Tinnitus
Overview of tinnitus
Unusual perception of sound (buzzing, ringing, roaring, whistling or hissing) in the head or ears, in the absence of any external acoustic (sound) sources is medically termed as tinnitus. The word tinnitus is derived from the Latin word, tinnire, which means ‘to ring.’ In UK, approximately 1 in 10 people are affected by tinnitus at some point of their lives while in America 1 in 7 or 8 people are affected by tinnitus.1,2 It is commonly prevalent among adults aged 40–80 years and occasionally in children.
The frequency of tinnitus in a patient may be irregular, continuous or pulsatile (synchronous with the heartbeat). Irrespective of the frequency, tinnitus is bothersome and is often quite upsetting. Several patients get accustomed to its presence while others might get depressed. By and large, stress exacerbates tinnitus.
Signs and Symptoms
Tinnitus involves the annoying sensation of hearing sounds in your ear when no external sound is present. Signs and symptoms may include:
- Noise in your ear, such as ringing, buzzing, roaring, whistling or hissing
The noise may vary in pitch from a low roar to a high squeal, and you may hear it in one or both of your ears. In some cases, the sound can be so loud it interferes with your ability to concentrate or hear properly.
Earwax buildup may worsen tinnitus. Excess wax in your ear canal can reduce your ability to hear outside noises and amplify internal noises.
Cause for Tinnitus
Causes for tinnitus
Most cases of tinnitus can actually result from the same conditions that cause hearing loss. The underlying conditions that might lead to tinnitus include the
Classification of tinnitus
Classification of tinnitus
Tinnitus may be vibratory and nonvibratory type. The former type is caused by transmission of vibrations to the cochlea (inner ear structure) from adjacent tissues or organs while the latter type is produced by biochemical changes in
Evaluation of Tinnitus
Initially, evaluation of the patient with tinnitus begins with past medical history (such as onset, location, pattern and characteristic of tinnitus; hearing loss; and exposure to ototoxic medications/factors) followed by a thorough head and neck examination and audiometric testing (such as audiography, speech discrimination testing and tympanometry). Patients with unilateral (one ear) or pulsatile tinnitus are more likely to have serious underlying disease and should be referred to an ENT specialist.2,5 Depending on the severity of tinnitus, several patients require both MRI and CT scan to satisfactorily assess the underlying pathology.4
Treatment of tinnitus
Treatment of tinnitus
The severity of tinnitus varies from an occasional perception of noise in one or both ears, to an unbearable sound that drives some people to attempt suicide.5 First and foremost, the underlying condition has to be treated efficiently.
Do’s and Do nots
Do’s
- Overcome your fear of tinnitus
- Accept your tinnitus as a normal part of your life
- Keep busy and focus on stimulating and enjoyable activities
- Surround yourself with ambient and environmental sounds
- Gain strength from others who successfully manage their tinnitus
- Employ relaxation & stress management strategies that work for you
Do nots
- Continually monitor the level of your tinnitus
- Work through an endless range of cures
- Live in hope of a miracle cure
- Talk about it constantly with family and friends
- Remain angry about this unfair intrusion in your life
- Spend frequent periods listening to your tinnitus
- Remain anxious/depressed about your tinnitus
- Feel guilty about not coping
Advice from your physician
Most cases of tinnitus aren't harmful. However, if tinnitus persists or gets worse or you also experience hearing loss or dizziness, see your doctor.
- If due to age-related hearing loss or damage to your ears by exposure to excessive noise, no treatment can reduce the noise.
- Treatment consists mostly of managing the problem. Your doctor can discuss with you steps you can take every day to reduce the severity of the noise or to better cope with the noise.
- If the ringing in your ears is due to another health condition, your doctor may be able to take steps that could reduce the noise, such as removing impacted earwax.
- Tinnitus resulting from a vascular condition often can be corrected by fixing the underlying problem.
- If a medication you're taking appears to be the cause of tinnitus, your doctor may recommend discontinuing the drug or switching to a different medication.
Many medications have been tried to relieve tinnitus with varying degrees of success. Tricyclic antidepressants, such as amitriptyline and nortriptyline, have been used with some success, but these medications have troublesome side effects, such as dry mouth, blurred vision and constipation. Gabapentin and acamprosate are effective in relieving tinnitus for some people.
Written by: Healthplus24 team
Date last updated: August 10, 2011