Tinnitus

Tinnitus is commonly defined as the subjective perception of sound by an individual, in the absence of external sounds. This may be an intermittent sound or an annoying continuous sound in one or both ears. Its pitch can go from a low roar to a high squeal or whine. Tinnitus is not a disease in itself but a common symptom, and because it involves the perception of sound or sounds, it is commonly associated with the hearing system. In fact, various parts of the hearing system, including the inner ear, are often responsible for this symptom.

Tinnitus and Hearing: Tinnitus may be caused by different parts of the hearing system. At times, for instance, it may be caused by excessive ear wax, especially if the wax touches the ear drum, causing pressure and changing how the ear drum vibrates. Middle ear problems can also cause tinnitus, such as a middle ear infection or the buildup of new bony tissue around one of the middle ear bones which stiffens the middle ear transmission system (otosclerosis). Another cause of tinnitus from the middle ear may be muscle spasms of one of the two tiny muscles attached to middle ear bones. Most subjective tinnitus associated with the hearing system originates in the inner ear. Damage and loss of the tiny sensory hair cells in the inner ear (that can be caused by different factors) may be commonly associated with the presence of tinnitus. It is interesting to note that the pitch of the tinnitus often coincides with the area of the maximal hearing loss.

Other causes of tinnitus: One of the preventable causes of inner ear tinnitus is excessive noise exposure. In some instances of noise exposure, tinnitus is the first symptom before hearing loss develops, so it should be considered a warning sign and an indication of the need for hearing protection in noisy environments. Certain common medications can also damage inner ear hair cells and cause tinnitus. These include non-prescription medications such as aspirin, one of the most common and best known medications that can cause tinnitus and eventual hearing loss. As we age, the incidence of tinnitus increases. A special category is tinnitus that sounds like one’s heartbeat or pulse, also known as pulsatile tinnitus. At times, the presence of pulsatile tinnitus may signal the presence of a vascular tumor in the general vicinity of the middle and inner ear. When noting this type of tinnitus, it is advisable to consult a physician as soon as possible to rule out the presence of this type of vascular tumor. Conditions that affect the hearing nerve can also cause tinnitus, the most common being benign tumors, typically originating from one of the balance nerves in close proximity to the hearing nerve. These are commonly referred to as acoustic neuroma or vestibular schwannoma. Tinnitus caused by an acoustic neuroma is usually unilateral and may or may not be accompanied initially by a hearing loss.

There are a number of non-auditory conditions that can cause tinnitus, as well as lifestyle factors. Hypertension or high blood pressure, thyroid problems, and chronic brain syndromes can all cause tinnitus without any specific auditory problems. Stress and fatigue may cause tinnitus, or can contribute to an exacerbation of an existing case. Poor diet and lack of exercise that may cause blood vessel and heart problems may also either cause it or exacerbate an existing condition. It is also possible that tinnitus could be caused by food or beverage allergies, but these causes are not well documented and are difficult to sort out.

Tinnitus Treatment: In most cases, there is no specific, tried-and-true treatment for ear and head noise. If an otolaryngologist finds a specific cause for your tinnitus, he or she may be able to offer specific treatment to eliminate the noise. This determination may require imaging studies, audiological tests, tests of balance function, and other laboratory work. However, most of the time, other than linking the presence of tinnitus to sensory hearing loss, specific causes are very difficult to identify. Although there is no specific medication for tinnitus, occasionally medications may be tried and some may help to reduce the noise. Options include hearing amplification ( hearing aids ), meditation, cognitive therapy, sound therapy/retraining therapy, temporomandibular disorder treatment. Tips to avoid tinnitus include avoiding noise exposure, controlling blood pressure, decreased salt intake, avoidance of stimulants such as coffee/tea/cola/tobacco, and getting regular exercise. Concentration and relaxation exercises can help to control muscle groups and circulation throughout the body. The increased relaxation and circulation achieved by these exercises can reduce the intensity of tinnitus in some patients.

Childhood tinnitus It is relatively rare but not unheard of for patients under 18 years old to have tinnitus as a primary complaint. However, it is possible that tinnitus in children is significantly under-reported, in part because young children may not be able to express this complaint. Also, in children with congenital sensorineural hearing loss that may be accompanied by tinnitus, this symptom may be unnoticed because it is something that is constant in their lives. In fact, they may habituate to it; the brain may learn to ignore this internal sound. In pre-teens and teens, the highest risk for developing tinnitus is associated with exposure to high intensity sounds, specifically listening to music. In particular, virtually all teenagers use personal MP3 devices and nearly all hand-held electronic games are equipped with ear buds. It is difficult for a parent to monitor the level of sound children are exposed to. Therefore, the best and most effective mode of prevention of tinnitus in children is proper education relative to excessive sound exposure, as well as monitoring by parents or other caregivers.