Tinnitus is the term used to describe a sound that is heard internally by the body and not from an external source. It can be subjective, meaning only the person experiencing it can hear it, or objective, which can be heard by a doctor during an examination.

How Common is Tinnitus?

Tinnitus is a condition that almost everyone experiences at some point, with ten million people dealing with it, according to the American Tinnitus Association.

What are signs and symptoms of Tinnitus?

Signs and symptoms of Tinnitus include: - Hearing noises like ringing, buzzing, hissing, or whistling in the ears. - The noises may not be constant and can come and go at certain points. - Only the person experiencing tinnitus can hear these noises.

How do you get Tinnitus?

Tinnitus can be caused by a variety of factors, including noise trauma, health conditions such as heart disease and diabetes, certain medications, diseases of the ear, somatosensory stimulation, Chiari malformation, and exposure to loud noises.

What else can Tinnitus be?

Cytomegalovirus, High cholesterol (Hypercholesterolemia), Lyme disease, Measles, Meningitis, Tumors (Neoplasm), A type of syphilis that affects the nervous system (Neurosyphilis), Rubella, Sickle cell anemia, Small vessel disease, Stroke, Tumor.

What kinds of test are needed for Tinnitus?

The types of tests that may be ordered to properly diagnose tinnitus include: - Hearing test (audiogram) to assess hearing loss and compare bone conduction to air conduction - Air-bone test to evaluate hearing ability through the bone of the ear - Masking tone test to measure how long the ringing is reduced when a masking tone is used - X-ray or MRI may be conducted if there are unexplained differences in hearing and balance that cannot be explained otherwise It is important to note that these tests are not always necessary for diagnosing tinnitus, and their use depends on the specific circumstances and symptoms of the individual patient.

How is Tinnitus treated?

Tinnitus can be treated through various methods. Some of the recommended treatments include stress reduction techniques, cognitive therapy, masking with pleasant sounds or music, improving sleep hygiene, and using hearing aids with built-in sounds. Medications like alprazolam and antidepressants may also be considered in certain cases. Additionally, new approaches such as deep brain stimulation have shown promise in managing tinnitus. Support and following a treatment plan are also crucial in managing the condition.

What are the side effects when treating Tinnitus?

When treating tinnitus, there can be side effects associated with certain medications. For example, medications like alprazolam, which can help manage symptoms, may have side effects including dependency. Additionally, antidepressants may be considered in some cases, but they can also have their own side effects.

What type of doctor should I see for Tinnitus?

You should see an otolaryngologist (ear, nose, and throat doctor) for tinnitus.

Tinnitus

What is Tinnitus?

Tinnitus is the term used when a person hears a sound that is not coming from an external source, but is instead produced internally by the body. Most of the time, this type of noise is subjective, meaning that only the person experiencing it can hear it. It can’t be measured or detected using any instruments. However, sometimes, tinnitus can be objective, which means it can be heard by a doctor during an examination. This kind of tinnitus might be the result of an aneurysm – a balloon-like bulge in an artery. Other conditions that might cause this kind of tinnitus include issues with the temporomandibular joint (the joint connecting your jaw to the side of your head), known as TMJD, and spasms in the tensor tympani muscle, which is one of the muscles in the ear.

What Causes Tinnitus?

Tinnitus, or the perception of noise or ringing in the ears, can be caused by a variety of factors:

* Noise trauma is the most common cause, especially among workers in loud environments. For instance, hearing loss at a specific frequency (like 4000 Hz) might cause a person to hear a similar tone in their ears when there is no external source of sound.
* Health conditions such as heart disease, high blood pressure, and diabetes can also lead to tinnitus. Certain medications could make someone prone to tinnitus, especially if taken in high amounts. For example, taking too much aspirin might cause ringing in the ears, and the problem usually goes away once one stops taking the aspirin.
* Diseases of the ear can result in tinnitus. Included in these are Meniere’s disease, a disorder of the inner ear, and other health problems that affect the eighth cranial nerve, which carries signals from the inner ear to the brain.

Surprisingly, about 20% of people who seek help for tinnitus actually have normal hearing. Some people experience a type called somatosensory tinnitus, where sensations from the neck or jaw joint stimulate a part of the brain called the dorsal cochlear nucleus, which controls our hearing. It is like when sudden movements, similar to those experienced in whiplash or jaw joint disorders, trigger anatomical changes in the hearing control part of the brain.

A less common cause of tinnitus is Chiari malformation, a condition where the lower part of the brain (the cerebellar tonsils) presses on the auditory nerve, causing the ringing noise. This can affect one or both ears.

Risk Factors and Frequency for Tinnitus

Tinnitus, a condition involving ringing or other noises in the ears, is something almost everyone experiences at some point. The American Tinnitus Association indicates that ten million people deal with tinnitus. This condition is not just limited to developed countries; it’s also widespread in non-industrialized nations.

People who are frequently exposed to loud noises have a higher likelihood of acquiring tinnitus. This includes military personnel due to gunfire and explosions, movie and stage workers involved in preparing explosive scenes, and musicians, especially those like drummers or performers who are constantly in front of loudspeakers.

Children can also experience tinnitus. However, it often goes unrecognized as they might not understand what’s happening.
It can also occur in people working in loud environments like factories, where shouting is necessary due to the noise. However, only a small percentage of these workers develop tinnitus.
Sometimes, tinnitus can be accompanied by hyperacusis, a heightened sensitivity to everyday noises. People with this condition find ordinary sounds, like closing doors or books dropping, excessively loud or even unbearable.

Signs and Symptoms of Tinnitus

Tinnitus is a condition in which you hear noises like ringing, buzzing, hissing, or whistling in your ears. It might not be constant; sometimes you may hear it at certain points and then not hear it at other times. The interesting thing about this condition is that only you, as the person experiencing tinnitus, can hear these noises.

When you go to the doctor for a checkup related to tinnitus, they will conduct a physical exam that will primarily focus on examining your ear and your nervous system. Here are the steps of the examination:

Your ear canal will be checked for any discharge, foreign objects, or excess wax.
Your eardrum, or tympanic membrane, will be checked for any infections or tumors, which might appear as a red or bluish mass.
You will undergo a basic hearing test at the bedside.
Your cranial nerves, especially those involved in balance, will be tested, as well as your arm and leg strength, sensation, and reflexes.
The doctor will use a stethoscope to listen for any abnormal sounds from the blood vessels in your neck and near your ear.

Testing for Tinnitus

If you have tinnitus, which is a condition where you hear a ringing in your ears, you usually don’t need to get an X-ray or an MRI. These tests are only conducted if there’s a mystery difference in the hearing and balance of your ears that can’t be explained otherwise.

A hearing test, also known as an audiogram, can help figure out whether this condition is causing hearing loss. In this test, you will be asked to identify sounds that match the intensity of the ringing you hear due to tinnitus. The sound specialist or audiologist will play these sounds at different volumes, and you’ll estimate how loud your tinnitus sounds. They will also compare your hearing ability when heard through your ear’s bone versus through an earphone. This comparison is known as an air-bone test. If you can hear sounds better through the bone of your ear, this might indicate otosclerosis – a treatable ear condition.

Otosclerosis is when the stapes, which are tiny bones in your ear, don’t move as they should. There’s a surgical procedure that can fix this issue and help restore typical hearing. This surgery can also potentially alleviate tinnitus in some patients. However, for others, the ringing might remain or get worse.

The audiologist will also time how long the ringing is reduced when a masking tone is used. The longer the tinnitus is suppressed, the more likely you’ll see a significant improvement over time.

Treatment Options for Tinnitus

The American Academy of Otolaryngology has created a set of recommendations to help manage tinnitus, which is a condition characterized by a ringing or buzzing sound in the ears. Here are some methods they suggest:

Stress Reduction: Techniques such as biofeedback and measured breathing can help lower stress. While stress doesn’t cause tinnitus, reducing it can lessen the severity of the condition.

Cognitive Therapy: This is a type of therapy aimed at understanding what tinnitus is, how it affects you and learning how to manage it. Like an itch, recognizing and understanding the symptoms can help reduce their impact.

Masking: This involves using a device to play sounds that can distract you from the noise of tinnitus. These could be different types of sounds or even music. Masking sounds aim to replace the internal tinnitus sound with more pleasant, relaxing ones. Listening to white noise or pleasant sounds, or music with the same frequency of the tinnitus sound removed, are examples of this technique.

Sleep improvement: Since tinnitus can disturb your sleep, improving your sleep hygiene can also help manage the condition.

While there is currently no medication that cures tinnitus, some substances like magnesium, alpha-lipoic acid, and N-acetyl cysteine have been studied for their potential to protect against noise-induced hearing loss. However, it’s hard to tell if their effects are real or simply result from the placebo effect, or the impact of being part of a treatment program.

Deep brain stimulation is a new approach that has shown promise in managing tinnitus. It’s believed to work by changing unwanted neural circuits in the brain.

A crucial part of managing tinnitus is providing support and a plan to follow. Two common programs used in treatment are Tinnitus Retraining Therapy and Neuronomics, where patients learn to adapt to or ignore the tinnitus sounds, respectively.

If tinnitus is accompanied by hearing loss, hearing aids can often help. Some of these devices also come with built-in sounds designed to soothe or distract from the tinnitus sounds. Medications like alprazolam can also help manage symptoms, but there may be side effects, including dependency. In some cases, if patients do not respond to other types of therapy, antidepressants may be considered.

There are several medical conditions that can cause certain symptoms. These include: