Tinnitus - ringing sounds in the ears

What Is Tinnitus?

Tinnitus is ringing sounds in the ears. The person experiencing it may describe it as roaring, humming, or a hissing sound in the ears. This kind of noise can be very annoying and disturbing to the one facing this problem. A steady and high-pitched ringing sound in the ears is the most common form of tinnitus. Although annoying, this type of tinnitus does not indicate a severe complication. Sometimes it may be so intense as to disturb a person's sleep. Tinnitus can be temporary or permanent. Although tinnitus is associated with hearing loss, it is not the cause. Also, hearing loss does not bring about tinnitus. Tinnitus is not linked to hearing difficulty. True to this fact, some people with tinnitus might become overly sensitive to sounds, and this condition is called hyperacusis. These people require ways to keep them away from external noises.

What Is the Cause of Tinnitus?

Tinnitus can occur due to many reasons or no reason at all. If you have factors such as wax, infection, fluid in-ear, or middle ear diseases, you may experience sounds. The following are the causes of tinnitus:

• When a sound wave is received, the delicate and tiny hair cells in the ear move, triggering electrical signals which move from the ear to the brain. With aging or increased exposure to excessive sounds, these hairs bend down or are broken, leading to leaving impulses.

• Blockage of the ear due to earwax, fluid buildup, dirt, or foreign materials results in a change in pressure within the ear leading to tinnitus.

• An injury to the head and neck impacts the hearing functions of the brain, inner ear, and hearing nerves resulting in tinnitus.

• Exposure to loud noises and taking harmful medicines damaging the inner ear commonly results in tinnitus. Drugs like non-steroidal anti-inflammatory drugs (NSAIDs), antidepressants, diuretics, cancer drugs, antimalarial drugs, and certain antibiotics can cause or worsen tinnitus.

• Meniere’s disease is an inner ear disorder characterized by abnormal internal ear pressure that indicates tinnitus at an early stage.

• Eustachian tube dysfunction is characterized by tube expansion connecting the middle ear and throat.

• Otosclerosis or stiffening of bones in the middle ear.

• Inner ear muscle spasms.

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• Acoustic neuroma.

• Tumors of the head and neck.

• Malformed blood vessels, atherosclerosis, and other vascular disorders.

• Temporomandibular joint disorders.

• Thyroid disorders, autoimmune disorders, migraines, etc.

• People who have high blood pressure, diabetes, and are anemic are also more prone to get tinnitus. Some diseases of the nervous system can rarely cause tinnitus.

• More commonly, stress and anxiety play a role in causing or aggravating the existing sounds.

What Increases the Risk of Developing Tinnitus?

• Exposure to loud noises from heavy equipment, firearms, chain saws.

• Long periods of exposure to sound from portable music devices.

• Men have an increased risk.

• Increasing age

• Smoking and drinking alcohol.

• Obesity, cardiac diseases, history of trauma to head, hypertension, arthritis.

How Can We Diagnose Tinnitus?

1. Audiological Examination: If you have tinnitus, getting a thorough ENT examination is essential. Your doctor will also advise you to undergo hearing tests called audiometry. This test is done in a soundproof room with earphones. Sound is played in one ear at a time, and the test results are compared with the typical results for each age group.
2. Movement: Worsening of tinnitus with movements like moving the eyes, clenching the jaws, and moving the arms, neck, and legs help in identifying an underlying condition.
3. Laboratory Investigations: The blood tests are taken to determine anemia, thyroid disorders, vitamin deficiencies, and cardiac diseases.
4. Imaging Tests: Imaging tests like CT scan and MRI scan are taken to diagnose tinnitus.

How Is Tinnitus Treated?

1. Whenever possible, the cause of tinnitus needs to be rectified. The following are the causative treatments:

• Earwax blockage is removed to minimize the symptoms of tinnitus.

• Tinnitus caused by vascular disorders is treated by surgery or medication to treat the vascular problem.

• If tinnitus is due to age-related hearing loss or noise-related, hearing aids are used in the treatment.

• Tinnitus caused by drugs is treated by stopping the medication and replacing it with an alternative.

2. Your doctor may then put you on anti-anxiety medicines. The important thing would be to not concentrate on the sound and try relaxation techniques.

3. People, who have an associated hearing problem and tinnitus, will benefit from using a hearing aid. Patients who have disturbed sleep due to tinnitus will be advised to use a loud clicking clock/high-speed fan at night. These measures will help mask the existing sounds in the ear.

4. Also, there are some devices called tinnitus maskers that are available in the market, and they will mask the existing noises in the ear and help you.

5. For patients who have to live with tinnitus, behavioral therapies like tinnitus retraining therapy (TRT) and cognitive behavioral therapy (CBT) help in bringing about behavioral modifications.

How Can We Prevent Tinnitus?

1. Use hearing protection aids when working or exposed to places that have loud noises.

2. Keep low volume when using portable music devices.

3. Restrict the intake of caffeine, alcohol, and nicotine.

4. Prevent obesity and other cardiovascular disorders by taking a healthy diet and doing regular exercises.

What Are the Complications of Tinnitus?

The following are the complications of tinnitus:

• Difficulty sleeping.

• Stress.

• Fatigue.

• Anxiety and depression.

• Fussiness.

• Memory problems.

• Difficulty in concentrating.

• Headache.

• Problems in family and work life.

Conclusion:

Tinnitus is a disturbing condition that brings about problems in both personal and professional life. If you experience any of the symptoms, it is advisable to consult with your ENT specialist rather than sticking to home-treatment methods. With proper treatment, tinnitus can be managed.