Tinnitus

Tinnitus is the perception of a sound that has no external source. Some of the more common sounds reported are ringing, humming, buzzing, and cricket-like. It can be constant or intermittent and is heard in one ear, both ears or in the head. Tinnitus can originate in the middle ear (behind the eardrum) or in the sensorineural auditory system.

THE MOST COMMON CAUSES ARE:

• Noise exposure (e.g. from shooting or machines at work)
• A natural part of the aging process
• Head injury (e.g. from a car accident or fall)
• As a side effect of medications (e.g. aspirin — see ototoxic drugs)

Many causes are unknown.

Tinnitus is usually accompanied by hearing loss, and sometimes accompanied by loudness hyperacusis (when moderately loud sounds are perceived as very loud). Some 50 million adults suffer from tinnitus (it can also affect children). For 12 million, the problem is severe enough that it impacts their everyday life. Because tinnitus can be a symptom of a more serious disorder, it is important to have an appropriate health evaluation, from an audiologist or physician.

The Impact of Tinnitus

Tinnitus affects people differently. The most common areas in which tinnitus has a direct influence are:

• Thoughts and emotions. Some are annoyed, bothered, depressed, anxious or angry about their tinnitus. They think and focus on their tinnitus often.
• Hearing. In some, the sound of the tinnitus competes with or masks speech or environmental sound perception.
• Sleep. Many tinnitus sufferers report that their tinnitus interferes with them getting to sleep. It can also make it more difficult to get back to sleep when they wake up in the middle of the night.
• Concentration. Some tinnitus sufferers report that they have difficulty focusing on a task because of their tinnitus. This might include reading a book or the newspaper.

The Treatment of Tinnitus

For most tinnitus sufferers, there is no cure. There is no pill or surgery that has been shown to eliminate tinnitus in scientific studies that have been replicated and accepted by the healthcare community.

There are some important exceptions to this. Some forms of tinnitus, particularly middle-ear tinnitus, can be treated. Sometimes a medication can cause tinnitus, and stopping or changing medications can eliminate the tinnitus (check with whoever prescribed the medication).

There are two broad categories of treatments that help people adjust to their tinnitus.

• Counseling. Counseling can be beneficial with thoughts and emotions, hearing, sleep and concentration. One example of this approach is Tinnitus Activities Treatment, which includes individualized collaborative counseling in each of these areas.
• Sound Therapy. Many tinnitus sufferers report that the presence of background sound reduces the prominence or the loudness of their tinnitus. The background sound can be present in the environment (e.g. fan noise). There are nonwearable devices that produce pleasant background sound (e.g. raindrops). Additionally, wearable maskers or sound generators are available that produce a ‘shhh’ noise (these can also be combined with hearing aids). The use of hearing aids improves communication, reduces the stress associated with intensive listening, and also can partially mask the tinnitus. Music can also be very effective in nonwearable and wearable devices.
• Self-help Books. There are also some excellent self-help books available.

Conclusion

If you or someone you know suffers from tinnitus, I urge you to contact a physician who specializes in the ear (an otologist or otolaryngologist) or an audiologist as soon as possible.

Richard Tyler, PhD – The University of Iowa, Iowa City, IA