DEAR READER: Yes, but first let me explain the condition. Tinnitus is a roaring, hissing, clicking, buzzing or ringing in the ears that is likely related to an underlying disorder such as ear injury, hearing loss or disorder of the circulatory system.

There are two forms of tinnitus — subjective and objective. The subjective form is common and can be heard only by the person whose ears are affected. This type is generally connected to the outer, middle or inner ear; however, the auditory nerve or portion of the brain that interprets nerve signals might also be involved. The objective form of tinnitus is less common but can be heard by a physician during examination and generally involves blood vessel, muscular or inner-ear-bone problems.

The inner ear contains delicate hairs that move with the pressure of sound. The cells of the ear then release an electrical signal via the auditory nerve to the brain that ultimately interprets the signal as sound. Should the hairs become bent or broken, they send random impulses to the brain that can result in tinnitus.

Some of the more common causes for the condition include repeated exposure to loud noises, as with using a lawn mower or chain saw or listening to music through earphones; excessive wax buildup in the ears; the normal aging process; and abnormal changes in bone growth. Less common causes include Meniere’s disease, injury, hypertension and benign tumors called acoustic neuromas.

A number of medications, including aspirin taken in high doses, some antibiotics, diuretics and others can cause tinnitus or worsen it.

Diagnosis begins with an examination to determine whether simple earwax impaction might be to blame. A medical history that includes drugs and over-the-counter medicines or supplements will help a physician determine whether the medication is to blame. If so, a change or discontinuation might be appropriate.

While tinnitus of unknown cause cannot be cured, there are a number of treatments that can reduce or mask its severity. Protect your ears with plugs, cotton or muffs when exposed to loud noises. If appropriate, reduce your alcohol intake, because it dilates blood vessels and causes a greater flow to the already damaged ears.

To provide related information, I am sending you a copy of my Health Report “Ear Infections and Disorders.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

DEAR READER:
I have to disagree. If you had looked more closely at the letter, you would have noticed that the patient claims to have gone back repeatedly because she was not receiving the answer she wanted rather than because she had to. She was so convinced that the penicillin shot would work, she likely did not listen to the physician.

I am confident that this physician tried to recommend other options. Because the writer was so upset that she wasn’t given what she wanted, when she wanted it, she failed to say what, if anything, her primary care physician recommended. As far as telling her to see an ENT, he did, at least in his letter to her and most likely tried to refer her during her repeated office trips.

You state that this physician used the patient has a testing ground. I would like to know how you came to this conclusion based on her letter since she says nothing about testing or other treatments. Please read more thoroughly and rationally before spouting off about incompetent doctors and patients being used as test subjects.