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Everything You’ve Always Wanted to Know About Tinnitus But Were Too Shy to Ask

Description: If you hear some kind of continuous or intermittent ringing in your ears occasionally, you might be experiencing tinnitus. Read all about the causes, symptoms, and solutions in this article.


The medical condition known as tinnitus (ti-ni-tis) is a sensation of hearing some ringing, hissing, chirping, buzzing, and whistling sounds either continuously or intermittently. Additionally, the sound varies in loudness and is at its worst when there is no background noise or the noise is low especially at night when you are lying in your bed.
   
Tinnitus affects one out of five individuals – around 50 million people in the U.S. -- and while it isn’t serious, the appearance of tinnitus symptoms may mean that there are underlying conditions like an ear injury, circulatory system disorder or age-related loss of hearing in the individual. There are cases in which the sound is in sync with the heart beat known as pulsatile tinnitus.

The Two Types of Tinnitus


If you are not aware of what causes tinnitus, you need to understand that this condition is not responsible for a person’s loss of hearing. Some people who experience it, in fact, have no hearing difficulties, and others have even become more sound-sensitive. Admittedly, tinnitus can often interfere with a person’s ability to hear actual sounds or be able to concentrate.

In some cases, however, it continues even after the underlying conditions have been treated. Blockages or infections in the ear can cause tinnitus and although it can be annoying, it improves with the right tinnitus treatment. Traditional and alternative therapies can bring considerable relief by covering up unwanted sounds or decreasing their volume.

Most people are unaware that there are two types of tinnitus. One is known as subjective tinnitus which means you are the only one who can hear all those sounds. This type of tinnitus is usually caused by problems in the inner, outer or middle ear, issues that involve the auditory, or hearing, nerves or dysfunction in the auditory pathways or the way the brain interprets the nerve signals as a sound.

Objective tinnitus, on the other hand, is what the ear doctor hears when he does a physical examination on a patient. This tinnitus is rarer and caused by problems in the blood vessels, the bone of the inner ear or contractions of the muscles. Around 90% of tinnitus cases are the results of hearing loss induced by noise or prolonged exposures to loud sounds.

How Tinnitus Develops


These exposures can cause permanent damage to the cochlea, an organ located in the inner ear of a person. The spiral-shaped cochlea has cells sensitive to sound. People who work as pilots, landscapers, carpenters, rock musicians, and street repairers are among those who have a high risk of developing tinnitus symptoms as well as those who operate loud devices like chainsaws and guns.

Those who listen to very loud music repeatedly can also develop tinnitus. Even one exposure to extremely loud and sudden noise can be traumatic for the cochlea and cause tinnitus. Although not one exact cause for tinnitus has been confirmed, numerous health conditions develop or worsen when tinnitus occurs. Damage to the ear’s inner cells is one cause.

Other Likely Causes of Tinnitus


Tinnitus happens when the delicate, tiny hairs found in the inner ear move relative to the pressure that results from sound waves. The ear’s cells release a signal through the auditory nerve to the brain which then interprets the signal as a sound. Broken or bent hairs in the inner ear leak random signals to the brain, misinterpreting them as sounds and causing tinnitus.

Other tinnitus causes you should know about include:

  • Meniere’s disease: this is a disorder of the inner ear which can cause a sensation of spinning motion known as vertigo together with a fluctuating loss of hearing as well as feelings of pressire or fullness in the ear; this disease usually affects only one ear.

  • Temperomandibular Joint Disorder (TMJ): problems in the joints located on either side of the head, in front of the ears where the lower bone of the jaw meets the skull, could cause tinnitus.

  • Neck or head injuries: trauma to the neck or head may have an effect on the inner ear primarily because the ear’s nerves are linked to brain function. Injuries like these cause tinnitus only in one ear.

  • Acoustic neuroma: this a benign, or non-cancerous, tumor which develops on the brain’s cranial nerve that runs from the brain to the inner ear and controls hearing and sound balance; it also causes tinnitus only in one ear.

  • Age-related loss of hearing: this condition typically causes tinnitus in those who are age 60 and above. Medically known as presbycusis, age-related loss of hearing worsens as the person grows older.

  • Loud noise: exposure to loud noises for prolonged periods causes tinnitus. MP3 players, iPods or other devices that produce sounds can cause tinnitus as well even when the exposure is on a short-term but regular basis.

  • Earwax: earwax actually protects the ear’s canal by trapping dirt to slow down bacterial growth. When too much of it accumulates it becomes hard to wash away by natural means, build up, causes irritation, and develops into tinnitus.

  • Changes in the ear bone: when bones stiffen in the middle ear, the condition known as otosclerosis develops and affects the hearing which results in tinnitus. This is abnormal growth of the ear bone which is hereditary.

  • Medications: several medications, notably aspirin, as well as sedatives, antibiotics, antidepressants, and anti-inflammatories can cause tinnitus, which has been noted as a possible side effect for around 200 medications.

  • Other medical conditions: hypertension or high blood pressure, anemia, diabetes, underactive thyroid glands, and diseases of the cardiovascular and circulatory systems can also cause tinnitus.

  • Viral infections, migraines, allergies, headaches, improper drainage of body fluids, genetic predisposition, and an impaired or weakened immune system have also been shown to cause tinnitus in some cases.

Among other tinnitus causes alcohol has also been found to be contributory to the condition’s aggravation alongside tobacco, caffeinated drinks, and certain foods. According to some researchers, fatigue, stress, depression, and other anxiety-related conditions can also become causes for tinnitus, albeit the exact reasons of how these can cause it have yet to be confimed.

Blood Vessel Conditions and Tinnitus


In very rare cases, tinnitus is caused by disorders in blood vessels or pulsatile tinnitus, as previously mentioned, such as atherosclerosis or the hardening of arteries from increased cholesterol levels and the buildup of other deposits. When this happens, those major blood vessels closest to the inner and middle areas of the ear lose elasticity and fail to expand slightly or flex when the heart beats.

A narrowing of the carotid artery in the neck or a vein the neck, known as the jugular vein, causes turbulence in the blood flow and makes this process irregular, which results in tinnitus. Also, the condition called AVM, short for arteriovenous malformation, can cause tinnitus when an abnormal connection between veins and arteries develops. AVM, however, occurs generally in one ear only.

There are several tinnitus remedies available for treatment of underlying medical conditions which may cause tinnitus, but an ear doctor has to first identify the symptoms. Tinnitus due to existing medical conditions may require various treatments. The removal of impacted earwax, for instance, can help reduce tinnitus symptoms. Likewise, changing certain medications found to cause tinnitus can also be prescribed.

Still, of all known tinnitus causes medications have been overlooked yet they significantly contribute in exacerbating tinnitus. These medications include those containing quinine for treating malaria, water pills or diuretics like furosemide, ethacrynic acid or bumetanide, pharmaceutical drugs for the treatment of cancer such as vincristine and mechlorethamine, and, taken in high doses, even aspirin.

Tinnitus and Dizziness


Yes, tinnitus causes dizziness which can either be classified as vertigo or lightheadedness. The former is characterized by a spinning sensation accompanied by a loss of balance while standing and the latter is characterized by feeling faint. Either way, dizziness occurs when the brain’s blood supply decreases which may be caused by low levels of blood pressure or dehydration from vomiting, diarrhea or a fever.

The latter is almost always associated with problems concerning the inner ear. Among the causes of vertigo, the most common is Meniere’s disease, already mentioned earlier in this article, and acoustic neuroma, also discussed previously. Labyrinthitis is another ear condition that is characterized by the middle ear’s inflammation as a result of a viral infection.

BPPV, short for benign paroxysmal positional vertigo, occurs when the inner ear’s calcium crystals dislodge from their normal positions and move to one of several semicircular cancels and develop as an irritation. It occurs most commonly in older people when their heads suddenly change positions including looking under or up, rolling over on the floor or in bed, tilting the head or sudden motions of the head.

Tinnitus Causes and Treatment Recommendations


More often than not, the condition cannot be treated and making its symptoms less annoying or bothersome is the only tinnitus relief possible. The use of chemicals in the form of medications is out as a solution since it may worsen the condition. Adjustments in lifestyles are the better option as well as resorting to home remedies. If your condition is in the onset period of six months or less, improvement rate is high.

The doctor to see for a tinnitus condition is known as an otolaryngologist. This doctor is capable of providing you with some form of tinnitus relief including sound therapy, specialized hearing aids with/without maskers for ear levels, and listening to background music, which can help alleviate anxiety or depression caused by tinnitus. Treatment of anxiety or depression can be combined with relieving tinnitus.

Because it affects the ear which is directly linked to the brain, tinnitus drug treatment options can be potentially dangerous, especially if they are antidepressant, anticonvulsant, and anxiolytic in nature. Even intratympanic injections – meaning injections of substances or drugs into the middle ear or tympanum through the ear drum – are not advisable without any benefit that can be derived from them.

Supplements and Acupuncture as Natural Treatments


Some dietary supplements have been touted as a natural treatment for tinnitus, including such herbs, botanicals, vitamins, and minerals as gingko biloba, zinc or melatonin, when they are advertised on TV, the radio, and the internet, but there hasn’t been any evidence that these have benefits for tinnitus.

As a tinnitus treatment lipoflavonoid supplements have been promoted, albeit their effectiveness has been based on preliminary research or studies only. These supplements reportedly contain several ingredients which are typically proprietary blends of some vitamins (B complex and C), choline, eriodictyol glycoside, flavonoids, and inositol, among others.

A tinnitus acupuncture treatment performed by licensed acupuncturists who may have had acupuncture as part of clinical training in either Japan or China is believed by some to be effective after ten sessions. There aren’t enough studies or sufficient information to determine, as of this writing, whether or not acupuncture can cure tinnitus, although it can help relieve some symptoms according to some patients.

TMS for Tinnitus


The new modality for tinnitus is called the transcranial magnetic stimulation (TMS) but its possible benefits have not been proven just yet. According to the Mayo Clinic, TMS involves using magnetic fields for the stimulation of the brain’s nerve cells in order to improve depression symptoms. An electromagnetic coil is placed on the scalp near the forehead to create electric currents to stimulate brain cell activity.

Because several studies found that tinnitus patients may benefit from TMS, researchers at the Loyola University Medical Center (LUMC) has been examining patients who have tinnitus as well as depression, two conditions which are debilitating, according to Dr. Murali Rao, the principal in the LUMC study. Still according to Rao, perception of so-called “phantom sounds” in depressed people can actually be more pronounced.

Although there has been no update on the use of TMS for tinnitus, Rao, who chairs Loyola University’s Department of Psychiatry and Behavioral Neurosciences at the Chicago Stritch School of Medicine, has said that TMS treatments for tinnitus will not require any form of sedation or even anesthesia and those who undergo them can resume normal activities afterwards, albeit a side effect is a mild headache.

Can Children Develop Tinnitus?


Tinnitus in individuals below 18 is rare but not really unheard of. Reports of tinnitus occurring in children may be under-reported mainly because children, especially those who are very young, find it difficult to express tinnitus symptoms. These symptoms may also be hard to detect in children who have congenital sensorineural loss of hearing accompanied by the condition. Children with both sensorineural hearing loss and tinnitus often habituate to their condition.

This is because their brains have learned to ignore the internal sound. In children who are in the cusps of puberty and adolescence, their frequent and prolonged exposure to sounds of high intensity, specifically rock music, from MP3, MP4s, iPods, and other devices, and their participation in electronic games on the internet or hand-held gadgets increase their risk in acquiring tinnitus at an early age.

Ear buds and headsets often come with the purchase of these devices and gadgets, further encouraging listening to music and other auditory features with much more intensity. While parents may be unable to prevent their children from using such devices or gadgets, they can program their children’s devices and gadgets and set limits on the output for maximum volume.

Possible Treatments for Tinnitus


As mentioned earlier, there is no tinnitus cure but for the minority afflicted with the condition due to cardiovascular causes such as blood vessel disorders, repairing the blood vessels in question may help in reducing tinnitus symptoms. Cessation of taking pharmaceutical drugs is the solution for those whose tinnitus conditions have been caused by reactions to medications.

Other solutions include:

  • Avoiding or reducing the consumption of both caffeine and salt.
  • Relaxation therapy to combat fatigue which can trigger tinnitus.
  • Quitting smoking.
  • Retraining therapy.
  • Zinc supplementation may help those who zinc deficiency since this has been shown to occur in people with low levels of zinc.
  • Masking therapy.
  • Melatonin supplements for those whose sleep are disturbed or interrupted due to tinnitus may find relief.
  • Behavioral therapy.
  • Avoiding irritants which have been proven to exacerbate tinnitus.
  • Noise coverage such as soft, low volume music.
  • Stress management since stress makes tinnitus worse.
  • Reducing alcohol consumption because alcohol dilates the blood vessels and forces an increase in blood flow, especially in the areas near the inner area.
  • Engaging in daily exercise or a workout thrice a week to improve the condition of the circulatory system which includes the blood flow.
  • Controlling the levels of blood pressure since high blood pressure levels can trigger tinnitus.
  • Using meditation and other mental techniques to divert attention away from tinnitus whenever it manifests itself.
  • Although it has not been confirmed effective as a treatment, ginkgo biloba supplements may help as a natural remedy for tinnitus.

Retraining Therapy and Other Therapies


Retraining therapy involves retraining nerve pathways directly associated with the sense of hearing to condition the brain to “get used” to the abnormal sounds of tinnitus. The conditioning process of habituation retrains the brain to ignore noise to make the patient unaware of the sound. This therapy involves counseling as well as wearing a sound generator.

Other retraining therapies include:

Masking


Tinnitus maskers are devices designed as “white noise” machines that can add both artificial and natural sounds to the environment of a person afflicted with tinnitus to “mask” or suppress the ringing sound cause by tinnitus. Simply put, a tinnitus masker will increase the sound levels in the environment of the tinnitus patient to mask them with less intrusive and calming sounds.

Biofeedback


This is the tinnitus treatment cure or technique of making involuntary or unconscious bodily processes which the senses can detect, after which these processes are manipulated consciously by mind control. According to ucsfhealth.org of the University of California-San Francisco Health Center, biofeedback combined with counseling can relieve certain stress patterns which may worsen with tinnitus.

Electrical Acoustic Stimulation (EAS)


EAS involves implanting a cochlear implant and a hearing aid for patients with hearing loss in the same ear so that the hearing aid will amplify low frequencies acoustically while the cochlear implant will stimulate middle as well as high frequencies electrically. The inner ear then processes both of the stimuli simultaneously. International studies show that a synergistic effect occurs between a cochlear implant and a hearing aid.

Stress Reduction


A technique known as the “mindfulness-based tinnitus reduction” (MBTR) may help those suffering from tinnitus to learn separating the ringing sound from stress, anxiety, and other emotions of a negative nature that often triggers it. This technique teaches the tinnitus-afflicted to deal with the condition and experience it as a regular body sensation instead of getting rid of it.

MBTR is based on the principle of mindfulness-based stress reduction which was found to be highly effective for people who have to deal with arthritis in particular and physical pain in general. This tinnitus “version,” however, has been tailored to specifically address the symptoms of tinnitus. Participants learn the technique in eight weeks or two months.

Cognitive-Behavior Therapy


After an otolaryngologist evaluates a tinnitus patient, an assessment is done to measure how far gone tinnitus is in the patient. Cognitive behavior therapy (BT) is then introduced as a reversal of tinnitus’ negative impact on the quality of life and psychology health of the tinnitus patient. CBT is often combined with sound stimulation to help alleviate tinnitus symptoms.

CBT’s aim is to break the destructive cycle that negativism brings to a tinnitus patient’s emotional state that often develops into anger, anxiety, and depression. These negative emotions block the progress of the patient’s habituation and prolong his/her suffering. CBT educates the tinnitus patient on the effects of well-being for managing tinnitus successfully.

The goal of CBT is to teach the tinnitus patient to adopt an effective and realistic attitude when dealing with tinnitus attacks by learning to separate fact from fiction when it comes to the causes, persistence, and prolonged circumstances of tinnitus.

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