My niece in Poland never was vaccinated for mumps when she was a baby. That's something they don't do in Poland. She got mumps this past April and started to hear ringing in her ear. The doctors said it could be permanent. She is 12 years old. Is there any hope for her?

Diane L.

Unfortunately, the mumps virus is a well-known cause of "sensorineural hearing loss" (hearing loss due to damage to the inner ear or the hearing nerve). The virus, like CMV, rubella and rubeola, can cause labyrinthitis (inner-ear infection). With mumps, this is a very destructive infection. Any hearing loss that your niece suffered as a result of this infection is almost certainly permanent. The ringing in her ear is a sign of such an injury, just as pain is a sign of injury to most other parts of the body. If she has her hearing tested, it will most likely show some degree of nerve deafness.

Your niece does need to have her hearing tested, not so much to confirm the diagnosis, but mainly to determine whether she needs hearing aids. If her hearing loss is significant, it could affect her ability to learn in school -- and that could cause a lifetime of problems!

There is no cure for tinnitus (ringing in the ears) but there are a number of treatment options:

1. Live with it. If your niece is not disturbed by the tinnitus (if it is not interfering with her ability to learn, play or sleep), then treatment is not necessary.
   
2. Hearing aid(s). If her hearing loss is severe enough to require hearing aids, then she may notice that her tinnitus is much less noticeable when she is using her aids. This occurs because the hearing aids amplify environmental noise but do not amplify her tinnitus.
   
3. Masking. Many individuals with tinnitus find that background noise (an electric fan or air filter, for example) makes the tinnitus diminish in intensity. There are even sophisticated instruments known as "tinnitus maskers" that deliver a low level of noise to the afflicted ear(s). The noise is carefully selected so that it will mask the tinnitus.
   
4. Biofeedback, hypnosis and other forms of conditioning. These are safe treatments that some individuals have found to be very effective. It may be difficult to find a professional who can administer such treatment, however.
   
5. Drug therapy. If all else fails and if the tinnitus is making the patient miserable, drug treatment (typically with antidepressants or antiseizure drugs) can be attempted. Such drugs have significant side effects, so this is truly a treatment of last resort.
   
6. Surgery. This is not an option. There are NO operations for tinnitus -- your niece's parents must beware of any doctor who claims that an operation will cure their daughter's tinnitus!
   

For more information, contact the American Tinnitus Association or see my column on nerve deafness and sudden hearing loss.