Understanding the Basics of Tinnitus

What Does Tinnitus Mean?

Tinnitus is described as a sensation of ringing that is perceived in the absence of an external sound. It is not a disease per se, but the symptom of an underlying condition. It can be so disturbing that the person is unable to carry on with his routine work and feels depressed and agitated. It can present as a buzzing, roaring, hissing, or whistling noise in the ears. It is most commonly referred to as ‘ringing in the ears.’

As there is no external source for these sounds that people hear, these sounds are also referred to as phantom sounds. It can, at times, interfere with real sounds that people are supposed to hear and can lead to anxiety and stress.

An individual can hear sound in either one ear or both the ears, and it is more common in older adults, but can affect people of all ages. It affects around 15 to 20 percent of people worldwide. These symptoms are generally not a sign of something serious, but it can worsen with age and become bothersome. If it is due to infections or ear blockages, then treating the underlying cause will also help get rid of this annoying sound.

What Are the Types of Tinnitus?

There are two types of tinnitus.

• Subjective Tinnitus - When the affected individual is the only one perceiving it. This is the more common type.

• Objective Tinnitus - Rarely, a serious condition may be the cause of tinnitus, and this can be perceived by the examining doctor and other people close to the affected individual. It is usually due to the presence of abnormal blood vessels in the ears. The doctor can identify pulsating sounds when the affected person’s heart beats.

What Are the Signs and Symptoms of Tinnitus?

The most common description is that of a sensation of ringing in the ears. But, it may also include other sensations such as the following.

• Buzzing.

• Whooshing.

• Clicking.

• Hissing.

• The sensation may be present continuously or on and off.

• The noise may be high pitched or dull.

• It may be perceived on one side or both.

What Causes Tinnitus?

The following are some of the most common causes of tinnitus:

1) Inner Ear Hair Cell Damage - This is the most common cause. Normally, sound waves make tiny hair in the inner ear move and trigger cells in the inner ear to send a signal to the brain through the auditory nerve. These signals are then interpreted by the brain as sounds. When these tiny hairs get damaged or broken, random electrical signals reach the brain resulting in tinnitus.

2) Presbycusis - It is also called hearing loss with age or age-related hearing loss. Age-related hearing loss that starts around 60 years of age can also cause tinnitus.

3) Exposure to Extreme Sounds - Exposure to sounds such as a bomb going off, heavy equipment, chain saws, etc., can cause such ringing sensation. It can also be a result of listening to really loud songs using earphones or headphones for long periods.

4) Earwax - The wax in the ear protects the ear canal by not allowing dust particles to pass through. But when too much wax gets accumulated, it causes hearing loss or irritation, resulting in tinnitus.

5) Otosclerosis - It is the stiffening of the bones in the middle ear. This condition might affect the hearing and cause tinnitus.

6) Meniere's Disease - Meniere's disease is a condition that is caused by abnormal fluid pressure in the inner ear. Tinnitus is considered to be an early indicator of this disorder.

7) Atherosclerosis - The buildup of fats in the major blood vessels with age is called atherosclerosis. If the vessels near the middle or inner ear get affected, it can make the blood vessels rigid, which makes the blood flow forcibly with each heartbeat. This results in the person learning their heartbeats more prominently.

8) Head or Neck Injuries - Both these injuries can affect the inner ear and can cause one-sided tinnitus.

9) Acoustic Neuroma - It is a benign tumor that originates in the cranial nerve, which is a nerve that runs from the brain to the inner ear. This nerve controls balance and hearing.

10) Eustachian Tube Dysfunction - The eustachian tube, which is the tube that connects the middle ear to the throat, stays expanded throughout. This makes the ear feel full.

11) Inner Ear Muscle Spasms - The inner ear muscles can spasm resulting in hearing loss, ear fullness, and tinnitus. Muscle spasm can be due to neurologic diseases like multiple sclerosis.

12) Temporomandibular (TMJ) Disorders - The joint between the head of the lower jaw and skull, present on each side of the head, is called TMJ. Any problems in this joint can result in tinnitus.

13) Hypertension - High blood pressure can make tinnitus more prominent.

14) Medications - The following medications can cause or worsen tinnitus:

• Antibiotics - Erythromycin, Neomycin, and Vancomycin.

• Antimalarial drug - Quinine.

• Antidepressants.

• Chemotherapy - Methotrexate and Cisplatin.

• Diuretics - Bumetanide and Furosemide.

• Aspirin if taken in high doses.

What Are the Risk Factors of Tinnitus?

• Having a job that exposes one to loud noise all the time.

• Listening to music on earphones at high volume.

• Age-related hearing problems.

• Male gender.

• Smoking.

• Conditions that affect blood flow in the arteries.

How Is Tinnitus Diagnosed?

Any person who experiences tinnitus should be examined to rule out the possibility of a more severe issue. A person should also be examined if they have severe or worsening ongoing ringing, buzzing, or other noises in their ears. There may be a need for additional specialty exams.

Hearing tests can help reveal more details about the possible tinnitus reason. Depending on the findings of the medical history and physical evaluation, additional tests, such as brain imaging with Magnetic resonance imaging (MRI) or computed tomography (CT) scans, may be required.

When to Consult a Doctor for Tinnitus?

In the following situations, make sure that patient should consult a doctor:

• If the sounds bother too much.

• If one develops these sounds after an upper respiratory infection (cold or flu).

• If the sounds do not go away in a week.

• If tinnitus occurs suddenly or with no apparent cause.

• If one also experiences hearing loss or dizziness.

What Are the Treatment Options for Tinnitus?

It depends on the underlying cause of tinnitus. If the cause is unknown, they are managed by the following treatments.

• Tinnitus maskers: It is a device that emits white noise to offer a distraction from the uncomfortable ringing. With the assistance of a physician, individuals can make purchases of tinnitus maskers.

• Tinnitus retraining: It is a method to retrain the brain so that it learns to ignore the sound.

• Counseling: To learn about tinnitus and how to cope with it.

• Cognitive behavior therapy: Similar to retraining, this therapy is given to adapt to the noise so it does not interfere anymore.

Home Remedies:

• Avoid exposure to loud noise until the patient gets better.

• Many report a temporary relief from listening to a white noise such as the sound of the fan running or static from radio or television.

• Relaxation may help as this condition is worsened by stress.

• Staying away from alcohol and caffeine prevents it from getting aggravated.

How Can Tinnitus Be Prevented?

• Use earmuffs to protect the ears from loud sounds at work.

• Avoid continuous use of earphones and headphones at high volume.

• Abstain from putting earbuds, keys and other objects in the ear.

• Have a healthy diet, exercise regularly and keep the heart healthy.

Complications:

This refers to the accompanying symptoms that the person is likely to experience.

• Weakness.

• Anxiety.

• Depression.

• Insomnia.

• Difficulty focusing on tasks.

• Forgetfulness.

Conclusion:

To conclude, tinnitus can highly impact someone’s quality of life. The effect of tinnitus on daily living varies, frequently depending on how severe the noise is. A quarter of those who experience tinnitus say that it gets worse over time. It is unlikely that long-term tinnitus will completely go away. However, it frequently gets simpler to cope with tinnitus over time, particularly when hearing loss is also present.