Understanding Tinnitus: Symptoms and Treatment

Tinnitus is a condition frequently defined as hearing sounds without the presence of external sounds. It is characterized by an intermittent or continuous ringing, swishing, hissing, clicking or similar type noise that appears to originate from the inner ear or head. It can affect either one or both ears and the sound can range from a low hiss to a high pitch squeal or whine. Tinnitus is not actually a disease, but is a symptom of another underlying problem or condition.

tinnitusThere are two types of tinnitus; subjective and objective tinnitus. Subjective tinnitus is the most common type and is a noise that only the patient is able to hear. Subjective tinnitus is most frequently associated with some type of noise-induced hearing loss but can also be caused by the following situations:

• Age-related hearing loss
• Exposure to loud noise
• Ear canal blockage such as from earwax
• Stiffening of the bones in the middle ear (otosclerosis)
• Medications such as antibiotics, cancer medications, diuretics, certain antidepressants and aspirin taken in high doses; in reality tinnitus is listed as a potential side effect for approximately 200 prescription and nonprescription medications
• Medical conditionals such as high blood pressure, cardiovascular disease, circulatory problems, diabetes, hypothyroidism, anemia and certain allergies

Some less common causes are:

• TMJ disorders
• A benign tumor on the cranial nerve leading to the inner ear
• Head or neck trauma
• Meniere’s disease

Objective tinnitus is much rarer, and can actually be heard by a physician during a physical examination. It can originate from muscle spasms that cause clicks or crackling around the middle ear or sometimes a pulsing sound resulting from altered blood flow or increased blood turbulence near the ear.

When seeking treatment for tinnitus, physicians first try and determine the underlying cause of the condition; sometimes it is as simple as removing excessive earwax from the ear or a foreign object, such as a hair that is rubbing against the eardrum. If the physician doesn’t immediately ascertain the underlying problem, they will order additional testing such as a hearing test, MRI scan, CT scan or an ABR (auditory brain stem response) test. If an underlying cause is found, they will treat the problem and the tinnitus will typically be resolved.

Unfortunately however, the underlying cause is frequently undetermined and the condition persists. When this happens, patients often seek alternative treatment to find some relief. Tinnitus retraining therapy is one form of treatment that attempts to retrain the brain to become accustomed to the abnormal sound to the point where it “ignores” the noise. Audiologists and otolaryngologists typically work in conjunction and utilize a combination of counselling and the use of a sound generator.

Hearing aids are also exceptionally useful in providing tinnitus relief, especially if the patient suffers from some form of hearing loss as well. There are several different hearing aid options available and an audiologist can recommend the right one depending on the severity and the particular problem. Untreated tinnitus can have a significant impact on an individual’s quality of life; fatigue, depression, anxiety, irritability, insomnia, lack of concentration and stress are common consequences of tinnitus. Seeking help to reduce or eliminate tinnitus can help to restore quality of life and alleviate any side effects of the condition.

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