Sunday, December 21, 2014

Definition

A ringing, buzzing, whistling, hissing or other noise, heard in the ear in the absence of environmental noise.

Description

Tinnitus, from the Latin word "tinnire," meaning to ring or tinkle like a bell, is a hearing ailment that affects over 35 million Americans. Most often, it affects people over the age of 40, but it is now being seen more frequently in young people who are exposed to loud, amplified music.

Tinnitus is characterized by annoying ear noises, which can be soft as a whistle or loud enough to be completely debilitating. Tinnitus can also cause sleep disturbance and interfere with concentration.

Tinnitus is not a disease in itself, but a symptom that something is wrong in the auditory system. While theories exist, the actual mechanism responsible for tinnitus remains unknown, as does the origin of the ear noises. But tinnitus is not just in the patient's imagination. It is a physiological or neurological event that has not yet been identified.

Tinnitus can occur in a single episode, temporarily for a few days or weeks, or permanently. It can occur in one ear (unilaterally) or both ears (bilaterally). While more common in both ears, the rare unilateral ailment can be more serious.

Causes

Acoustic trauma, from noises such as loud music, concerts and gunshots, can cause tinnitus.

Noises that can cause tinnitus with long-term exposure occur in the home and workplace environments. These include noise from welding equipment, power saws, jackhammers, vacuum cleaners, power mowers, snow blowers and some kitchen appliances.

The loud, sustained sounds created by recreational machines, such as powerboats and snowmobiles, can also be damaging.

Other causes of tinnitus are allergies, diabetes, high cholesterol, high blood pressure, ear wax buildup, tumors, Meniere's disease, medications (sometimes too much aspirin) and old age (the natural degeneration of hearing).

A rare form of tinnitus is caused by abnormalities in blood vessels around the ear which cause noise when muscles contract in the ear.

When physicians can identify the cause of tinnitus (e.g., earwax buildup, high cholesterol or the presence of a tumor), relief may be possible through treatment available for those conditions.

Diagnosis

In addition to taking a complete medical history, your physician will do a physical exam that will include screening for hearing loss or other deficiencies. You also may be referred for formal hearing tests.

Treatment

If an underlying cause of tinnitus can be found, then of course, it should be treated. Hypertension should be lowered and anemia corrected. Meniere's disease, characterized by tinnitus, vertigo and hearing loss, may respond to diuretics and vasodilators, but if your tinnitus does not improve with time, your doctor may suggest various treatments, ranging from home remedies and commonsense measures to highly specialized surgical treatment.

One simple treatment is to play background music while at home. This often blocks tinnitus and is especially useful when trying to fall asleep. A Beethoven sonata is soothing to one's clamoring ear and helps to invite slumber.

Tinnitus maskers are helpful to some. This device fits like a hearing aid and is tuned to play sounds at the same frequency as the person's tinnitus, thus producing a dampening effect on the unwanted noise. If hearing loss accompanies tinnitus, a hearing amplifier alone may raise incoming sound enough to block the tinnitus. A hearing aid and masker in one unit can also be tried.

Low doses of tranquilizers can reduce tinnitus, perhaps by direct effect on the cochlea or acoustic nerve, or perhaps by alleviating anxiety which often accompanies tinnitus.

Oral antidepressants (e.g., nortriptyline orally at bedtime) may be effective for symptom relief.

If stress-induced tinnitus is present, psychological counseling, hypnosis or biofeedback may be beneficial. These can help reduce the emotional tension that produces unwanted muscle spasm in the tiny tensor tympani or stapedius muscles within the ear cavity.

Your physician may also suggest surgical treatment.

Questions

How can the underlying cause of tinnitus be found?

Are there any tests that need to be done to diagnose the cause?

What is the cause of the tinnitus?

What treatment will you be recommending?

Is this reversible?

Will you be prescribing any medication? What are the side effects?