What is Tinnitus?

What Is Tinnitus?

Tinnitus is a false perception of sound by a person as ringing, buzzing, roaring, or hissing sounds in the absence of actual sound. It can be heard in either one ear or both ears. In most cases, these noises are not external sounds meaning that other people cannot listen to them.

Tinnitus is divided into two types, namely, subjective tinnitus and objective tinnitus. In the case of subjective tinnitus, only the affected person can hear the sound, while in objective tinnitus, it can be heard by the doctor examining the patient. Pulsatile tinnitus is an example of objective tinnitus. In it, a rhythmic pulsing sound that occurs in synchrony with the heartbeat can be heard by the examining doctor.

How Prevalent Is Tinnitus?

The prevalence rate of tinnitus is around 15 to 20%. Older adults are more prone to get tinnitus.

What Causes Tinnitus?

Various conditions giving rise to tinnitus are:

• Trauma to ear.

• Noise exposure (sudden exposure to loud sound or prolonged exposure to noise of engines, gensets, etc.).

• Associated audiovestibular disease (hearing and balance-related diseases).

• Family history.

• Ototoxic medications (medications that cause damage to the ear and its balance functions).

• Systemic diseases such as multiple sclerosis (MS), cerebrovascular accidents (stroke), neoplasm (tumors), syphilis, degenerative neurological process as in advancing age.

• Otological surgeries (ear-related surgeries) as a complication.

• Anxiety, insomnia (loss of sleep), and depression.

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How Is Tinnitus Manifested?

Although most commonly described as a ringing sensation in the ears, tinnitus can also have other forms of phantom noises like the following:

• Clicking.

• Hissing.

• Roaring.

• Buzzing.

• Humming.

The noises heard with tinnitus usually vary in pitch and sound from low-pitched to high-pitched. It can occur either intermittently or can be present throughout. In a few severe cases, the tinnitus sounds are very loud such that it interferes with the ability of hearing or concentration.

What Increases the Risk of Developing Tinnitus?

1. Aging is a significant risk factor for tinnitus because the amount of functioning nerve fibers in the ears reduces with aging.

2. Tinnitus is more commonly seen in males as compared to females.

3. Exposure to loud noises for an extended period also increases the chances of getting tinnitus.

4. Chronic smokers and alcoholics have a greater risk of developing tinnitus.

5. Individuals with chronic medical conditions like hypertension, arthritis, cardiac diseases, obesity, and head injuries are more prone to tinnitus.

How Can We Diagnose Tinnitus?

Diagnosis of tinnitus can be made solely by the symptoms presented. However, to treat tinnitus, the underlying causative factor should be identified. To identify it, either the type of sound can be helpful, or some tests are to be performed.

The different sounds and their respective causes are explained below:

• Low-Pitched Ringing Sounds: It can be due to Meniere's disease, earwax blockage, or otosclerosis (stiffening of the inner ear bones).

• High-Pitched Ringing Sounds: It is the most commonly occurring tinnitus sound, which can be due to exposure to loud noises, intake of certain medicines, acoustic neuroma, and hearing loss. However, in the case of acoustic neuroma, the tinnitus sound is continuous in nature.

• Pulsing, Humming, or Rushing Sound: Vascular causes like hypertension cause these types of sounds. They are seen with changes in the position.

• Clicking Sound: Muscular contractions in and around the ears can be the causative factor when clicking sounds are heard in tinnitus.

In addition, the following tests are also used to determine the underlying cause of tinnitus.

• Audiological Examination: In this test, the individual is seated in a soundproof room with a headset. They are asked to note down the time when they can hear the sound, which is then compared with the average result for that age. The results obtained help in diagnosing the cause of tinnitus.

• Laboratory Examination: Blood disorders like anemia and other medical conditions like thyroid problems, vitamin deficiencies, and cardiac diseases are diagnosed with the help of laboratory investigations.

• Imaging Tests: Imaging tests like computed tomography (CT) and magnetic resonance imaging (MRI) can help identify the underlying cause.

• Movement: Movement of the eyes, neck, or extremities and clenching of the jaw are done to check if there is any alteration or worsening of the tinnitus sounds with movement.

How Is Tinnitus Treated?

There is no cure for tinnitus as such. Treatment depends on the causative factor for tinnitus. Hence the primary disease has to be treated. Along with this, supportive therapy for tinnitus is necessary.

The following are the causative treatments of tinnitus:

1. Removal of Earwax: If there is blockage of the ear due to earwax, removing it can help relieve symptoms of tinnitus.

2. Use of Hearing Aids: Tinnitus that occurs due to age-related or noise-induced hearing loss can be alleviated by using hearing aids.

3. Treating Vascular Disorders: Vascular disorders responsible for tinnitus should be treated appropriately with medications, surgery, or lifestyle modifications.

4. Stopping the Medication: If a particular medication is the cause of tinnitus, then replacing that medicine with an alternative drug would be helpful.

In addition, the following supportive treatments may be recommended:

• Noise Suppression: Tinnitus symptoms can become less noticeable when the surrounding noises are suppressed. This can be done with the help of white noise machines and masking devices. White noise machines help produce sounds similar to environmental or static sounds like rain or waves. This thereby makes the tinnitus sounds less noticeable and also improves sleep. In the case of masking devices, a low-pitched continuous sound is produced that suppresses the tinnitus sounds.

• Counseling: The mental strain accompanying tinnitus can be treated by undergoing counseling therapies like tinnitus retraining therapy and cognitive behavior therapy (CBT).

• Medications: No medication can help in the treatment of tinnitus. However, drugs used in the treatment of underlying diseases can be helpful. Also, anti-anxiety and anti-depressive medications are prescribed to reduce the associated mental trauma.

What Are the Complications of Tinnitus?

The effect of tinnitus varies from one individual to another. In some cases, tinnitus is known to have a severe impact on the quality of life of the affected individual.

Following are the complications that are associated with tinnitus:

• Headache.

• Stress.

• Tiredness.

• Problem with sleep.

• Anxiety and depression.

• Irritability.

• Difficulty in concentration.

• Problems with memory.

• Impact on the quality of both work and personal life.

Conclusion:

Tinnitus can be problematic for the patients both in terms of mental and physical health. With proper diagnosis and treatment, tinnitus can be best managed. Therefore, reach out to a health care provider at the earliest to get the best possible solution and prevent further complications.