What is Tinnitus?
Tinnitus (pronounced both ti-NIGHT-us and TIN-i-tus) is the perception of sound in the ears where no external source of sound exists. Tinnitus can be a temporary condition, lasting only a few minutes, or it can be a long term condition which can last indefinitely.
In nearly all cases, the sound that the sufferer hears is only heard by that person. Tinnitus sounds different to every sufferer. Some words used to describe tinnitus include, “ringing,” “wooshing”, “crackling,” “static,” “screeching,” “buzzing,” and even “hissing.” The sound from tinnitus never includes words or melodies.
Tinnitus is often a symptom of hearing loss, but it can be a symptom of other diseases as well.
Prevalence of Tinnitus
The American Tinnitus Association estimates that over 50 million Americans experience tinnitus to some degree. Of those, over 12 million suffer severely enough to seek medical attention. About 2 million of those cases are severe enough that the sufferer can’t function normally.
Causes of Tinnitus
To understand what causes tinnitus, you must begin by understanding how we hear. (If you’d like to see a short video animation of tinnitus, click here.)
The outer part of the ear, or auricle, acts as a satellite dish to capture sound and direct it into the ear canal. Once in the ear canal, sound waves cause the ear drum (tympanic membrane) to vibrate. This causes the three small bones in the ear the malleus, incus, and stapes to vibrate, which they in turn pass onto the middle ear cavity. As this signal gets transferred into the cochlea, the vibrations cause small hair cells to move. The movement of these hairs triggers an electrical signal which the 8th nerve carries to the brain to be interpreted as sound.
When tinnitus occurs, something causes the hair cells in the cochlea to transmit nerve pulses which the brain interprets as sound.
Often this happens because the cells in the cochlear are somehow damaged. The exact causes are unknown, but we do know that tinnitus often occurs when:
Patients experience a sensorineural hearing loss. Exposure to loud noise damages and destroys the cells in the cochlea. 90% of tinnitus sufferers also experience some level of hearing loss. Hearing loss often worsens tinnitus. When the ear is not able to hear outside sounds as well, it becomes easier to hear “noise” within the ear.
- Patients take ototoxic medications. Certain drugs have tinnitus as a side effect. Often this is not permanent. You should discuss all risks associated with medications with your physician.
- Patients experience sinus or ear infections. Many people, especially children, experience tinnitus in conjunction with ear and sinus infections. This usually clears up along with the infection.
- Patients have a greater amount of ear wax than normal. Sometimes a prevalence of ear wax build up can trigger or exacerbate tinnitus. You should seek the care of a physician to remove the ear wax.
- Patients have experienced head or neck trauma.
- Patients have experienced jaw misalignment.
- Patients have experienced certain types of tumors.
- Patients have experienced diseases such as hypo- or hyperthyroidism, lyme disease, and fibromyalgia. When tinnitus is caused by another disorder, treating the disorder oftentimes alleviates the tinnitus.
Treating Tinnitus
Neuromonics: The treatment utilizes a customized neural stimulus combined with specific music, delivered according to a coordinated program. The treatment is designed to interact, interrupt, and desensitize tinnitus disturbance for long term benefit. Neuromonics has been shown to reduce symptoms quickly and provide significant, long-term relief. This treatment has been shown to be effective for 90% of suitable tinnitus cases.
SoundCure Serenade: SoundCure is an innovative treatment for sufferers of tinnitus. The Serenade®device incorporates state of the art treatment and proven sound therapies in a customized tinnitus treatment. Multiple user-focused features make Serenade an easy-to-use yet advanced treatment option. The Serenade is programmed by an audiologist to your specific needs.
Hearing Aids: Many people notice tinnitus only when they are in a quiet environment. This happens because the ambient noise prevalent in day to day life covers up tinnitus. When something happens to cause hearing loss, there is less ambient noise to cover the tinnitus, thus making it appear louder. For many people, treating the cause of the hearing loss can completely or partially cover up the tinnitus. Hearing aids are often a good option to treat certain types of hearing loss. A hearing exam performed by an audiologist can determine what type of hearing loss is occurring and he or she can recommend appropriate treatment.
Tinnitus Retraining Therapy: Tinnitus Retraining Therapy (TRT) teaches the brain to recognize that tinnitus is not a threat and can be ignored. TRT in conjunction with maskers if often an effective treatment.
Sound Therapy: Oftentimes, external sound can “mask” the tinnitus and help the brain to not pay so much attention to it. This can be something as simple as turning on a fan, a radio or a simple sound generator. Sometimes, an audiologist will prescribe a masking device which creates a constant sound in the ear. A simple analogy behind this treatment is that of getting a new refrigerator. You notice the sound the refrigerator makes for a few days until your brain learns to ignore the sound. A masker works in much the same way. As the brain learns to ignore the sound being generated by the masker, it also begins to ignore the tinnitus.
Alternative Treatments: There are many “natural” remedies for tinnitus. However, at the present time, the American Tinnitus Association has the following to say about these treatments:
“Some people have taken minerals such as magnesium or zinc, herbal preparations such as Ginkgo biloba, homeopathic remedies, or B vitamins for their tinnitus and found them to be helpful. Others have experienced tinnitus relief with acupuncture, cranio-sacral therapy, magnets, hyperbaric oxygen, or hypnosis. A few of these therapies have been researched in an attempt to verify the anecdotal claims. But the results have not conclusively identified these treatments as helpful for tinnitus. Your doctor might give you clearance to try them for tinnitus anyway given that they generally carry little risk to health and some people find them helpful.” (American Tinnitus Association, November, 2009)
Drug Therapy:Many drugs have been researched and used to relieve tinnitus, but there is not a drug that has been designed specifically to treat tinnitus. Some drugs that have been studied include anti-anxiety drugs like Xanax, antidepressants like nortriptyline, antihistamines, anticonvulsants like gabapentin, and even anesthetics like lidocaine. All successfully quieted tinnitus for some people.
Coping Therapies
There are many ways to cope with tinnitus. The following are some suggestions:
- Rest and relaxation. Tinnitus tends to be exacerbated when you are tired and under stress. Getting at least 8 hours of sleep each night along with relaxation techniques (such as yoga and deep breathing exercises) can help to lessen the effects of tinnitus.
- Limit caffeine, alcohol and sodium. These things have been shown to have adverse effects on blood pressure, which in turn makes tinnitus worse.
- Protect your hearing. Hearing-loss induced tinnitus gets worse as hearing loss increases. Protect your hearing by avoiding loud noises and wearing ear plugs in noisy environments.
Choosing and Seeing a Professional for Tinnitus Treatment
You should choose a medical professional (either an Audiologist or an ENT) who is experienced in tinnitus treatment. Make sure that the professional is licensed and qualified to provide the kind of treatment in which you are most interested. Drug therapy can only be prescribed by a licensed M.D. Neuromonics and TRT are only provided by certain audiologists and ENTs.
Make sure that you take a list of medications that you are currently taking to your appointment.
Next Steps
Tinnitus doesn’t have to ruin or even rule your life. There is help available and there are resources available to help you choose the course of treatment that is right for you. Don’t waste time blaming yourself for your tinnitus—do something about it today!
If you are concerned about your tinnitus, you are not alone. You can click hereto take a quick self assessment to see if you need to see a tinnitus specialist, such as those at Timpanogos Hearing & Balance, or call 801-770-0801 to schedule a consultation with one of our tinnitus specialists.
