Everyone would have experienced tinnitus at least once in their life – that is, the sudden sensation of a buzzing ear at a quiet environment or feeling troubled by high frequency noises. Persistent episodes of tinnitus are symptoms of a dysfunctional middle ear, degenerative nerves, or inflammation of the external auditory canal. Patients experiencing persistent tinnitus should therefore seek medical advice.
In general, persistent tinnitus are related to illnesses in the outer and middle ear. Outer ear illnesses are generally caused by a buildup of earwax or a blockage caused by pus, which can be relieved by removing the earwax and treating the inflammations with medication. Middle ear illnesses include dysfunctional eustachian tubes, otitis media, and endolymphatic hydrops. The eustachian tube connects the nose and the ear, balancing the air pressure in the middle ear. Viruses can however invade through the eustachian tube into the ear, causing otitis media, deregulating air pressure in the middle ear and inducing hydrops, therefore inducing tinnitus and ear blockage.
Most middle ear diseases can treated medically; hydrops can be drained by piercing a hole in the eardrum, though such procedure is rare. However, if the illness concerns degenerative nerves, the resulting tinnitus has no treatment.
The most concerning aspect of tinnitus is the possibility of nasopharyngeal cancer. As the Eustachian tube neighbors the nasopharynx, such tumor will exert pressure on the tube, blocking it and inducing hydrops in the middle ear. Nicknamed “Guangdong Tumor” and common in many Asian regions, nasopharyngeal cancer finds 900 victims in Hong Kong annually, predominantly in male patients, ranking at top 10 of the most common cancer.
The 4-stage nasopharyngeal cancer can be caused by excessive intake of preserved food, an Epstein Barr virus infection, or purely by pregenital factors. As early symptoms of nasopharyngeal cancer are similar to that of rhinitis, namely tinnitus, runny nose and nasal congestion, even experienced doctors can be mistaken. Diagnosis of nasopharyngeal cancer can be achieved via Epstein Barr virus tests, endoscopy, CT scans and MRI scans.
Treatment of nasopharyngeal cancer begins with diagnosis of the severity. Treatments appropriate to the patient’s conditions will be prescribed, ranging from surgery, radiotherapy, chemotherapy, and targeted therapy. Radiotherapy, which includes stereotactic radiotherapy and brachytherapy, are preferred by doctors at an early stage, which uses radiation to destroy cancer cells. Chemotherapy can also be performed at an early stage, as a replacement or compliment to radiotherapy. Targeted therapy is appropriate for chemotherapy patients who have developed drug resistance or have advanced to a later stage. Finally, surgery is appropriate for patients with tumors that have recurred but not spread, using endoscopy to remove the tumor entirely.