Typewriter Tinnitus is a rare form of Tinnitus caused by a compression of the auditory nerve. How is this condition diagnosed and treated. Let’s explore.
Typewriter Tinnitus
What does it sound like and what are its symptoms?
As the name suggests, Typewriter Tinnitus sounds like a typewriter in operation. The sound can also be described as a machine gun or Morse code like sound. The sound of pop corn popping in the microwave is also a common comparison. But, the main characteristic of this Tinnitus sound is that the sound is intermittent with periods of silence in-between them. This is why it is sometimes called Staccato Tinnitus as well.
What is Your Tinnitus Handicap Score?
Calculate your THI Score in about 2-3 Minutes
As for symptoms, Typewriter Tinnitus usually presents itself in only one ear (unilateral). But, there have been a number of cases where it is bilateral as well. Studies have also suggested that this condition is often also accompanied by vertigo. Small case studies have shown that around 50% of people with Typewriter Tinnitus will also suffer from Vertigo like symptoms. The type of vertigo accompanying this form of Tinnitus is called paroxysmal vertigo.
How is it diagnosed?
Diagnosing Typewriter Tinnitus is usually done by evaluating patient history and feedback, with MRI scans and also by evaluating patient’s response to Carbamazepine, an anticonvulsant drug that eases auditory nerve compression. More on Carbamazepine later in this post.
An MRI scan can visually show the anterior-inferior cerebellar artery (AICA) loop around the cochlear nerve (NVC-C). The extent of looping will also determine the severity of this form of Tinnitus. The looping is usually classified into three types, depending on the extent of neurovascular contact that is presented.
How Severe is Your Tinnitus?
Find out by using this THI (Tinnitus Handicap Inventory) Scoring Calculator
Though MRI and patient input and history is effective in helping diagnose Typewriter Tinnitus, a successful response to Carbamazepine is usually used to confirm said diagnosis. Carbamazepine as treatment is discussed next.
How is it Treated?
Carbamazepine, an anticonvulsant used to treat Epilepsy and neuralgia is the most commonly prescribed medication for Typewriter Tinnitus. It uses a sodium channel blocking mechanism to ease the compression on cranial nerves like the cochlear nerve.
Patients are typically given a dosage that ranges between 200 to 400 mg/day, depending on their body weight. Once Tinnitus subsides, typically in two weeks, the dosage is lowered to a lower maintenance dosage of about 100mg/day.
This study of 22 people with Typewriter Tinnitus showed that 100% of the participants had a favorable response to Carbamazepine. 3 out of the 22 patients had a complete suppression of their Tinnitus while 19 had a partial but significant suppression.
The study also showed that vertigo as an accompanying symptom improved or resolved as well.
However, Typewriter Tinnitus has a tendency to relapse when Carbamazepine is stopped. About 60% of patients relapse. Patients who were older or who had a more intrusive type of Tinnitus have a higher risk of relapse.
It should also be noted that Carbamazepine is NOT an effective treatment for regular Tinnitus.
Surgical decompression of the auditory nerve is also a potential treatment for Typewriter Tinnitus. But, this treatment is still a largely unexplored option at the time of writing this post.
How to avoid?
Cranial nerve compression, just like any other nerve compression is usually caused by improper posture, muscle weakness, repetitive activities or injuries to muscle, ligament and tendon groups.
If you have Typewriter Tinnitus, you probably have some problems with your neck, shoulder or maybe even your upper back muscles. This post explains several head and neck Tinnitus exercises that might be able to help keep this form of Tinnitus from relapsing or worsening. However, please note that the exercises are meant to help ease regular Tinnitus. If any of the exercises cause discomfort, pain or a worsening of your Typewriter Tinnitus, you must stop and avoid performing them.
