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Abstract: A 27-year-old female presented to the clinic with “intermittent tinnitus for 10 days, aggravated for 3 days” after staying up late. After performing pure tone audiometry, acoustic conductance examination and CT examination of the middle ear, the diagnosis of “neurological tinnitus” was confirmed. After full communication with the patient about her condition and treatment plan, she was treated with hormones and drugs to improve circulation and nerve nutrition.
Basic information】Female, 27 years old
Disease Type】Tinnitus of neurological origin
Hospital】Northern War Zone General Hospital
Date of consultation】July 2021
Treatment plan】Medication (methylprednisolone tablets + ginkgo biloba + cytophosphatidylcholine sodium capsule)
[Treatment Period] Outpatient medication for 1 week, then review, then consolidate treatment for 1 week
Treatment effect】Tinnitus disappeared and normal life resumed
I. Initial consultation
Ten days ago, the patient developed bilateral tinnitus after staying up late. He reported that the sound was intermittent and buzzing, accompanied by vertigo, but his hearing was not affected. Initially, he did not pay attention to it, but in the last 3 days, the sound of tinnitus changed from intermittent to continuous, and the sound became louder and more pronounced at night, making it impossible to rest and work normally, so he came to our hospital for consultation. The patient was advised to do pure tone audiometry, acoustic conductance examination and middle ear CT. The pure tone audiometry results indicated that the patient’s hearing had decreased at 4000Hz, but because it was high frequency, it did not affect the speech frequency, so the patient felt that his hearing was not affected, and the acoustic conductance and middle ear CT indicated that it was normal, and he was diagnosed as having neurological tinnitus according to the examination results.
II. Treatment process
After communicating with the patient about his condition, the patient agreed to undergo medication. Because the onset of tinnitus was the first time, the patient was given the oral hormone methylprednisolone tablets for shock treatment. Before using the hormone, the patient was asked in detail about his general condition, and there were no contraindications to the use of hormone. In addition, the patient was told to ensure a regular work and rest schedule, avoid staying up late, and review after 1 week.
III. Treatment effect
The patient came for follow-up after 1 week of application of methylprednisolone tablets and reported that the tinnitus had improved significantly by 3 days of medication, and now the tinnitus has completely disappeared and there is no vertigo. The patient reported that the tinnitus had improved significantly after 3 days of medication, and now the tinnitus has completely disappeared without vertigo. The patient asked whether to continue to apply Ginkgo biloba and cytarabine sodium capsule orally, and suggested to continue consolidation to half a month to avoid recurrence of the disease, and the patient expressed his understanding. As the tinnitus disappeared, the patient resumed normal life and was very satisfied with the treatment effect.
IV. Precautions
We are glad that the patient’s tinnitus symptoms disappeared after medication and improvement of living habits. In daily life, patients should ensure sufficient rest time and avoid drinking coffee, tea and other refreshing drinks. Pay attention to a light diet, avoid spicy and stimulating foods, eat fish and shrimp to supplement zinc appropriately, and avoid bad habits such as smoking, drinking alcohol and staying up late to avoid aggravating the disease. Avoid contact with noisy environment and wear earplugs if necessary to reduce the stimulation of sound to the ear. If the disease recurs or there are adverse reactions during the medication, follow up with the hospital in time.
V. Personal insight
Neurological tinnitus is a common disease in otolaryngology. It is relatively short in onset and better treated in young patients, just like the patient in this case. However, some patients with neurological tinnitus miss the best treatment time due to untimely treatment, resulting in a poor prognosis and failure to recover from tinnitus and even gradual hearing loss at a later stage. Therefore, if tinnitus symptoms appear in your life, you must go to the hospital in time to improve the relevant examination to avoid delaying the best time for treatment.