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Tinnitus: Ringing In The Ears And What To Do About It

By Sarah Sohns, AuD | October 7, 2016

Tinnitus (pronounced /tih-NITE-us/ or /TIN-ih-tus/) is the perception of sound with no external sound source. Tinnitus is a common medical condition: as many as 60 million Americans have tinnitus. It is rarely a sign of a serious medical problem but it sure can be annoying. While there’s no cure for chronic tinnitus, it often becomes less noticeable and more manageable over time or with certain intervention. You can help ease your tinnitus by educating yourself about the condition.

For many with tinnitus, they hear a ringing sound. For others, they describe whistling, buzzing, chirping, hissing, humming, roaring, or even shrieking. The sound may seem to come from one ear or both, from inside the head, or from a distance. It may be constant or intermittent, steady or pulsating.  Most tinnitus is subjective, meaning that only the person with tinnitus can hear the noise.  Sometimes it’s objective, meaning that someone else can hear it, too.

Tinnitus is typically caused by damage to hair cells in the inner ear known as the cochlea. The hair cells in our cochleas transform sound waves in to electrical signals that then travel along the auditory nerve to the brain’s auditory cortex. When the hair cells are damaged, the brain does not receive signals causing abnormal activity in the nervous system which results in the illusion of sound or tinnitus.

Common Causes of Tinnitus

  • Hearing loss: tinnitus is especially common in people over age 55 and is strongly associated with hearing loss.
  • Exposure to loud noises: occupational or recreational noise exposure can damage the auditory system and result in hearing loss and tinnitus. If you’re often exposed to loud noises, it’s important to reduce the risk of hearing loss by using personal protective devices such as earplugs, earmuffs, or custom-fitted devices.
  • Middle ear problems: head and sinus congestion, impacted ear wax, or foreign objects in the ear can cause tinnitus.
  • Medications: Aspirin and other NSAIDS, certain antibiotics, certain antiseizure drugs, certain cancer drugs, loop diuretics, tricyclic antidepressants, antimalarial drugs are medications that have been known to have tinnitus as a side-effect.  It’s important to discuss your medications with your doctor if you experience tinnitus.

When should I seek medical help or treatment?

If you experience tinnitus or develop tinnitus, it is important to see your doctor. She or he will ask you questions including describing your tinnitus, review your medication, give you a physical examination, and may do a series of tests to try to find the source of the problem. Your doctor may refer you to an audiologist: tinnitus that’s continuous, steady, and high-pitched (the most common type) generally indicates a problem in the auditory system and requires hearing tests conducted by an audiologist. Pulsatile tinnitus calls for a medical evaluation by an ear, nose, and throat physician.  MRI or CT imaging may be needed to check for a tumor or blood vessel abnormality.

There is no FDA-approved drug treatment for tinnitus. No over the counter products—supplements or herbs have been proven to be effective.  Some alternative medicine treatments, such as acupuncture may be recommended by peers but it too has been found to be no better than a placebo.

In addition to treating associated or underlying problems, there are several strategies that can help make tinnitus less bothersome. Your general health can affect the severity and impact of tinnitus. You should evaluate your diet, physical activity, sleep, and stress level and take steps to improve them.  Other strategies include cognitive behavioral therapy, tinnitus retraining therapy, masking, biofeedback and stress management. If you have age-related hearing loss, a hearing aid can often make tinnitus less noticeable by amplifying external sounds. No single approach works for everyone, and you may need to try various combinations of techniques before you find what works for you. 

About The Author
Sarah Sohns, AuD, is an Audiologist at the Temple Head & Neck Institute and an Instructor of Clinical Otolaryngology/Head and Neck Surgery at the Lewis Katz School of Medicine at Temple University. Sarah specializes in auditory-evoked responses, matching amplification technology to patient needs using evidence-based practice, tinnitus evaluation and management, validation of hearing aid fittings, and ototoxicity.



Resources

  • American Academy of Audiology, www.audiology.org
  • American Tinnitus Association, www.ata.org