John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
A medical history, physical examination, and a series of special tests can help determine precisely where the tinnitus is originating. It is helpful for the doctor to know if the tinnitus is constant, intermittent or pulsating (synchronous with the heart beat,
referred to as pulsatile tinnitus), or is it associated with
hearing loss or loss of balance (vertigo). All patients with persisting unexplained tinnitus need a hearing test (audiogram). Patterns of hearing loss may lead the doctor to the diagnosis.
Other tests, such as the auditory brain stem response (ABR), a computerized test of the hearing nerves and brain pathways, computer tomography scan (CT scan) or, magnetic resonance imaging (MRI scan) may be needed to rule out a tumor occurring on the hearing or balance nerve. These tumors are rare, but they can cause tinnitus.
What is the treatment of tinnitus?
After a careful
evaluation, your doctor may find an identifiable cause and be able to treat or
make recommendations to treat the tinnitus. Once you have had a thorough
evaluation, an essential part of
treatment is your
own understanding of the tinnitus (what has caused it,
the person's specific symptoms, and options for treatment).
Tinnitus medications
In many cases, there is no specific treatment for tinnitus. It
may
simply go away on its own, or it may be a permanent disability
that the
patient will have to "live with." Some
otolaryngologists (ear specialists) have
recommended niacin to treat
tinnitus. However, there is no scientific evidence to suggest that niacin helps
reduce tinnitus, and it may cause problems with skin flushing.
The drug gabapentin (Neurontin,
Gabarone), was studied in high doses, and reduced the annoyance level of the tinnitus in some patients, but did not decrease the volume of the noise, and was not found to be better than placebo.
A 2005 study in Brazil using acamprosate (Campral), a drug used to
treat alcoholism, showed a nearly 87% rate of relief of symptoms. Studies of this drug for treatment of tinnitus are currently ongoing in the United States.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
A brain tumor can be either benign (non cancerous) or malignant (cancerous), primary, or secondary. Causes and risk factors include age, gender, family history, and exposure to chemicals. Symptoms range from headaches, leg and feet numbness to seizures. Treatment is dependant upon the type and location of the brain tumor.
Temporomandibular joint disorder, or TMJ, is a disorder of the temporomandibular joint(s) that causes signs and symptoms including ear pain, bite problems, headaches, dizziness, clicking sounds in the jaw, tinnitus and/or locked jaws. Behaviors or conditions that can lead to TMJ include teeth grinding or clenching, fingernail biting, habitual gum chewing, trauma to the jaw, stress, and occupational hazards. Treatment for TMJ may include heat, ice, a soft diet, antiinflammatory medications, physical therapy, stress management, occlusal therapy, correction of bite abnormalities, and surgery.
The Eustachian tube is a membrane lined tube that connects the middle ear space to the back of the nose. Problems include partial or complete blockage which can cause popping, clicking, and ear fullness. Allergies, sinus and ear infections, or the common cold can cause this blockage, while altitude changes can cause symptoms in those persons with Eustachian tube problems. Treatment includes several maneuvers (swallowing, chewing gum, yawning etc.), which can be done to improve Eustachian tube function.
Vertigo is a feeling of spinning movement, and at times accompanied by nausea and vomiting occur. Vertigo is most often associated with an inner ear problem. The treatment for vertigo can be lifestyle changes and medication if necessary.
Brain aneurysm (cerebral aneurysm) is caused by microscopic damage to artery walls, infections of the artery walls, tumors, trauma, drug abuse. Symptoms include headache, numbness of the face, dilated pupils, changes in vision, the "worst headache of your life," or a painful stiff neck. Immediate treatment for a brain aneurysm is crucial for patient survival.
A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. Not getting enough sleep can hurt memory performance, health, and your mood.
Smoking is an addiction. More than 430,000 deaths occur each year in the U.S. from smoking related illnesses. Secondhand smoke or "passive smoke" also harm family members, coworkers, and others around smokers. There are a number of techniques available to assist people who want to quit smoking.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Fatigue can be described in various ways. Sometimes fatigue is described as feeling a lack of energy and motivation (both mental and physical). The causes of fatigue are generally related to a variety of conditions or diseases for example, anemia, mono, medications, sleep problems, cancer, anxiety, heart disease, drug abuse, and more. Treatment of fatigue is generally directed toward the condition or disease that is causing the fatigue.
Meniere disease (idiopathic endolymphatic hydrops) is an inner ear disorder with symptoms that include vertigo, tinnitus, hearing loss, and the sensation of ear fullness. Diuretics, anti-vertigo, anti-nausea and low salt diets are the primary treatment for Meniere disease. Surgery may be recommended if the vertigo cannot be controlled with medication.
Nasopharyngeal cancer is a form of cancer in which malignant cells form in the nasopharynx tissues. Risk factors include being of Chinese or Asian ancestry and exposure to the Epstein-Barr virus. Symptoms and signs of nasopharyngeal cancer include a sore throat, a lump in the neck or nose, trouble hearing, nosebleeds, headaches, and trouble hearing, breathing, or speaking. Treatment depends upon the stage of the cancer, the tumor size, the type of cancer, and the patient's health and age.
Ear was is a natural substance secreted by special glands in the skin on the outer part of the ear canal. It repels water, and traps dust and sand particles. Usually a small amount of wax accumulates, dries up, and then falls out of the ear canal carrying with it unwanted particles. Under ideal circumstances, you should never have to clean your ear canals. The absence of ear wax may result in dry, itchy ears, and even infection. Ear wax may accumulate in the ear for a variety of reasons including; narrowing of the ear canal, production of less ear wax due to aging, or an overproduction of ear wax in response to trauma or blockage within the ear canal.
Regular physical activity can reduce the risk of disease. Regular exercise can also reduce the symptoms of stress and anxiety. There are fitness programs that fit any age or lifestyle.
Objects or insects in the ear can be placed in the ear by patients themselves, or an insect crawling in the ear. Ear wax can also cause ear problems if Q-tips are overused to clean the ears. Symptoms of an object in the ear are inflammation and sensitivity, redness, or discharge of pus or blood. When to seek medical care for an object or insect in the ear is included in the article information.
Nicotine is delivered to the brain through smoking, chewing, or sniffing tobacco. Nicotine is an addictive agent. Common names for nicotine products include smokes, cigs, butts, chew, dip, spit, or snuff. Habitual nicotine use leads to many debilitating medical conditions.
Adult brain tumors are diseases in which cancer (malignant) cells begin to grow in the tissues of the brain. The brain controls memory and learning, senses (hearing, sight, smell, taste, and touch), and emotion. It also controls other parts of the body, including muscles, organs, and blood vessels. Tumors that start in the brain are called primary brain tumors.
Noise-induced hearing loss may be an acoustic trauma (temporary hearing loss), or permanent due to an acute acoustic trauma. Experts agree that continual exposure to more then 85 dBs (decibels) is dangerous to the ears. Ear plugs and ear muffs can help prevent noise-induced hearing loss as well as decreasing exposure to loud noises.
Smokeless tobacco can have negative health effects such as cancers, poor oral health (gum disease and tooth decay), infertility, pregnancy complications, and nicotine addiction.
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