What is tinnitus?
Tinnitus is the perception of sound in one or both ears or in the head when there is no external source present in the environment. It is important to know that tinnitus is a symptom, not a disease. The sensation of tinnitus can be described in a number of ways and varies from person-to-person. It may sound like a hissing, ringing, whooshing, roaring, whining, cricket-like, or any number of sounds. It may be persistent or fluctuate over time. The noises perceived may vary in pitch (such as a low roar to a high squeal) and volume (from soft to loud). Although the symptoms associated with tinnitus may be bothersome, in most cases tinnitus is not a sign of something serious. It is important, however, to be seen by an otolaryngologist (Ear, Nose and Throat physician) for a complete medical examination and by an audiologist for a comprehensive hearing examination to rule-out any serious underlying health condition.
There are two kinds of tinnitus.
- Subjective tinnitus is tinnitus only you can hear. This is the most common type of tinnitus and can be caused by outer, middle or inner ear disorders. It can also be caused by problems with the hearing (auditory) nerves or the part of your brain that interprets nerve signals as sound.
- Objective tinnitus is tinnitus your healthcare provider can hear when he or she does an examination. This type of tinnitus is rare and can be caused by caused by blood vessel problems or muscle spasms.
How common is tinnitus?
The American Tinnitus Association (ATA) estimates that over 50 million Americans experience some degree of tinnitus with approximately 10 million adults having tinnitus severe enough to seek professional assistance from a hearing healthcare provider. So, if you do experience tinnitus—YOU ARE NOT ALONE!
What causes tinnitus?
There are many underlying cause of tinnitus. It some cases, the cause may be unknown. For many people, tinnitus may be caused by one of the following conditions:
- Age-related hearing loss (known as presbycusis).
- Exposure to loud noise.
- Earwax blockage in the ear canal.
- Changes in the middle ear bones (such as a condition know as otosclerosis).
- Meniere's disease (an inner ear disorder where the tinnitus is accompanied by fluctuating hearing loss, dizziness, and ear fullness).
- Stress and depression.
- Head or neck injuries.
- Dental problems (such as temporomandibular disorders).
- Acoustic neuroma (a benign tumor on the hearing nerve also called a vestibular schwannoma).
- Cardiovascular disorders (sometimes causing a pulsatile-type tinnitus sensation).
- Certain medications (including some antibiotics, cancer medications, diuretics or water pills, quinine, aspirin taken high doses.
What are the consequences of tinnitus?
There is a wide response to the perception of tinnitus among people. For many,
tinnitus can significantly affect quality of life. Although it affects people differently, tinnitus has been associated with:
- Sleep disturbance
- Concentration difficulty
- Memory problems
- Anxiety and irritability
How will a visit to Audiology help me?
Management strategies offered by the Section of Audiology are part of a multidisciplinary approach to the treatment of tinnitus (Tinnitus Management Clinic). Sound therapy accompanied by intensive counseling and education about tinnitus are the primary avenues of tinnitus management offered by Audiology. For many patients, sound therapy it provides significant relief from tinnitus. Regardless of the form of sound therapy recommended, the rationale for its use is the same. That is, the objective of sound therapy is to increase the level of external sounds in order to decrease your perception of the tinnitus. Sound therapy can also prove to be soothing or may serve as a distracter from the tinnitus. Following are brief summarizes of sound therapy options.
- Environment Enrichment Devices: A variety of simple-to-use devices (including CDs) can be used to increase the level of background sound to decrease your perception of tinnitus. These include: tabletop sound machines that can generate different types of sounds (for example, rain, wind, waterfalls); CD/mp3 recordings of music and/or nature/environmental sounds.
- Sound Generators: These adjustable ear-level devices produce a broadband sound (“sshhh”) that is delivered directly to the ear. These devices can be used for both tinnitus masking and habituation-based treatments such as tinnitus retraining therapy. Sound generators provide a control over their tinnitus and allow patients to pay less attention to the tinnitus. When used for masking purposes, sound generators may provide immediate relief for may people. Habituations treatments may last up to 12- 18 months but may provide greater long-term benefit.
- Neuromonics: A pleasant acoustic signal (embedded in music) is delivered to the ear through high fidelity earphones and a small credit-card size processor. This form of music therapy is a very pleasant alternative and requires at least 6 months of active treatment time. The music also tends to enhance relaxation to help an individual cope with the tinnitus.
- Hearing Aids: Hearing aids are beneficial for patients who have both tinnitus and hearing loss. Hearing aids provide relief from the tinnitus by amplifying the ambient background sounds while also improving communication function by amplifying incoming speech sounds.
- Combination Instruments: These units are appropriate for people who require the use of hearing aids and may gain additional benefit from the use of a sound generator. A combination unit is both a hearing aid and sound generator in a single unit. An mp3 player can also be added if music is found to be beneficial in providing relief.