Tinnitus is an abnormal perception of a sound reported by a patient. This “head noise” is unrelated to an external source of stimulation. Tinnitus is a common disorder affecting over 50 million people in the United States. It may be intermittent, constant, or fluctuant, mild or severe, and tinnitus may vary from a low roaring sensation to a high-pitched type of sound. The location of the tinnitus may be in one or both ears, or it could also involve the head.
Classifications of Tinnitus
Tinnitus may or may not be associated with a hearing loss. It is classified as:
- Subjective tinnitus – A noise perceived by the patient alone, which is quite common. With this type of tinnitus, the patient has problems with the auditory (hearing) nerves or a deficit in the auditory pathway, which is the part of the brain that interprets nerve signals as sounds
- Objective tinnitus – A noise perceived by the patient as well as by another listener, which is relatively uncommon. With this form of tinnitus, the patient and the doctor can hear the head noise. This is usually due to a vascular issue, a muscle contraction, or an inner ear condition.
Symptoms of Tinnitus
The bothersome sound of tinnitus is described differently by different patients. The head noise may be of a low pitch to a high squeal, and it can affect one or both ears. Typical symptoms of these phantom noises are described as:
- Ocean waves
Causes of Tinnitus
Tinnitus is the term for the perception of noise when no external sound is present. It is often referred to as “ringing in the ears,” although some people hear hissing, roaring, whistling, chirping, or clicking. Tinnitus (often called head noise) is not a disease, but a symptom of another underlying condition – of the ear, the auditory nerve, or elsewhere. Tinnitus can be intermittent or constant, with single or multiple tones. Its perceived volume can range from very soft to extremely loud.
Factors that Contribute to Tinnitus
The exact cause (or causes) of tinnitus is not known in every case. There are, however, several likely factors which may cause tinnitus or make existing head noise worse. These include:
- Noise-induced hearing loss
- Wax build-up in the ear canal
- Certain medications
- Ear or sinus infections
- Age-related hearing loss
- Ear diseases and disorders
- Jaw misalignment
- Cardiovascular disease
- Certain types of tumors
- Thyroid disorders
- Head and neck trauma
Of the many factors that contribute to tinnitus, exposure to loud noises and hearing loss are the most common causes of tinnitus. Treating a hearing loss, either by medical management or with hearing aids can help. Modern digital hearing aids also provide tuned noise maskers, which may alleviate the tinnitus. Other new and effective tinnitus treatments are also available. If you have tinnitus, a comprehensive hearing evaluation by an audiologist and a medical evaluation by an otologist are recommended.
Tinnitus Treatment and Management
Tinnitus will not cause you to go deaf. Statistically, 50 percent of patients may express that their tinnitus decreases with time or is hardly perceptible. Generally, most patients will not need any medical treatment for tinnitus. There are several treatments and measures to help with the management of tinnitus.
Listening to a Fan or Radio
The external noise will mask some of the head noise. In addition, other sound source generators can be obtained and be adjusted to sound like environmental noises, and this is also effective in masking tinnitus. Generally, this is more advantageous if one is attempting to go to sleep.
Tinnitus Masker Device
A tinnitus masker is utilized for some patients. It is a small electronic instrument built into a hearing aid case. This device generates a sound which prevents the wearer from hearing his own head noise. The technology of a tinnitus masker is based on the principle that most individuals with tinnitus can better tolerate outside noise than they can their own inner head noise.
This is effective in reducing the tinnitus in some patients. Biofeedback training consists of exercises in which the patient learns to control various parts of the body and relax the muscles. When a patient is able to accomplish this type of relaxation, tinnitus generally subsides. Most patients have expressed that the biofeedback offers them better coping skills.
Other measures to control tinnitus include making every attempt to avoid anxiety, as anxiety will increase tinnitus. You should attempt to obtain adequate rest and avoid over-fatigue as patients who are tired seem to notice their tinnitus more. The use of nerve stimulants is to be avoided, as are excessive amounts of caffeine and smoking. Stimulating agents tend to make tinnitus worse.
Avoiding Certain Medications
There are some drugs which will also cause tinnitus. If you have tinnitus and are on medication, you should discuss the symptom of tinnitus with your physician. In many instances, once the drug is discontinued, the tinnitus will no longer be present. These medications include:
- Certain antibiotics (gentamicin, neomycin, and streptomycin)
- Antidepressants (amitriptyline and nortriptyline)
- Anti-inflammatory drugs (aspirin, ibuprofen, and naproxen)
- Antihypertensives (captoprin and ramipril)
- Heart medicines (propranolol and verapamil)
- Parkinson’s drugs (levadopa)
- Diuretics (furosemide and bumetanide)
- Supplements (vitamin A and niacin)
There are several medications which have been utilized to suppress tinnitus. Some patients benefit with these drugs and others do not. Each patient has an individual response to medication, and what works for one patient may not work for another. Some of these medications have been proven, however, to decrease the intensity of the tinnitus and make it much less noticeable. There is, however, no drug anywhere which will eliminate tinnitus completely and forever.
For tinnitus management, visit the American Tinnitus Association website for more information, ideas, and strategies at www.ata.org