What is tinnitus?
Tinnitus is a noise that you can hear, but the source is inside your ear. This can include sounds like ringing, buzzing, whistling, roaring, humming, mechanical/machine noises, etc. The noise can sometimes correspond with your own heartbeat. You may notice the noise coming and going, or constantly being present. The loudness can change as well. Sometimes it is obvious which ear it is coming from, but others may not be able to tell. Most patients find the noise much more noticeable and bothersome when they are in a quiet place, when they are tired, or when trying to fall asleep at night. Some people with tinnitus are much more sensitive to regular noises that generally do not bother those without tinnitus
How common is tinnitus?
Tinnitus is a common problem that can arise at any age, depending on the cause. The most common experience with tinnitus is an occasional temporary ringing after attending a loud concert or being exposed to loud noises. Less commonly, (~10% of people) have a persistent tinnitus that is mild and does not interfere with their quality of life. About 1 in 100 people however, have a persistent tinnitus that does significantly limit their quality of life.
What causes tinnitus?
In many cases, the cause is not known, with otherwise normal ears. The most common mechanism appears to be impulses sent from the nerves within the ears into the brain. There are examples of other conditions causing tinnitus:
- Tinnitus can show up around the same time as hearing loss associated with aging
- Meniere’s disease is a condition with attacks of vertigo, hearing loss, and tinnitus. It is believed to be caused by fluid imbalance within the inner ears.
- After exposure to loud noises for a long time or repeated events, permanent and progressive tinnitus can develop. Permanent tinnitus can also develop from a single loud noise experience.
- Some medications such as aspirin or quinine can cause tinnitus. Alcohol, smoking, and caffeine have also been associated with tinnitus.
- Tinnitus can arise after trauma to the ears or head
- Otoslcerosis is a condition where the tiny bones within the ear that conduct noise vibrations become stiff. This limited mobility may cause new noises in the ear.
- Certain diseases affecting the blood vessels, brain, or nerves can manifest as noise in the ears. Also, diseases affecting the body such as lack of iron, thyroid hormone imbalance, or diabetes can be associated with tinnitus.
- A tumor near the hearing nerve, or acoustic neuroma (or vestibular schwanoma) can cause tinnitus. Tinnitus in only one ear can be associated with this tumor, and consultation with a doctor is important in ruling this out.
- Tinnitus associated with an ear infection usually resolves when the infection clears
- Excessive ear wax, especially if the wax touches the ear drum, causing pressure and changing how the ear drum vibrates, can result in tinnitus.
- Studies have shown that mild tinnitus may worsen with emotional issues such as depression, anxiety, or stress.
What tests can be done?
One of Westside Head & Neck’s Ear Nose and Throat specialists will evaluate your ears and nerves that control the head and neck. Also, a hearing test can be ordered to look for any underlying issues. If the tinnitus is on one side or a disorder of the brain or inner ear is suspected, a CT scan may be performed as well.
What are my treatment options?
In some cases, an underlying cause can be identified and corrected in order to eliminate the tinnitus. Examples of this include stopping the causative medicine that has a side-effect of tinnitus, or taking an antidepressant medication when tinnitus is associated with emotional depression. In most cases however, there is no simple cure. Many patients appreciate reassurance in learning more about their condition and knowing that there is no serious underlying condition. There are various techniques to help cope with tinnitus that persists:
Quiet environments are generally more uncomfortable, as they make the tinnitus more noticeable. Sound therapy is a way of introducing more pleasant sounds to distract you from the tinnitus. Examples of this include introducing background noises from the radio, television, computer, or iPhone. Custom sound generators can create noises that help mask the tinnitus. Alternative sounds can also be listened to from smartphones or personal music players (ie iPods). Bedtime is especially frustrating for tinnitus sufferers, as the quiet setting magnifies the noise. Radio or stereos with sleep timers are helpful for providing distracting noises until you fall asleep. There are also special personal pillow speakers that keep others nearby from being disturbed.
Hearing aids have been found to provide some relief to those with (even slight) hearing loss associated with their tinnitus. The aid augments distracting sounds that you may have been missing otherwise.
Stress, anxiety and depression
Sometimes stress or anxiety can become worsened by the tinnitus. Studies have shown that relaxing and decreasing stress can have a positive impact on the tinnitus as well.