Tinnitus
is a noise in your ear that can be constant or periodic in nature. Up to 20% of
the world’s population may have tinnitus with 85% demonstrating some degree of
hearing loss that is justification for a thorough hearing test. Yes, it is
possible to have a hearing loss without being aware of it. Hearing testing is
highly recommended. Causes?
Tinnitus is similar to any chronic annoying pain. In one sense, the nerve is
making it known to the brain that some sort of trauma has occurred to the nerve
that may involve outer hair cells in the cochlea, the 8th nerve or the pathway
to the temporal lobe in the brain. However, tinnitus can be present with
factors involving the outer ear like a foreign object, wax, middle ear disease
or infection. Even a loose hair touching the eardrum can create a scratchy or
popping sound that can be described as tinnitus. Some tinnitus is described as musical
tones, roaring, chirping, buzzing frying, clicking, hissing, or pulsating
sound, etc. Most tinnitus is described as a "ringing" sound often at
the frequency where damage may have occurred.
- Loud
noise exposure: At the top of the list for causes for tinnitus and
certainly very high in Montana is shooting guns and the use of loud
equipment. Any noise that you have to shout over to be heard may generally
be considered to be damaging to the ears. It is best to avoid loud noise
or dampen it with appropriate ear protection. Important: know the sound
levels and read the NRR rating for any ear protection that is chosen.
Become familiar with OSHA standards for acceptable loud noise exposure. Be
sure that ear protection is fitting properly and that the full benefit of
protection is being received.
- Sinus
problems: Hearing may decrease or alternate between ears with a pressure
on the same side of the head as the sinus Problem. The problem may be more
obvious upon waking in the morning or on the same side that you sleep.
- Degeneration
of the bones in the middle ear: This can cause a noise in the ears.
- Injury
to the ear, head or neck: Injury to the head or neck may involve more of a
centralize non-specific tinnitus. This condition may occur with dizziness,
headache, nausea or memory loss.
- Meniere's
Disease: True endolymphatic pressure often includes: dizziness, low
frequency hearing loss, reduced speech recognition, periodic tinnitus
accompanied by drop in hearing, fullness or pressure in the ear and
sensitivity to loud sounds. Sodium is high on the list for possible cause
of this condition as sodium affects fluid levels in the body.
- Thyroid
Disease/hypo/hyper thyroid
- Ototoxic
substances May cause damage to hair cells resulting in tinnitus.
o a. Certain antibiotics-mycins
o b. Medications/prescription drugs: Read the labels and side
effects.
o c. Substances: sodium, Quinine, Aspirin, caffeine’s, nicotine,
alcohol, ibuprofen
o d. Chemotherapy, radiation
- High
blood pressure or heart disease pulsatile tinnitus: Approximately 3%.
Pulsatile tinnitus is a pulsating sound in the ear that occurs with the
heartbeat. This type of tinnitus may involve a vascular condition. The
condition may be detected with a stethoscope on the side of the neck.
Causes are known to be hypertension, heart murmur, glomus tumor, eustachian
tube disorders (from the ATA), etc. If pulsatile tinnitus is a problem, it
is best to see a physician.
- Neural
Tumor or compression of the nerve. Occasionally, tumors occur and cause
compression of the nerve. The most common characteristic of a tumor is
unilateral tinnitus.
- TMJ:
Jaw related tinnitus.
- Type
II Diabetes. Diabetes is a common cause of hearing loss and tinnitus.
- Presbycusis:
Age related hearing loss is most commonly genetic.
- Stroke:
If tinnitus shows up with a stroke, a hearing loss may also be identified.
However, this may not always be the case.
- Lyme
disease, fibromyalgia, and thoracic outlet syndrome according to the ATA
Why is tinnitus a problem?
Many tinnitus sufferers describe the sound as being obnoxious or annoying,
especially if it occurs intermittently and appears to get loud. In this manner,
it is much the same as a chronic pain. Tinnitus can be a distraction and
interfere with daily activities mostly because it causes emotional fears,
anxiousness or fear of hearing loss. It does not technically interfere with
hearing. Mostly tinnitus may be distracting, cause loss of focus of attention
or affect emotional sensitivity more than it reduces hearing. If hearing is
reduced with tinnitus, it is likely that there is a temporary hearing
impairment or permanent hearing loss. In more severe cases, the primary concern
is for sleep interference or interference with occupation and daily activities.
What to do?
- Eliminate
or reduce loud noise exposure as a possible cause! Use ear protection with
loud noise.
- Consider
a hearing test to see if there is a hearing loss associated with tinnitus
that you may or may not be aware of.
- Consider
a medical evaluation to be certain that there is not an underlying medical
condition or substance as a cause.
- A
hearing aid in circumstances where warranted can reduce the chronic
presence of tinnitus by masking with environmental sound that was not
heard previous to its use. A hearing aid generally does not cause tinnitus
to vanish. The tinnitus will likely be more apparent when not wearing the
hearing aid at night. 16% success is noted with hearing aids in the
research. The hearing aid in most situations is likely to improve upon the
stress of tinnitus by helping with hearing.
- Tinnitus
Masker: This is an instrument that can be used to substitute a static like
noise to cover up the tinnitus if tinnitus is annoying enough to interfere
with sleep or daily activities. Habituation is a method of helping the
person to adjust. The masking noise is introduced and subsequently
gradually removed to help the person unconsciously adjust to tinnitus. In
this manner, the tinnitus is not altered in any way. The person's
conscious or unconscious attendance to it is altered to the point of
acceptance. Studies suggest 64-84% success. Search: "tinnitus pillow
maskers" to find pillows that are designed to help.
- Masking
out the sound with a radio set in between stations or with some other noise
producing instrument. Using an MP3 player with substituted sounds such as
waterfalls, cricket noise or filtered noise.
- Counseling,
therapy or tinnitus retraining: There is no known cure for tinnitus that
does not have an obvious identifiable physiological cause that can be
treated medically or by removing the cause. Most people must learn to
adjust to the sound in their head that may remain for the rest of their
lives. For most people, the treatment is some form of adjustment. Once
tinnitus remains constant, the probability that it will remain is likely.
Cognitive behavior therapy may be considered in such instances or
retraining with the use of a tinnitus masker. An 80 % success rate has
been claimed.
- Medication
Some anti-anxiety medications may help. One study supported a 76% success
rate in comparison to 1% placebo group. The primary concern is
side-effects of drugs. Medication may be suggested if other approaches are
not successful primarily to help with sleep or anxiety. It is advisable to
see a physician for consultation regarding any medications to assist with
sleep disturbance.
- Alternate
therapies Some alternative approaches may help.
Consider: The ATA (American Tinnitus Association) offers; books, articles,
tinnitus centers and self -help groups Fifth International Tinnitus Seminar
offers; research International Tinnitus Study Group; publishes a newsletter
This information from a diversity of sources and: ATA Hearing Review A Brief
Overview of Tinnitus for Dispensing Professionals, Jay and McSpaden, PHD
Hearing Review, August 2007 Hearing Journal Tinnitus: Among Many Uncertainties,
A Message Of Hope is One Constant, David Kirkwood, June 1995 Hearing Journal.