What Is Tinnitus?
Tinnitus is more a symptom than a condition. It is the perception of sound in the absence of an external source. Though “tinnitus” is from a Latin word meaning to ring like a bell, the perceived sound is variously described not only as ringing, but also buzzing, hissing, or even roaring, whistling, or pounding. Almost everyone experiences intermittent tinnitus once in a while (especially in a quiet room), and it is nothing to be concerned about. Persistent tinnitus, however, can be distressing psychologically, since it can interfere with your ability to carry out everyday activities with these noises in or around your ears or head. It may also interfere with sleep, and it is sometimes a sign of a more serious underlying disorder. Treatment depends upon identifying the underlying problem, though often the cause is not identified. But whatever is responsible, there is usually damage to the microscopic hair cells (nerve endings) in the inner ear, particularly those responsible for detecting high-frequency sounds.
There is a less common form of tinnitus—objective tinnitus—in which the sounds you hear can also be heard by your doctor listening with a stethoscope. Usually these sounds are produced by either movement of the jaw or the flow of blood in major blood vessels of the head and neck.
Who Gets Tinnitus?
Researchers estimate that about 50 million Americans have occasional or constant tinnitus. About 12 million have such severe symptoms that they have sought medical help. The remainder experience a low level of noise that can still be a nuisance.
Persistent or intermittent noises in one or both ears (often described as ringing, buzzing, hissing, humming, whistling, roaring, or pounding).
Tinnitus can be associated with all types of hearing loss (though it doesn’t cause hearing loss) and may be a symptom of almost any ear disorder, including labyrinthitis, Ménière’s disease, otitis media, otosclerosis, acoustic neuroma, and presbycusis. About 80% of Americans with some degree of hearing loss also experience tinnitus.
Exposure to loud noises such as gunshots, jet engines, industrial machinery, amplified music and jack hammers is linked with tinnitus.
Certain conditions can produce an actual sound near the ear that an examiner can hear with a stethoscope. This phenomenon is known as objective tinnitus and can be caused by increased intracranial pressure, an aneurysm, temporomandibular jaw joint disorders, normal blood flow through an artery or vein, or a tumor pressing on a blood vessel or nerve.
Drugs such as caffeine, chemotherapy agents, aspirin, propranolol, levodopa, and quinidine can cause tinnitus.
More often than not no cause can be established.
What If You Do Nothing?
Tinnitus rarely goes away, and it often intensifies with age. But you can learn to live with it.
A patient interview and physical examination, including a detailed description of the sounds and when they occur, are conducted. You may be referred to an otologist (ear specialist) or otolaryngologist (ear, nose, and throat specialist). The specialist can determine if the problem is due to primarily to an ear condition or to another medical condition.
Audiometry (hearing tests) may be used to measure any hearing loss.
X-rays, CT scans, MRI or ultrasound scans may be used to detect a tumor or other abnormality.
Overcoming the sounds of tinnitus with less bothersome sounds is perhaps the most promising method of dealing with the condition. Background sound or static from a radio or television may successfully mask mild tinnitus and help sufferers to fall asleep. A white-noise machine that produces a low continuous noise can offer the same effect.
Sedatives may be prescribed to alleviate chronic sleep disturbance, although this is not recommended as a long-term solution.
Caffeine and sodium reduction can be of benefit. Large doses of aspirin should be avoided if possible. Although many herbal/mineral/vitamin supplements claim to reduce tinnitus, there is little scientific information available to show that they are consistently effective.
Hearing aids can amplify ambient sound and drown out tinnitus of medium or low pitch.
In more severe cases tinnitus masking may be prescribed. A masking device is worn like a hearing aid and emits a steady, monotonous noise like wind in the trees or a hum—a sound that quick becomes familiar and can be easily ignored. Masking devices for tinnitus must be approved by the FDA. Some devices are combined with hearing aids.
Tinnitus and depression may co-exist. Consult your doctor if you develop any symptoms of depression.
Tinnitus clinics and support groups are available in most major cities. They offer programs that improve coping skills. You can contact the American Tinnitus Association—www.ata.org—for groups near you.
Surgery may be used to correct an underlying disorder, such as a tumor, but may be ineffective in eliminating the tinnitus.
Prompt treatment with antibiotics can avert the disorder in cases of otitis media or other ear infections.
Noise-induced tinnitus can be prevented by avoiding loud sounds or using ear plugs or muffs.
Drug-induced tinnitus can be prevented by avoiding the drugs mentioned above.
When To Call Your Doctor
Call a doctor if ringing, buzzing, or other sounds disrupt daily activities or sleeping habits. Your physician may refer you to a specialist for further evaluation and treatment.
Reviewed by Alan Lipkin, M.D., Otolaryngologist, Private Practice, Denver, Colorado. Review provided by VeriMed Healthcare Network.