{"id":19185,"date":"2023-04-10T16:00:35","date_gmt":"2023-04-10T08:00:35","guid":{"rendered":"https:\/\/excelmedicalgroup.com\/?p=19185"},"modified":"2023-04-10T16:35:38","modified_gmt":"2023-04-10T08:35:38","slug":"disturbing-tinnitus","status":"publish","type":"post","link":"https:\/\/www.excelmedicalgroup.com\/en\/case-sharing\/disturbing-tinnitus\/","title":{"rendered":"Disturbing tinnitus"},"content":{"rendered":"

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Most adults will experience tinnitus problems in their lifetime, but fortunately most tinnitus will resolve on its own within a few days or weeks. But if the symptoms of tinnitus persist, and the root cause of the problem is not from the ear, nose and throat area, what is the problem?<\/p>\n

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After the patient had ruling out the possibility of tinnitus caused by internal problems such as ear, nose and throat, the neurosurgeon will examine the patient’s brain and neck in detail to see if tinnitus is caused by nerve or vascular disease.<\/p>\n

33-year-old Mr. Lin’s cervical disc herniation compress the spinal cord which is the central nervous system:<\/p>\n

Mr. Lam, a 33-year-old, has always lived a healthy and normal life, except for occasional neck pain at work. He has seen by a family doctor and an otolaryngologist in the past three months, and although he has undergone a detailed examination and taken medication, the tinnitus still persist day and night. Through the introduction of a friend, Mr. Lin sought consultation from a neurosurgeon for further diagnosis. MRI image with contrast showed that the C5,6 C6,7 of his cervical spine were herniated and compress into the central nerve of the spinal cord, resulting in tinnitus symptoms. As the condition was only mild and did not require surgery, only six months of medication and chiropractor treatment, Mr. Lin’s tinnitus symptoms disappeared. Six months later, MRI results also showed that his two levels of cervical disc herniation had greatly improved.<\/p>\n

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46-year-old Ms. Zhang’s arteriovenous malformation caused vascular tinnitus:<\/p>\n

Ms. Zhang, 46, sought medical treatment accompanied by her daughter. The left tinnitus that bother her for three months, the symptoms is differed from other ordinary tinnitus,\u00a0 it was synchronized with the pulse of her heart. Clinical examination showed that doctors could use the stethoscope on Ms. Zhang’s left head and neck to hear a murmur synchronized with the heartbeat pulse, which is typical of vascular tinnitus caused by the overlapping of arteriovenous malformations. After MRI angiography, Ms. Zhang underwent a two-hour minimally invasive pinhole cerebral vascular catheter surgery. Cerebrovascular surgeons use tiny titanium wire coils to block the overlapping alternation of abnormal sinuses and cerebral artery vessels near Ms. Zhang’s left ear to block the abnormal arteriovenous blood flow, thereby eliminating tinnitus. After the operation, Ms. Zhang was happily discharged home accompanied by her daughter. In addition to tinnitus, doctors say that the risk of hemorrhagic stroke caused by abnormal arteriovenous malformations is also relieved.<\/p>\n

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Mr. Leung 56 years old, suffered from auditory nerve tumor:<\/p>\n

Mr. Leung, a 56-year-old businessman, has been bother by tinnitus day and night in his right ear for the past six months, and an MRI examination by an otolaryngologist shows that a small tumor of five millimeters has grown on his right auditory nerve. Although other examinations also showed that Mr. Leung’s auditory nerve function remained normal temporarily, the doctor said that as the auditory nerve tumor slowly grew, but eventually Mr. Leung’s hearing in his right ear would gradually be lost. After being referred to the Department of Neurosurgery, the neurosurgeon discussed three treatment options with Mr. Leung : (1) conservative observation, (2) digital knife radiotherapy, and (3) minimally invasive surgery in neurosurgery to preserve auditory nerve function. Although the three treatment options each had pros, cons and risks, Mr. Leung chose minimally invasive surgery in the end. Under four hours of general anesthesia, the neurosurgeon monitored Mr. Leung’s auditory nerve conduction function uninterruptedly during the operation. Under the microscope, doctors carefully remove five millimeters of the tumor separately from the auditory nerve using a one- to two-millimeter microscopic surgical instrument. After the operation, Mr. Liang’s hearing and facial nerve functions were able to remain intact, and he no longer had tinnitus day and night.<\/p>\n

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Author<\/strong><\/span><\/p>\n

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DR. PETER K.H. PANG<\/strong><\/p>\n

MBBS (HK), FCSHK, FRCS (Edin), FHKAM (Surgery)<\/span><\/p>\n

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