What is tinnitus?
In tinnitus, sound is perceived without any external source, so other people cannot hear it.
There are several types of tinnitus, including ringing, buzzing, and roaring, among others. It is estimated that 10 to 25% of adults have tinnitus. Tinnitus can also affect children. Over time, tinnitus can improve or even disappear for children and adults, but it can also worsen in some cases. Chronic tinnitus lasts for more than three months.
It is unclear what causes tinnitus, but most people who suffer from it suffer from hearing loss to some degree. Tinnitus is rarely associated with serious medical problems and is usually not severe enough to interfere with daily life. Some people, however, report that it affects mood, sleep, and concentration. Tinnitus can cause anxiety and depression when severe.
Tinnitus cannot be cured, but it can be reduced with sound therapy devices (including hearing aids), behavioral therapies, and medication.
What are the symptoms of tinnitus?
Tinnitus symptoms can differ between individuals. You may perceive noises in one, two or all sections of your head; this could be a ringing, buzzing, humming, hissing or a squeal. It may be quiet or loud and low or high-pitched. The sound might come and go or stay constant; certain body movements such as neck turning, eye movement or simply touching a certain area can cause altered perception of the sound – somatosensory tinnitus.
The sounds of tinnitus are usually subjective, meaning only you can hear them. Often, the sound pulses rhythmically, often in time with your heartbeat, so it can be considered objective tinnitus if a doctor can hear the sounds with a stethoscope. The cause of objective tinnitus is known and can be treated.
What causes tinnitus?
Tinnitus is not fully understood, but the following factors have been linked to it:
- The most common cause of tinnitus is exposure to loud noise at work, during sports events, or at concerts. As a result of loud noises they may have experienced from gunfire, machinery, bomb blasts, or other similar sources, veterans often suffer from tinnitus as a service-related disability.
- Tinnitus is strongly associated with hearing loss and factors like aging and loud noise. However, some people with hearing loss do not develop tinnitus.
- Certain medications, especially those taken in high doses, can cause tinnitus as a side effect. There are many medications associated with tinnitus, including non-steroidal anti-inflammatory medications (for example, ibuprofen, naproxen, and aspirin), certain antibiotics, anticancer medications, antimalaria medications, and antidepressants.
- The ear canal can be blocked by earwax or an ear infection causing tinnitus.
- A head or neck injury can damage structures of the ear, the nerves that carry sound signals to the brain, or the areas of the brain that process sound, causing tinnitus.
There are a few less common risk factors for tinnitus, including:
- Tinnitus is a symptom of Ménière’s disease, an inner ear disorder that can also cause balance problems and hearing loss.
- A clenched jaw or grinding teeth can damage the surrounding tissues, causing tinnitus.
- Vestibular schwannoma (acoustic neuroma) is a benign tumor on a nerve connecting the inner ear to the brain that can cause tinnitus.
- High blood pressure, atherosclerosis, or malformations of blood vessels can affect blood flow and cause tinnitus.
- There is a link between tinnitus and diabetes, migraines, thyroid disorders, anemia, and autoimmune disorders such as lupus and multiple sclerosis.
- Some people develop tinnitus for no apparent reason, but others have a variety of possible causes.
What is the ear’s perception of noise?
Among the leading theories of tinnitus is that damaged nerves in the inner ear cause tinnitus by signaling to parts of the brain that process sound. Despite the fact that tinnitus appears to occur in the ear, the phantom sounds are actually produced by the auditory cortex in your brain.
In several studies, tinnitus has been linked to abnormal interactions between the auditory cortex and other neural circuits. Since the auditory cortex communicates with other parts of the brain, including those that control attention and emotions, some people with tinnitus have changes in these non-auditory brain regions.
We would be happy to see you in our office for initial analysis and treatment of hearing loss. Many times, we have technology or treatment methods available that can help.
In some cases, you might be referred to an otolaryngologist (also called an ENT or an ear, nose, and throat doctor). A ENT will examine your head, neck, and ears, ask you about the tinnitus sounds and when they started, as well as refer you to an audiologist who can assess your hearing and tinnitus.
The ENT may order imaging tests like magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound if your tinnitus pulses. Your tinnitus may be caused by a structural or underlying medical condition, which can be revealed by imaging tests.
What about research?
Researchers at the National Institutes of Health (NIH) and other research centers, many of which are funded by NIDCD, are exploring tinnitus and developing new treatment strategies. Since tinnitus appears to be caused by changes in neural networks in the brain, researchers are testing whether magnetic or electrical stimulation of the brain can help treat it.
The following topics are currently being researched:
- In addition to suppressing tinnitus, cochlear implants restore functional hearing in those with severe to profound hearing loss. In order to suppress tinnitus without damaging acoustic hearing, researchers are using non-invasive electrical stimulation on the inner ear to reduce tinnitus without damaging acoustic hearing.
- Acoustic stimulation can be combined with other types of electric stimulation on the tongue, head, or neck in order to provide long-term relief from tinnitus.
- In repetitive transcranial magnetic stimulation (rTMS), short magnetic pulses are delivered to the brain using an electromagnetic coil. Since preliminary trials of rTMS have yielded mixed results, researchers are now determining the ideal coil placement and frequency of patients’ visits.
- Deep brain stimulation (DBS) is usually employed to treat those with certain movement disorders or neuropsychiatric conditions. To the surprise of some individuals undergoing this therapy, they experienced a decrease in tinnitus symptoms. Contrasting rTMS, invasive surgery is necessary for the insertion of electrodes in the brain with DBS. Initial results from employing DBS to reduce tinnitus have been encouraging; however, more research is essential to determine whether this method should be routinely used solely for tinnitus management.
- Tinnitus is being treated with a number of medications, but none have been approved by the U.S. Food and Drug Administration.
- Researchers are developing second-generation versions of a drug that reduces mice’s tinnitus.
- Cochleas sense sound in the inner ear. Researchers are looking at how tinnitus is linked to hyperactivity in central auditory neurons. Scientists are studying the cellular mechanisms that cause increased activity in order to control and relieve tinnitus symptoms.
- The scientists are reviewing a large genetic database of hearing loss and tinnitus patients in order to identify genetic risk factors. Genetic associations may make it possible to predict, prevent, screen, and treat hearing impairment and tinnitus associated with aging.
- There is a wide range in tinnitus symptoms and brain imaging results. Researchers are studying data collected from participants monitoring their condition with a smartphone app and using brain imaging technology in order to better understand the different types of tinnitus. In order to identify which treatments will be most effective for different types of tinnitus, they are trying to identify distinct tinnitus profiles.
Talk to us if you feel tinnitus relief could be beneficial to you at your initial consultation. Many modern hearing aids have built-in sound therapy and tinnitus masking functions.