Tinnitus is the perception of sound experienced by a person as noise in the absence of external noise. Tinnitus is not a disease itself. The sound can be buzzing, hissing, whistling, roaring, ringing, humming or hissing. It can be continuous or occur intermittently. It may be pulsatile or non-pulsatile. Tinnitus does not have to dramatically affect your quality of life. You should avoid focussing too much attention on your tinnitus. Avoid excessive noise, find relaxation and stress management techniques that work for you.
Approximately, 17 to 20% of Australians suffer from some degree of tinnitus, varying from mild to severe. It is common for a person's to be affected by stress or tiredness.
Tinnitus can be triggerred along the auditory pathway. The majority of patients have tinnitus due to hearing loss at the cochlea or cochlear nerve level. PET scanning and functional MRI studies indicate that the loss of cochlear input to neurons in the central auditory pathways (such as occurs with cochlear hair cell damage due to ototoxicity, noise trauma or a lesion of the cochlear nerve) can result in abnormal neural activity in the auditory cortex causing tinnitus.
Causes of tinnitus:
- Exposure to loud sounds
- Extreme stress and trauma
- Otosclerosis (fixation of the stapedius in the middle ear)
- Meniere disease (see previous article for more details)
- Some medications
- Presbycusis (sensorineural hearing loss with aging)
- Eustachian tube dysfunction (see previous article for more details)
- Vascular disorders (usually pulsatile tinnitus) such as arterial bruits, arteriovenous shunts, paraganglioma and venous hums. This condition is rare.
- Neurological disorders due to spasm of one or both muscles within the middle ear (the tensor tympani and the stapedius muscle)
- Vestibular schwannoma (tinnitus usually on one side)
Effects of tinnitus:
Tinnitus can be extremely debilitating, affecting a person's ability to work or cope with normal life activities. People with tinnitus may suffer from extreme stress, depression, frequent mood swings, depression, anxiety attacks, tension, irritability, frustration, poor concentration and sleep problems.
Treatment of tinnitus:
Treatment of tinnitus include identifying the underlying treatable causes and addressing the effect of tinnitus on quality of life. For many patients, tinnitus is a chronic condition; goals of treatment are to lessen its impact and associated disability, rather than to achieve absolute cure.
- Avoid exposure to loud sounds will lessen tinnitus and prevent further hearing loss
- Minimising stress. Ensure adequate sleep and do relaxation technique. Depending the severity of trauma and which area of ear is involved, treatment will be directed at the underlying problem
- Referring patient to ENT specialist for surgery for Otosclerosis may improve the tinnitus condition
- Cease any medications that may be causing tinnitus including some of the supplements
- Hearing aids in patients with presbycusis may result in an improvement in tinnitus symptoms
- For pulsatile tinnitus, consideration for CT or MRI of brain to find out any causes of vascular disorders
- Relaxation technique or Cognitive behavioural therapy for muscles spasm
- If MRI confirms tumour in inner ear, referral to ENT specialist or neurosurgeon for removal of the tumour
- In very rare circumstances when tinnitus become unbearable, surgical resection of cochlear nerve may the last resort but this will result in permanent deafness
There are no specific medications for treatment of tinnitus. Beware of advertisement claim there is medication to cure tinnitus.
