The sensation of hearing a sound in your ear without any actual external sound is called Tinnitus. The volume of the sound that you listen to when you are suffering from tinnitus can range from quiet background noise to a noise that is louder than actual external sounds.
Tinnitus is one of the most common diseases related to the ear (otologic problems) as it affects nearly 5% of all adults at some point in their lives. It can cause different types of disorders in the body (somatic) and mind (psychological). It forces one to disassociate themselves from the surrounding environment and can, therefore, seriously affect your quality of life.
Following are the two types of tinnitus:
|Objective Tinnitus||Subjective Tinnitus|
|• Audible to another person: The sound coming from the ear canal is audible to another person|
• Somato sound: When you hear your physician using this term they are generally referring to Objective Tinnitus
|• Subjective Tinnitus: Audible only to the person suffering from it|
• Tinnitus: The term physicians use to refer to Subjective Tinnitus
• Grinding steel
• Fluorescent lights
• Falling tap water
• Escaping steam
• Ringing sound
• Clicking sound
• Buzzing sound
• Hissing and Humming sounds
• Sporadic – they come and go
• Persistent- they are present all the time
Some of the most common trigger factors for tinnitus are
• Chronic progressive hearing loss
• Noise exposure
• Psychological stress
• Somatic(physical) factors
Small movements that could bring changes in the outer hair cell when followed by loud noises, can trigger tinnitus. Typically tinnitus is a consequence of multiple factors and not just one factor. So, for example, someone facing chronic progressive hearing loss and one or two of the other trigger factors is at a greater risk of experiencing tinnitus than someone who is just experiencing hearing loss.
Tinnitus itself is not referred to as a disease. If you consult a doctor and tell them that you hear tinnitus-related sounds- they will see it as a symptom of a disorder related to your auditory system.
Note: The auditory system includes:
• Auditory nerve – that connects the inner ear to the brain
• Part of the brain responsible for producing sounds
Several factors can cause tinnitus like:
• Excessive ear wax
• Ear infections
• Heart diseases
• Blood vessel related disorders
• Hormonal changes in women
• Abnormalities in thyroid
• Meniere disease
• Brain tumors
• Living or working in an environment with loud noises or sounds
• Damage or trauma to the ear
• Hair cell damage in the inner ear
• Side effects of certain medications like:
– Non-steroidal anti-inflammatory drugs
– Some cancer drugs like Cisplatin
Note: Tinnitus is the most commonly reported problem among soldiers who return from war or among people who frequently visit light night clubs or concerts.
Pulsatile Tinnitus is a form of tinnitus which is characterized by rhythmic pulsing in the ear. Generally, this rare type of tinnitus is caused by problems associated with blood flow in the head or the neck
Alert: In some cases,tinnitus can be the first stage of hearing loss; hence under no circumstances should you ignore it or take it lightly.
Persistently experiencing the symptoms of tinnitus can have severe implications for your life. Generally, the following is noticed in people experiencing tinnitus:
• Suicidal tendencies
• Lack of concentration
In case you are experiencing the symptoms of tinnitus, you would need to see one of the following doctors to identify the underlying cause:
• ENT specialist (Otolaryngologists)
• Hearing expert (Audiologist)
Tinnitus is itself a symptom of a disorder; hence the diagnostic tests recommended by your doctor will aim to identify the underlying cause of tinnitus. Some such tests include:
• Examination of nose, neck, and ears:
• Balance testing
• MRI of the skull
• (Computer tomography) CT of the skull
• Testing otoacoustic emissions (sound from the inner ear)
• Brain stem evoked response audiometry (BERA): this is a non-invasive method. In it, the hearing is assessed by observing the electrical activity from the inner ear to the inferior colliculus.
Note: the inferior colliculusis present in the midbrain and serves as the main sound center of the body.
As of now, no cure has been found for tinnitus. However, if it starts severely affecting the quality of your life, your doctor may recommend following for the management of the discomfort:
• Acoustic neural simulation- this treatment is recommended for the loud cases of tinnitus. In Acoustic neural stimulation, the changes in the nerve circuits of the brain that cause tinnitus are recreated so that eventually, you stop responding to it.
• Hearing aids- Recommended to people whose tinnitus is accompanied by hearing loss as well
• Sound generators-
– Wearable: electronic devices that generate pleasant sounds to mask the noise by tinnitus are placed in the ear. These are small in size and so won’t be uncomfortable to wear.
– Tabletop: unlike wearable sounds generators these are placed in close proximity but not in the ear
• Cognitive-behavioral therapy (CBT): this helps in accepting the inconvenience caused by tinnitus and then building the will to live with it and to manage it better. Essentially counseling helps in changing your thinking process.
No, there are no cures for tinnitus; however, with the help, you can manage the discomfort better. Minor cases of tinnitus may resolve on its own.
MBBS (ENT- Honours) (KGMC-Lucknow),
M.S. (KGMC- Lucknow), FAOI (AIIMS), FAOI (U.K.)
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