Tinnitus

Tinnitus is the perception of abnormal ear or head noises. Tinnitus is a symptom that often serves as a warning of other problems, including hearing loss and tumors.

Causes

Many diseases and conditions are associated with Tinnitus, including:
  • Hearing loss, most frequent cause of persistent tinnitus
  • Exposure to loud noises
  • Wax or a foreign body in the ear canal
  • Temporomandibular joint disease (TMJ)
  • Sinus infection
  • Allergies
  • Ear infection
  • Fluid in the ear
  • Ruptured membrane in the ear
  • Ménières disease
  • High or low blood pressure
  • Injury to the head or neck
  • Tumors
  • Blood vessel disorders, such as an aneurysm or hardening of the arteries
  • Diabetes
  • Thyroid problems
Brief Tinnitus that is not persistent can be normal in adults with normal hearing.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.
  • Exposure to loud noises
  • Depression
  • Stress
  • Fatigue
  • Anxiety
  • Certain medications:
    • Aspirin
    • Quinine and its derivatives
    • Some antibiotics [aminoglycosides]
    • Some diuretics [water pills]
  • Toxins:
    • Heavy metals
    • Carbon monoxide
    • Alcohol

Symptoms

The sensations of Tinnitus may have the following characteristics:
  • Ringing, roaring, buzzing, whistling, or hissing sounds
  • Intermittent, continuous, or pulsatile quality
  • Same or varying intensity
  • Single or multiple tones
  • Ringing that comes and goes
  • More annoying symptoms at night or when there are fewer distractions
  • Sensation of normal internal events such as blood pulsing or muscles contracting

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Special attention will be paid to your head, neck and ears.
You will be asked questions about:
  • Your sensations
  • Medication use
  • Whether breathing, dizziness or anything else increases or decreases the sensation
The doctor will look at your ear canal and eardrum using an instrument with a light that is held at the external opening of the ear. A tuning fork can help evaluate hearing. You should receive a complete hearing test. Other tests, such as an MRI scan, may be ordered to rule out serious conditions.

Treatment

Tinnitus treatment depends on what is causing the symptoms. This may mean, for example:
  • Wearing a specially made splint to help manage TMJ
  • Taking antibiotics for a sinus or ear infection
  • Removal of wax from the ear canal
Therapy aims to eliminate or reduce the bothersome sensations. Treatment may include: Medication
Antidepressants may be helpful in some patients.
Mechanical Devices
Devices include:
Hearing Aid - relieves tinnitus and improves hearing in some patients with hearing loss
Tinnitus Masker - a device that emits a low level of white noise that helps cover up the internal sensations and block out external noises
Lifestyle and Self-Care Measures
Measures include:
  • Learn and practice stress-management and relaxation techniques.
  • Biofeedback may help. Biofeedback teaches people how to control body functions they normally do not think about.
  • Consider seeing a counselor to develop new coping skills and relaxation techniques.
  • Consider joining a support group.
  • Avoid anything that makes tinnitus sensations worse, such as:
    • Loud noises
    • Alcohol
    • Smoking
    • Salt
    • Caffeine
  • Exercise regularly to improve circulation.
  • Make time to relax and get enough sleep.
  • Playing a radio or a white-noise machine for about 30 minutes at bedtime may help relieve the ringing sensations at night.
Surgery
Surgery may help relieve certain causes of tinnitus. Tinnitus caused by a tumor frequently subsides after the growth is removed. Abnormalities in the blood vessels can often be corrected with surgery. Surgery may also be an option for patients with Ménières disease.

Prevention

You may be able to prevent Tinnitus from developing with a few simple measures:
  • Avoid exposure to excessive noise.
  • Wear earplugs in noisy situations.
  • Wear earmuffs when mowing the grass.
  • Learn and practice stress-management and relaxation techniques.
  • Limit use of drugs that damage hearing.