301 Hospital: 1. Patient: Thank you, Dr. Wang, I will follow your instructions to do an MRI as soon as possible, or else it’s really a piece of heart disease. Patient: Hi Dr. Wang, I had an MRI and the doctor said there are no abnormalities. The doctor said that there is no abnormality, plus the previous full set of hearing and temporal bone CT. But recently, the tinnitus sound near the left side of my head has become louder again, and there is a slight tinnitus sound near the right side of my head. I was very anxious. I’ve been taking medication, Shu Er Dan, Ginkgo biloba, Micropo, B1, for almost a month now, I think, but my left tinnitus has not been reduced, but slightly aggravated, and a new tinnitus in the brain (zipping sound) has appeared, and I want to cry helplessly. I have been treating it, but my condition is getting more and more complicated. 1, I feel that my tonic sound is a bit like self-sound overpowering, what should I do if the self-sound is overpowering? 2, does the tzitzit sound indicate a problem somewhere other than the auditory system, and what do you see as a possible problem with my symptoms? What other tests do I need to do? 3. Are there any medications or treatments that are more effective for tinnitus? My medication was originally for tinnitus in my left ear, but is there a better medication or treatment for the tinnitus in my scalp that is now nuisance? Thank you, Dr. Wang, for taking time out of your busy schedule to reply! Wang Hongtian, Department of Otorhinolaryngology, Beijing 301 Hospital: You can bring elastic earplugs if the self-sound is too strong. It is recommended that you have a “tinnitus examination”. It is recommended to try lidocaine drip. 2% lidocaine 1mg/kg.body weight + 2 times the volume of saline drip for more than 10 minutes and observe the effect. If the tinnitus is not aggravated, you can continue to apply it once a day for 10 days for 2-3 courses. Patient: Thank you for your reply: I have recently read your book, and it says that lidocaine has the effect of temporarily relieving tinnitus as a regular treatment for tinnitus. But I would like to ask, why do I need to use lidocaine to treat tinnitus when the book says that it can only temporarily relieve tinnitus and the effect is not sustainable? Is there any long-term effect of lidocaine? What is a “tinnitus test”? Does it mean tinnitus matching? Patient: How does Professor Wang think hyperbaric oxygen is effective for tinnitus without hearing loss or organic pathology? Wang Hongtian, Department of Otolaryngology, Beijing 301 Hospital: Although lidocaine can only briefly relieve tinnitus, it means that tinnitus can be cured! The effective time of lidocaine can be prolonged by using continuous static drip or using a pump. Tinnitus examination includes tinnitus matching, tinnitus masking test, tinnitus scale, etc. Wang Hongtian, Department of Otolaryngology, Beijing 301 Hospital: We do not advocate hyperbaric oxygen therapy. Patient: Hello, Director Wang: I have recently adapted to tinnitus and my auditory allergy has started to seriously affect my life. The symptoms of my auditory allergy are that my ears are very painful and uncomfortable when I hear a very small sound, and I can’t communicate with people. Not being able to go out, go to the street, go to the supermarket, or take the bus was a very painful experience for me, it was unbearable. Life was very painful. Because I speak good English, I have visited many English websites, mainly the American Tinnitus Association, the British Tinnitus Association, the British Deafness Research Society, Jastreboff’s personal website, Jack Vernon’s consultation area, and websites specializing in auditory allergies, etc. Basically, they all recommend using TRT (Tinnitus Treatment, which is very effective for both tinnitus and auditory allergies. (For tinnitus it can help with adaptation and for auditory allergies it can help with recovery, and auditory allergies are better treated with this therapy.) According to Jastreboff, the specific implementation of TRT for auditory allergy is to listen to pink noise for about 6 hours a day at a volume just audible, with significant results in 6 months and 80% of patients recovering within 6 months to 1 year. The British Deafness Research Society (a charitable non-profit research organization) has research materials that claim that with sound therapy, most patients can recover and lead a normal life within 12 to 18 months. Regarding the recommended sound, these sites say that pink noise is best, but it must be very well-recorded pink noise, which can harm the ear if it is crudely made. If you use digital playback, you must use .wav or .assi format, mp3 format will have some key voice signal loss, the effect is very bad. Recorded CDs are the best, so there is no distortion of the voice signal. So I decided to use this therapy. My problem at the moment is that I can’t find a better pink noise for the therapy. When I searched the internet for pink noise, most of them are pink noise for helping to pour disks, I am not sure if they are the same as pink noise for treating the ear. I know you are an expert in implementing TRT, so I would like to ask you if you have any pink noise or white noise specifically for treating the ear with TRT at your place or the PLA General Hospital. If you have an audio file, can you send me one to 我的邮箱是[email protected].如果有CD的话 and I will go to the General Hospital to purchase a copy. If neither is available, Director Wang can recommend where to find or purchase pink noise. I am living a very painful life and I hope Director Wang can help me. Again, thank you very much, Director Wang. Wang Hongtian, Department of Otolaryngology, Beijing 301 Hospital: I admire you for looking up so much information. We officially published a tinnitus treatment CD in 2002, in which we use white noise and pink noise, and you can try it. Patient: Director Wang, thank you for your answer, but for auditory allergy, pink noise is particularly effective because the high frequency sound is smaller and more acceptable, so the desensitization process is also much better. White noise may sound more unpleasant for people with hearing allergies because the high frequency sound is the same energy as the low frequency. 1.I would like to know if you have pink noise there, or which place you recommend to find or purchase pink noise. 2. Regarding your white noise CD, where can I buy it in Beijing, or do I have to go to the General Hospital? If so, is it possible to buy the CD directly without registering? 3. In terms of the effectiveness of sound therapy, is there a big difference between using a loudspeaker, listening with headphones, and a noise-generating device like a hearing aid? If there is a difference, which one is more effective? Thank you, Director Wang. Wang Hongtian, Department of Otolaryngology, Beijing 301 Hospital: You can download pink noise on the Internet. White noise and pink noise 1. In logarithmic coordinates, the energy of white noise is distributed with an increase of 3 dB per octave, and pink noise is uniformly distributed. 2.In linear coordinates, the energy distribution of white noise is uniform, and the pink noise is distributed by decreasing 3dB per octave. The transformation of white noise and pink noise: Add an attenuation filter with 3dB per octave attenuation to the white noise, and you can get the pink noise. We have such a CD in our hospital, but not elsewhere. It can be bought without registration. A noise generator (noise-generator) similar to a hearing aid works best. Patient: Thank you, Director Wang, for such a careful and detailed answer! I have a few more questions: 1. Can I buy white noise CDs at the General Hospital on weekends? I see that you don’t have a clinic schedule on weekends, is it possible to find other medical staff to buy CDs. 2. Is there a big difference between noise generator and CD player? 3. Do you sell noise makers at General Hospital? What is the approximate price. Thank you, Director Wang, for your reply! Patient: Sorry, one more question. If I can buy CDs on the weekend, can I buy a pair of elastic earplugs together? Is there a place that sells earplugs and CDs? Thank you again, Director Wang! Wang Hongtian, Department of Otolaryngology, Beijing 301 Hospital: 1. You can’t buy CDs on weekends, the person in charge is not working. 2.Noise maker and CD player play very different 3.We have noise maker, and tinnitus masking device, about 10,000 yuan or more. Patient: Thank you, Director Wang, for your reply. My financial condition is not good enough, so I can only use CDs reluctantly. I’ll consider it later when I have money. Is the noise CD available Monday through Friday during business hours? Also, are CDs and elastic earplugs available in the same place? I’d like to buy a few pairs of earplugs. Thank you! Wang Hongtian, Department of Otolaryngology, Beijing 301 Hospital: Noise CDs are available from Monday to Friday during business hours, and the CDs cost 200 yuan each. Buy CD and elastic ear plugs are in the same place elastic ear plugs 10 yuan per pair Patients: Thank you, Director Wang reply! Also please tell me the reason why noise makers are better than white noise CDs in treating tinnitus and auditory allergies, please trouble Director Wang. Wang Hongtian, Department of Otolaryngology, Beijing 301 Hospital: The noise maker can make all kinds of noise Patient: Thank you, Director Wang. Thanks again for your patient answer, Director Wang! Wang Hongtian, Department of Otolaryngology, Beijing 301 Hospital: Okay, wish you a speedy recovery. The first thing you need to do is to get a good idea of what you’re doing. Is it mainly acoustophobia or psychological irritability? Patient: Hello, Professor Wang! Time flies, and a year has passed in a flash. I’m reopening my consultation this time mainly because I want to report my recent condition to you, to make a summary of my condition, and to be a kind of help and encouragement to other patients. I’ve been using broadband pink noise therapy for the last year, and now I’ve basically recovered, and my pain valve is similar to normal. But I mainly want you to report on tinnitus today, because it used to be my biggest problem, but thanks to your help, I am now fully adapted. I remember when I first got tinnitus on New Year’s Day in 2009, I was in a trance every day, and I even felt worse than death, so I was living a very painful life every day. When I first saw you, you told me that there were two definitions of cure (tinnitus disappeared or adaptation), but I was always obsessed with how to make the tinnitus disappear. But the infusion gave me a buffer time from hope to disappointment. It is most painful when you hope to be cured but are told that there is no good way. It helped me a lot to achieve the transition. After that, I started to listen to broadband noise, and at first I felt that it had little effect, and I was still irritable. Later, I thought that listening to noise was a formality, but the most important thing was to divert my attention from tinnitus, so I started to prepare for the in-service examination. Once I started preparing for the exam, I really didn’t have time to think about tinnitus because I had to read a lot every day, so the effect of tinnitus on me became less and less, and I basically adapted to it after a few months. In retrospect, the reason why I was irritable at the beginning was largely because I was not in the mood to do anything else after I got tinnitus, so I just stopped doing it, and I had nothing to do every day and lacked emotional support, so I kept thinking about tinnitus day and night. Once you have something important in your mind that you need to think about and deal with, the time left for tinnitus will naturally be less and less, and the effect of tinnitus on you will be less and less, and finally you will adapt to it. Therefore, I would like to tell those patients who are still suffering from tinnitus (or those who are practicing the therapy) that noise is just a formality, but the most important thing to do is to find something you like or something that is very important to you. If we just listen to the noise and do not do something that requires our attention, it is still very difficult to take our attention away from the tinnitus and to get used to it. If there are any patients who are still suffering from tinnitus or hearing allergy, please contact me at 可以联系我[email protected],共同探讨和交流. Finally, I would like to thank Professor Wang for bringing TRT to us and helping us to adapt to tinnitus better and faster. Your philosophy of curing tinnitus with two definitions has given me, and many other patients, great encouragement and hope, and at a time when we needed it most. I hope you take care of your health knowing that you are now on a mission in Lhasa with the lack of oxygen at the plateau. You are a beacon of light in the hearts of our tinnitus patients, so your health is the hope for all of us. Finally, I wish you good work, family happiness and good health!