E-ISSN:2456-3110

Case Report

Management of Karnanaada

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 4 April
Publisherwww.maharshicharaka.in

Ayurvedic management of Karnanaada w.s.r. to Tinnitus - A Case Report

D Kabade R1*, Kumatagi R2, M Timmapur G3
DOI:10.21760/jaims.9.4.49

1* Rajesab D Kabade, Associate Professor, Department of Shalakya Tantra, BLDEA’s AVS Ayurveda Mahavidyalaya Hospital Research Centre, Vijayapur, Karnataka, India.

2 Roopa Kumatagi, Assistant Professor, Department of Shalakya Tantra, BLDEA’s AVS Ayurveda Mahavidyalaya Hospital Research Centre, Vijayapur, Karnataka, India.

3 Gangadhar M Timmapur, Professor Head, Department of Shalakya Tantra, BLDEA’s AVS Ayurveda Mahavidyalaya Hospital Research Centre, Vijayapur, Karnataka, India.

Shalakya Tantra is one of the branches among Astanga Ayurveda. Karnanada is one of the Karnagata Roga explained in Shalakya Tantra. It is the most common complaint encountered in clinical practice of Shalakya. Vata dominant Tridosha along with Rakta presents as the chief pathological factors in the case of Karnanada. Karnanada can be correlated with tinnitus. It is the condition in which there is a perception of sound that appears to originate in the head in the absence of external stimuli. Epidemiologically this disease is present in 38% population below the age of 40 years and 68% population above the age of 40 years. This is a case study of patient aged about 19 year female came to Shalakya Tantra OPD with complaints of ringing sound in right ear for the last 1 year which was mild in nature. Since 15 days symptom is increased and she also complained of disturbed sleep and irritation. The patient was treated with Nirgundi Taila Karnapoorana, Ksheerabala Taila Nasya along with oral administration of Sarivadi Vati for one week. The patient showed marked relief in symptoms of tinnitus. There was no recurrence during a follow-up of four weeks. The treatment reveals that Ayurvedic interventions are effective in the management of tinnitus quite efficiently.

Keywords: Karnanada, Tinniitus, Nirgundi Taila, Ksheerabala Taila

Corresponding Author How to Cite this Article To Browse
Rajesab D Kabade, Associate Professor, Department of Shalakya Tantra, BLDEA’s AVS Ayurveda Mahavidyalaya Hospital Research Centre, Vijayapur, Karnataka, India.
Email: 		D Kabade R, Kumatagi R, M Timmapur G, Ayurvedic management of Karnanaada w.s.r. to Tinnitus - A Case Report. J Ayu Int Med Sci. 2024;9(4):296-299.
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https://jaims.in/jaims/article/view/3264

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-02-13 2024-02-23 2024-04-03 2024-03-13 2024-03-21
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
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© 2024by D Kabade R, Kumatagi R, M Timmapur Gand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

Karnanada is a Karnaroga studied under Jatru-Urdhwagata Vikara. The vitiated Vata Dosha either entering into other channels (Vimargagamana) or encircled by Kaphadi Doshas in Shabdavaha Srotas (auditory canal) produces different types of sounds[1] in the ear like Bheri, Mrudanga, Shankha etc. is known as Karnanada or Karna Pranada.[2] The vitiated Vayu gets lodged in the Shabdavaha Srotas, thereby causing different types of sounds in the ear called as Karnanada.[3] Etiological factors of Karna Roga such as Avasyaya (exposure to snow), Jalakreeda (swimming, diving), Karna Kandooyana (probing of EAC) and Mithya Yogena Shastrasya (improper use of instruments during examination of ear and during treatment) has been mentioned by Yogaratnakara.[4] Acharya Haritha explained that Karnanada can be caused by different Doshas and sound produced accordingly in the disease. If one hears sounds like crepitus of teeth, flute with burning then it is due to Pitta Dosha. If one hears sounds of thundering its due to Kapha Dosha.[5] Hetus described in Nidana causes vitiation of Vata. Vata gets lodged in the Shabdavaha Srotas. It causes a perception of different sounds leads to Karnanada.

Karnanada can be correlated to Tinnitus - perception of sound (ringing or noise), which has external stimuli. Approximately 1/3rd people experience tinnitus sometime in their lives.[6] Tinnitus can be categorized into different groups - subjective and objective, pulsatile and non pulsatile, vascular and non vascular and idiopathic. Tinnitus can be diagnosed with the help of history taking, physical examination, audiologic evaluation, tinnitus evaluation, radiological imaging and blood tests. There are different treatment modalities to treat the tinnitus like Masking, Counseling, psychotherapy, pharmacotherapy, Acoustic therapy and tinnitus retraining therapy etc. Despite all measures the result is unsatisfactory.

The clinical features of Karnanada are very similar to tinnitus.

The common treatment regimen of Karna Roga can be grouped as Ghritapana (use of ghee), Rasayana (rejuvenation), Avyayam (no exercise), Ashirasnana (no head bath), Brahmacharya (no intercourse) and Akathana (avoidance of excessive speaking).[7] Among Karna Roga, the treatment line of

four diseases such as Karnashoola, Pranada, Karnakshweda and Badirya are similar.[8]

Case Report

Age - 19 years

Occupation - student

Sex - female

Religion - muslim

Consulted - Shalakya Tantra OPD of BLDEAS AVS AMV Vijayapur.

Chief complaints

Complaints of ringing sound in the right ear for the past 1 year and disturbed sleep and irritation for past 1 month.

History of present illness

The subject was apparently normal 1 year ago. Then she gradually developed ringing sound in the right ear since a year. Later she noticed symptom has aggravated from past 1 month associated with disturbed sleep and irritation. She approached allopathic doctors, there ear drops and medicines were given still she didn’t find any relief and with all complaints she came to our college hospital and approached the Shalakya Tantra OPD to get Ayurvedic Treatment.

History past illness

No history of Nasal allergy.

Not a known case of DM and Hypertension

Personal history

Diet: Mixed type of diet

Appetite: Moderate

Koshta: Madhyama

Micturition: regular and normal

Bowel habits: regular and normal

Sleep: disturbed sleep

Vitals

Respiratory rate: 22/min

Temperatre: 98.6°F

Blood pressure: 110/70 mm of Hg


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Plulse: 78/min

Physical examination

Weight: 44kg

Height: 152 cm

Pallor: No pallor

Lymphadenopathy: no lymphadenopathy

Ashta Sthana Pareeksha

Nadi: 78/miin

Mutra: 1 Vega/day

Mala: 5-6 Vega/day

Jihwa: Alipta

Shabda: Prakruta

Sparsha: Prakruta

Drik: Prakruta

Akriti: Madhyama

Systemic examination

CVS - Normal

CNS - Normal

RS - Normal

GIT - Normal

Examination of ear

Pinna: Normal

Pre and post auricular area: Normal

External auditory canal: Normal

Tympanic membrane: no discharge, no perforation, bilateral TM is intact

Qualitative test for hearing by tuning fork

Rinne’s test - AC>BC (B/L)

Weber’s test - lateralized to both ears

ABC - Normal (B/L)

The oral cavity proper, Larynx and Nose - Normal

Treatment modalities

Nasya - with Ksheerabala Taila with proper Mukha Abhyanga and Swedana, 8 drops into each nostril for 7 days.

Karnapoorana - with Nirgundi Taila after proper Karna Abhyanga for 7 days.

Sarivadi Vati - 2bd with warm water.

Observations and Results

After every follow-up patient reported comfort and improvement. After 1 month patient came for follow-up and explained that her problem is almost cured. She has 90% relief. Her condition is improved with a sound sleep. Previously she has complaints of disturbed sleep due to irritation, but now she is relaxed. She is asked to maintain healthy lifestyle and stay away from stressful situations.

Discussion

Non-surgical, non-invasive and cost effective management of tinnitus is possible with the adoption of Ayurvedic procedures coupled with that of proper diet habit, regimen and code of conduct. Acharya Charaka mentioned Karnanada as a Vataja Nanatmaja Vyadhi and Karna is one of the Adhistana of Vata Dosha.[9] Vata predominant causative factors are responsible for Karananada. Sneha becomes treatment choice to control the localized and increased Vata Dosha in case of Karnanada. Karnapoorana is the type of Bahya Snehana. Nirgundi Taila is a good Vatashamaka drug as it is prepared with Sneha along with other Dravya which acts especially as Vatashamaka. Ksheerabala Taila used for Nasya is best for Vatashamaka and effective in neurological diseases like Karnanada. Sarivadi Vati is the best Shamanoushadi given in all types of Karna Roga. These medications adopted in this case study given remarkable results.

Conclusion

The potential of Ayurvedic procedures and medicines is yet to be exploited. Ayurveda is capable of playing a major role in combating tinnitus and subsequently in checking compromised quality of life without imposing any adverse reaction to the user. In the present case patient having symptoms of Karnanaada treated with Vata Shamaka Chikitsa. Karnapoorana with Nirgundi Taila and Nasya with Ksheerabala Taila along with oral medications. In the modern era, people follow an unhealthy lifestyle which is the cause of


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many disorders. Our environment where we live and where we work should be healthy. In the case of tinnitus noise-free places should be opted to work. Ayurvedic literature also mentioned that Atiyoga and Ayoga of Indriya should be avoided. Prevention should be given prime importance in the management of the disease.

References

1. Ambikadatta Shastri, Sushruta Samhita of Sushruta with Ayurveda Tatva Sandipika Hindi Commentary, Uttartantra, Varanasi: Chaukhambha Sanskrit Sansthana, 2011; 115:20 – 7.

2. Yadunandana Upadhyaya, Madhava Nidana of Madhavakara with Madhukosha Commentary by Shri Vijayarakshita and Shrkanthadatta with Hindi Vidyotini Commentary, verses Chaukhambha Prakashan, 2019; 286: 2-3.

3. Atrideva Gupta, Ashtanga Hridaya of Vagbhata with Vidyotini Hindi Commentary, Utharasthana, Varanasi: Chaukhambha Prakashan, 2012; 692: 17 – 9.

4. Yogaratnakara, Yogaratnakara, Karnarogadhikara, edited by Shree Laxmipati Shashtri, Chaukhambha Prakashan Varanasi, 2013; 309: 1 – 2

5. Vaidya Jaymini Pandeya, Harita Samhita of Harita with Nirmala Hindi Commentary Varanasi: Chaukhambha Visvabharati, 2016; 449: 3 – 4.

6. Mohan Bansal, Diseases of Ear, Nose and Throat 3rd Edition, New Delhi: Jaypee Brothers Medical Publishers,2021; 111.

7. Schleuning AJ. Management of the patient with tinnitus. Med Clin North Am, 1991; 75(6): 1225-37.

8. Kashinath Shastri and Gorakha Nath Chaturvedi, Charaka Samhita of Charaka with Vidyotini Hindi Commentary, Sutrasthana Varanasi: Chaukhambha Bharati Academy, 2009; 128: 5 – 84.

9. Vagbhatacharya, Astanga Hridaya, Arunadatta,, Sutrasthana, Doshabhediya adhyaya12/1, Chaukhambha Surbharati Prakashan, Varanasi, 2015;192.


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