Tinnitus

Tinnitus Overview

Tinnitus, (pronounced tih-NIGHT-us or TIN-ih-tus) is a ringing, swishing, or other type of noise that seems to originate in the ear or head. Most of us will experience tinnitus or sounds in the ears at some time or another. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), almost 12 percent of men who are 65 to 74 years of age are affected by tinnitus.Tinnitus in the U.S. is almost twice as frequent in the South as in the Northeast.

Tinnitus can be extremely disturbing to people who have it. In many cases it is not a serious problem, but rather a temporary disturbance that may go away. However, some people with tinnitus may require medical or surgical treatment. Twelve million Americans suffer from tinnitus, and one million experience it so severely it interferes with their daily activities.

Tinnitus can arise in any of the four sections of the hearing system: the outer ear, the middle ear, the inner ear, and the brain. Some tinnitus or "head noise" is normal. A number of techniques and treatments may be of help, depending on the cause.

Tinnitus Causes

Tinnitus is not a disease in itself but rather a reflection of something else that is going on in the hearing system or brain.

• Probably the most common cause for tinnitus is hearing loss. As we age, or because of a specific trauma to the ear (through noise, drugs, or chemicals), the portion of the ear that allows us to hear, the cochlea, is damaged.

Current theories suggest that because the cochlea is no longer sending the normal signals to the brain, the brain becomes confused and essentially develops its own noise to make up for the lack of normal sound signals. This then is interpreted as a sound, tinnitus.

This tinnitus can be made worse by anything that makes our hearing worse, such as ear infection or excess wax in the ear.

Tinnitus caused by ear trauma is usually noticed in both ears, because both ears are usually exposed to the same noises, drugs, and other influences

Loud noise exposure is a very common cause of tinnitus today, and it often damages hearing as well. Unfortunately, many people are unconcerned about the harmful effects of excessively loud noise from firearms, high intensity music, or other sources.

• Ten million Americans have yet suffered irreversible noise-induced hearing loss, and 30 million more are exposed to dangerous noise levels every day, according to the NIDCD.

• Other causes of tinnitus include drugs such as aspirin (if overused), aminoglycoside antibiotics (a powerful form of infection-fighting drug), and quinine.

• Meniere's disease includes dizziness, tinnitus, and fullness in the ear or hearing loss that can last for hours, but then goes away. This disease is actually caused by a problem in the ear itself. Tinnitus is merely a symptom.

• The most common type of tinnitus is known as subjective tinnitus, meaning that you hear a sound but it cannot be heard by others.

• A rare cause of subjective tinnitus includes a certain type of brain tumor known as an acoustic neuroma. The tumors grow on the nerve that supplies hearing and can cause tinnitus. This type of tinnitus is usually only noticed in one ear, unlike the more common sort caused by hearing loss usually seen in both ears.

• A much more uncommon sort is called objective tinnitus, meaning your doctor may sometimes actually hear a sound when he or she is carefully listening for it.

• Pulsatile tinnitus is usually related to blood flow, either through normal or abnormal blood vessels near the ear. Causes of pulsatile tinnitus include pregnancy, anemia (lack of blood cells), overactive thyroid, or tumors involving blood vessels near the ear. Pulsatile tinnitus can also be caused by a condition known as benign intracranial hypertension-an increase in the pressure of the fluid surrounding the brain.

• Clicking types of objective tinnitus can be caused by jaw joint misalignment problems or muscles of the ear or throat "twitching."

• Some of the most common include a sound of crickets or roaring, buzzing, hissing, whistling, and high-pitched ringing.
• Other types of tinnitus include a clicking or pulsatile tinnitus (the noise accompanies your heartbeat).

Prevention

The only real prevention for tinnitus is to avoid damaging your hearing. Most causes other than hearing loss do not have prevention strategies.

According to the American Tinnitus Association, there are several things you can do to protect yourself from excessive noise-related tinnitus:

• Protect your hearing at work. Your work place should follow Occupational Safety & Health Administration regulations. Wear ear plugs or earmuffs and follow hearing conservation guidelines set by your employer.
• When exposed to noise that bothers your ears (a concert, sporting event, hunting) wear hearing protection or reduce noise levels.
• Even everyday noises such as blow drying your hair or using a lawnmower can require protection. Keep ear plugs or earmuffs handy for these activities.

Medical Treatment

Treatment for tinnitus depends on the underlying cause of the problem.

In the majority of cases, tinnitus is caused by damage to the hearing organ. In these cases, there is normally no need for treatment other than reassurance that the tinnitus is not being caused by another treatable illness.

In the very rare instance where the tinnitus is extremely bothersome, there are a number of treatment options.

• Some of the most helpful include antianxiety or antidepressant medication and sometimes maskers-small devices like hearing aids that help to block out the sound of the tinnitus with "white noise."
• For people who are bothered by tinnitus only when trying to sleep, the sound of a fan, radio, or white noise machine is usually all that is required to relieve the problem.
• Most people with tinnitus find that their symptoms are worse when under stress, so relaxation techniques can be helpful.
• Avoiding caffeine is advised, as it may worsen symptoms.
• Biofeedback may help or diminish tinnitus in some patients.
• Avoid aspirin or aspirin products in large quantities.

Hearing loss worsens the effect of tinnitus, so protection of hearing and avoiding loud noises is very important in preventing worsening of the symptoms.

In cases where the tinnitus is caused by one of the other rare problems (such as a tumor or aneurysm), treatment of the tinnitus involves fixing the main issue. Although this does not always resolve the tinnitus, some people note relief of their symptoms. Only a very few cases of tinnitus are caused by identifiable, repairable medical conditions.