Steve
......"last few days I've been considering surgery to have them take the ear off-line...to disconnect it. I don't think I can live the rest of my life listening to this constant ringing!".....
There are prob four or five "centers of excellence" in this area---others will claim to be---but in reality are not. Think I would make sure that I had the information from at least one of them---before deciding to go forwarded with
"take the ear off-line...to disconnect it."
One of the Centers is Northwestern Univ---some info from there:
Surgery:
Unlike some of the other treatments discussed here, surgery is not necessarily a placebo.
Nevertheless, only rarely is surgical treatment indicated, and even more rarely, is tinnitus relieved by surgery.
You should certainly consider surgery if your tinnitus is due to a tumor and also if it is due to a venous source (usually pulsatile in this situation).
For venous tinnitus, possibilities include jugular vein ligation, occlusion of the sigmoid sinus, or closure of a dural fistula.
Surgery may also be an option to consider if your diagnosis is otosclerosis, fistula or Ménière's disease.
Occasionally persons with Meniere's disease have relief or reduction of tinnitus from transtympanic gentamicin.
Microvascular compression syndrome, in theory, may cause tinnitus, but we have had very little success when the few patients we have seen with this syndrome have undergone surgery.
......And some more info from the Northwestern Univ site:
How is Tinnitus Diagnosed ?
Persons with tinnitus should be seen by a physician expert in ear disease, usually an otologist or a neurotologist. There should be an examination of the ears, and hearing should be tested. The audiogram sometimes shows a sensorineural deficit due to masking from the tinnitus. Tympanograms can sometimes show a rhythmic compliance change due to a middle ear vascular mass or due to contraction of muscles in the middle ear.
Inspection of the eardrum may sometimes demonstrate subtle movements due to contraction of the tensor tympani (Cohen and Perez, 2003). Myoclonus causes a thumping type sound. Myoclonus of the stapedius should result in visible contractions of the ear drum, which produce sounds audible to the examiner. An impedance bridge should document rhythmic changes in ear drum compliance. There should not be movement of the palate or other muscles (as this would suggest palatal myoclonus).
The eyes should be examined for papilloedema (swelling of a portion of the back of the eye called the "optic disk") as increased intracerebral pressure can cause tinnitus.
The TMJ joints of the jaw should be checked as about 28% of persons with TMJ syndrome experience tinnitus. The physician may also request a BAER test (clicks in ears), an ECOG, an MRI/MRA test (scan of the brain), and several blood tests (ANA, B12, FTA, ESR, SMA-24, HBA-IC, fasting glucose, TSH, anti-microsomal antibodies).
In persons with pulsatile tinnitus, additional tests maybe proposed to study the blood vessels and to check the pressure inside the head.
----Gentle pressure on the neck can be performed to block the jugular vein but not the carotid artery.
----The Valsalva maneuver reduces venous return by increasing intrathoracic pressure.
....If there is a venous hum, this usually abates or improves markedly.
....If the pulsation is arterial, these tests have no effects.
MRI/MRA or CT is often suggested in younger patients with unilateral pulsatile tinnitus. In older patients, pulsatile tinnitus is often due to atherosclerotic disease and it is less important to get an MRI/MRA. A lumbar puncture may be considered if there is a possibility of benign intracranial hypertension. More invasive testing includes the "balloon occlusion test", where a balloon is blown up in the internal jugular vein to see if it eliminates tinnitus.
Vestibular tests such as ENG or posturography are generally not helpful in diagnosing tinnitus. Tinnitus is rarely attributable to sinus disease and even if tests suggest that you have this common condition, it is unlikely that treatment of it will affect tinnitus.
Based on these tests, tinnitus can be separated into categories of cochlear, retrocochlear, central, and tinnitus of unknown cause.