E-ISSN:2456-3110

Case Report

Tinnitus

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 9 September
Publisherwww.maharshicharaka.in

Effective management of Karnanada (Tinnitus) - A Clinical Case Study

Shubha S Bhat1*, Rathi S2
DOI:10.21760/jaims.10.9.58

1* Shubha S Bhat, Final Year Post Graduate Scholar, Department of Shalakya Tantra, Government Ayurveda Medical College, Bengaluru, Karnataka, India.

2 Rathi S, Professor, Department of Shalakya Tantra, Government Ayurveda Medical College, Bengaluru, Karnataka, India.

Shalakya Tantra is one among the eight branches of Ayurveda wherein Karnaroga (ear diseases) has been discussed in detail. The Acharyas describe 28 types of Karna Roga, among which one of the diseases is Karnanada[1], characterised by abnormal perception of sound in the ear in the absence of external stimuli, and is often correlated with Tinnitus. Acharya Sushruta hold the deranged Vata Dosha accountable for the manifestation of Karnanada. This is a case study of a patient aged 52 years complaining of a ringing sound in both ear, first in left ear which was intermittent for 8 months, aggravated since one month, and the same complaints in right ear in the last 20 days. Patient was advised for Nasya with Ksheerabala Taila for 7 days, followed by Karnapurana with Maha Masha Taila for 7 days. Follow-up was done after one month of intake of Internal medicines.

Keywords: Karnanada, Tinnitus, Nasya, Karnapurana

Corresponding Author How to Cite this Article To Browse
Shubha S Bhat, Final Year Post Graduate Scholar, Department of Shalakya Tantra, Government Ayurveda Medical College, Bengaluru, Karnataka, India.
Email: 		Shubha S Bhat, Rathi S, Effective management of Karnanada (Tinnitus) - A Clinical Case Study. J Ayu Int Med Sci. 2025;10(9):359-362.
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https://jaims.in/jaims/article/view/4766/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-07-08 2025-07-15 2025-08-01 2025-08-15 2025-08-25
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© 2025by Shubha S Bhat, Rathi S and 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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ResultsDiscussionReferences
Shubha S B et al. Effective management of Karnanada (Tinnitus)

Introduction

Karnanada is one among the 28 Karnarogas mentioned by Acharya Sushruta. The vitiated Vata Dosha due to various Nidana like Jalakrida (swimming/ watersports), Mithya Yoga of Shabda (Exposure to loud noise for a long duration)[2] and other Vata Prakopaka Nidana entering Shabdavaha Nadi causes ringing sound in the ear leading to Karnanada. This can be co related to Tinnitus which has a latin origin “Tinnire” (To ring). Tinnitus can be Subjective where perceived sound is heard only by patient or Objective, where others can also detect sound.[3] The treatment mainly aims at Vatahara line of management such as Snehapana, Swedana, Snehavirechana etc.[4]

Case Report

Chief Complaint

A male patient of 52 years complaints of ringing sound in both the ear, in left ear in the last 2 years, intermittent in nature, has become continuous since 1-month and occasional ringing sound in Right ear in the last 20 days.

History of Present Illness

A male patient aged 52 years, known case of hypertension in the last 5 years was apparently normal before 8 months. Gradually, he developed a ringing sound in the Left ear, which was intermittent in nature and low in intensity. In the last one month, the intensity increased and started to affect his day-to-day life. He also experiences an occasional ringing sound in his right ear in the last 20 days. For the above-said complaints, the patient visited Shalakya OPD of GAMC, Bengaluru.

Past History - Known case of Hypertension under medication (T.Amlip 10mg 1-0-0)

Family History - Nothing contributory

Occupational History - Auto driver (Night shifts) in the last 18 years

Personal History

Diet - Mixed

Appetite - Good

Bowel & Micturition - Regular

Sleep - Reduced (4-5 hrs/day)

Vitals

Pulse Rate - 64/min

Respiratory rate - 20/min

BP - 130/90 mmHg

Temperature - 98.6°F

General Examination

Pallor - Ab

Icterus - Absent

Clubbing - Absent

Lymphadenopathy - Absent

Oedema - Absent

Ashta Sthana Pareeksha

Nadi - 64/min

Mutra - Prakruta, 4-5 times/day, once at night

Mala - Prakruta

Jihwa - Alipta

Shabda - Prakruta

Sparsha - Prakruta

Drik - Prakruta

Akruti - Adhyama

Systemic Examination

Respiratory System - NVBS heard

Cardiovascular System - S1, S2 heard, no murmur

CNS - Conscious, CN intact

GIT - P/A soft, non-tender

Local Examination

Ear Examination

  • Pinna - Normal
  • External Auditory Canal - Clear
  • Tympanic membrane - Right- Intact, sclerotic patch present in antero-inferior quadrant of left ear

Qualitative test for hearing by Tuning fork-

  • Rinne’s Test - AC>BC
  • Weber’s Test - Lateralised to Right ear

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Shubha S B et al. Effective management of Karnanada (Tinnitus)
  • ABC Test - Normal

Neurological Examination-

  • Cranial nerves - Intact
  • Romberg’s Test - Negative

Head and Neck Examination - No TMJ Dysfunction/ muscle tenderness

Dix Hallpike test- No nystagmus/ vertigo during/after manoeuvre.

Treatment

SNTreatmentDoseDuration
1.Nasya with Ksheerabala Taila8 drops in to each nostril in empty stomach in the morning7 days
2.Karnapurana with Maha Masha TailaQuantity sufficient to both ears7 days
3.Ashwagandha Churna0-0-1tsp with milk A/F30 days
4.T. Sarivadi Vati1-0-1 A/F30 days

Observations and Results

Patient was advised to follow healthy lifestyle and avoid night shifts and prolonged used of earphones. Severity was assessed using Tinnitus Handicap Inventory Severity Index (THI)[5] during each follow-up with considerable amount of relief in symptoms.

Before Treatment1st follow-up (After completion of Karnapurana)2nd Follow-up (After 30 days of internal medicines)
Grade 3Grade 2Grade 1

Discussion

Tinnitus, defined as the perception of sound (ringing, buzzing or hissing) in the absence of an external auditory stimulus, is a common auditory symptom that can significantly affect the quality of life. It is often associated with hearing loss, noise exposure, ototoxicity, ageing or idiopathic causes. In the Conventional system of medicine, while several treatment options exist (masking devices, CBT, Sound therapy)[6], no definitive cure is available in many cases, making it a burden to many patients. The Ayurvedic approach to Karnanada (tinnitus) emphasizes the correction of vitiated Vata dosha, particularly Prana Vata and Udana Vata, which are responsible

for the functioning of the ear and auditory pathways. The use of Nasya and Karnapurana as local therapeutic procedures plays a vital role in restoring the balance of doshas and improving sensory perception.

Nidana Parivarjana, being the first line of management, requires the patient to be counselled on making appropriate lifestyle changes. Nasya with Ksheerabala Taila[7] acts as Snehana and Brimhana (nourishing). Karnapurana or Karna Tarpana is a form of snehana which helps to mitigate aggravated Vata. This also helps in enhancing local circulation, promotes sound modulation. Maha Masha Taila[8] has ingredients which are Vatapittahara and the ingredients like Bala, Ashwagandha, Shatavari strengthen the nervous system, aiding in the recovery of damaged or weakened auditory nerves and Ashwagandha Churna acts as Brihmana and Rasayana (Nourishing and rejuvenating). Sarivadi Vati[9] containing herbs like Vacha, Haritaki and Pippali helps to regulate vitiated Vata- vital for auditory and vocal function.

Conclusion

Nasya, by its direct action on the head and sensory organs, helps in pacifying Vata in the Shira (head) and strengthens the auditory system. Karnapurana, through the instillation of medicated oils into the ear, nourishes the Shrotrendriya and supports nerve function. When combined with internal medications, a Vata-Kapha pacifying diet, and appropriate lifestyle modifications, these therapies offer a holistic and sustainable solution for managing Karnanada. Early intervention, individualized treatment, and adherence to Ayurvedic principles are key to successful management.

References

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Shubha S B et al. Effective management of Karnanada (Tinnitus)

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