Tinnitus: All you need to know

Tinnitus is ringing sensation in one or both of your, but you may also hear hissing, clicking, or whistling sounds. It can be temporary, or it can be chronic and persistent.. The noise you hear when you have tinnitus isn't caused by an external sound, and other people usually can't hear it. Tinnitus is a common problem. It affects about 15% to 20% of people, and is especially common in older adults.

What Causes Tinnitus?

Prolonged exposure to loud sounds is the most common cause of tinnitus. Up to 90% of people with tinnitus have some level of noise-induced hearing loss. The noise causes permanent damage to the sound-sensitive cells of the cochlea, a spiral-shaped organ in the inner ear. A single exposure to a sudden extremely loud noise can also cause tinnitus.

A variety of other conditions and illnesses can lead to tinnitus, including:

· Blockages of the ear due to a build up of wax, an ear infection, or any growth or tumour

· Ototoxic drugs - aspirin, several types of antibiotics, anti-inflammatories, loop diuretics, and antidepressants, as well as quinine medications

· Head and neck injuries

· Age-related hearing loss, which can cause deterioration of the cochlea or other parts of the ear

· Meniere's disease, which affects the inner part of the ear

· Otosclerosis, a disease that results in stiffening of the small bones in the middle ear

· Other medical conditions such as high blood pressure, cardiovascular disease, circulatory problems, anaemia, allergies, an underactive thyroid gland, autoimmune disease, and diabetes

· Neck or jaw problems, such as temporomandibular joint (TMJ) syndrome

· Eustachian tube dysfunction. In this condition, the tube in your ear connecting the middle ear to your upper throat remains expanded all the time, which can make your ear feel full.

Tinnitus can worsen in some people if they drink alcohol, smoke cigarettes, drink caffeinated beverages, or eat certain foods. For reasons not yet entirely clear to researchers, stress and fatigue seem to worsen tinnitus.

Tinnitus is usually caused by an underlying condition, such as excessive or cumulative noise exposure, for many people, tinnitus improves with treatment of the underlying cause or with other treatments that reduce or mask the noise, making tinnitus less noticeable. It can occasionally indicate a serious underlying medical condition.

Symptoms

Tinnitus is most often described as a ringing in the ears, even though no external sound is present. However, tinnitus can also cause other types of phantom noises in your ears, including: Buzzing, Roaring, Clicking, Hissing, Humming

Most people who have tinnitus have subjective tinnitus, or tinnitus that only you can hear. The noises of tinnitus may vary in pitch from a low roar to a high squeal, and you may hear it in one or both ears. In some cases, the sound can be so loud it interferes with your ability to concentrate or hear external sound. Tinnitus may be present all the time, or it may come and go.

In rare cases, tinnitus can occur as a rhythmic pulsing or whooshing sound, often in time with your heartbeat. This is called pulsatile tinnitus. If you have pulsatile tinnitus, your doctor may be able to hear your tinnitus when he or she does an examination (objective tinnitus).

When to see a doctor?

The first step is to treat any underlying cause of tinnitus. This[SCPR1] may involve:

· Prompt care for an ear infection or ear wax removal

· Discontinuing any ototoxic medications

· Treating any temporomandibular joint (TMJ) problems, which affect the joint between the jaw bone and the cheek bone

· Hearing aids for age related hearing loss

There is no cure for most cases of tinnitus. Most people become accustomed to it and learn to tune it out. Ignoring it rather than focusing on it can provide relief. When this does not work, the individual may benefit from treatment for the effects of tinnitus, insomnia, anxiety, hearing difficulties, social isolation, and depression. Dealing with these issues can significantly improve a person’s quality of life.

Prevention

In many cases, tinnitus is the result of something that can't be prevented. However, some precautions can help prevent certain kinds of tinnitus.

· Use hearing protection. Try to limit your exposure to loud sounds. And if you cannot avoid loud sounds, use ear protection to help protect your hearing. If you use chain saws, are a musician, work in an industry that uses loud machinery or use firearms (especially pistols or shotguns), always wear over-the-ear hearing protection.

· Turn down the volume. Long-term exposure to amplified music with no ear protection or listening to music at very high volume through headphones can cause hearing loss and tinnitus.

· Take care of your cardiovascular health. Regular exercise, eating right and taking other steps to keep your blood vessels healthy can help prevent tinnitus linked to obesity and blood vessel disorders. Limit alcohol, caffeine and nicotine. These substances, especially when used in excess, can affect blood flow and contribute to tinnitus.

· Diagnosis

To help identify the cause of your tinnitus, your doctor will likely ask you about your medical history and examine your ears, head and neck. Sometimes a cause can't be found. Common tests include:

· Pure tone audiometry: During the test, you'll sit in a soundproof room wearing earphones that transmit specific sounds into one ear at a time. You'll indicate when you can hear the sound, and your results will be compared with results considered normal for your age. This can help rule out or identify possible causes of tinnitus.

· Imaging tests: Depending on the suspected cause of your tinnitus, you may need imaging tests such as CT or MRI scans.

· Lab tests: Your doctor may draw blood to check for anemia, thyroid problems, heart disease or vitamin deficiencies.

What type of sound do you hear?

Clicking: This type of sound suggests that muscle contractions in and around your ear might be the cause of your tinnitus.

Pulsing, rushing or humming: These sounds usually stem from blood vessel (vascular) causes, such as high blood pressure, and you may notice them when you exercise or change positions, such as when you lie down or stand up.

Low-pitched ringing: This type of sound may point to ear canal blockages, Meniere's disease or stiff inner ear bones (otosclerosis).

High-pitched ringing: This is the most commonly heard tinnitus sound. Likely causes include loud noise exposure, hearing loss or medications. Acoustic neuroma can cause continuous, high-pitched ringing in one ear.

Tinnitus remedies

If your tinnitus is a symptom of an underlying medical condition, the first step is to treat that condition. But if the tinnitus remains after treatment, or if it results from exposure to loud noise, health professionals recommend various non-medical options that may help reduce or mask the unwanted noise. Sometimes, tinnitus goes away spontaneously, without any intervention at all. It should be understood, however, that not all tinnitus can be eliminated or reduced, no matter the cause.

1. Hearing aids

Most people develop tinnitus as a symptom of hearing loss. If you have tinnitus, you may find that the better you hear, the less you notice your tinnitus. A hearing aid is a small electronic device that uses a microphone, amplifier, and speaker to increase the volume of external noises. This can mollify neuroplastic changes in the brain’s ability to process sound and this in turn can reduce tinnitus.

2. Sound-masking devices

Sound-masking devices provide a pleasant constant external noise that partially fades out the internal sound of tinnitus. These devices can play white noise, pink noise, nature noises, music, or other ambient sounds. Most people prefer a level of external sound that is just slightly louder than their tinnitus, but others prefer a masking sound that completely drowns out the ringing.

Some people use commercial sound machines designed to help people relax or fall asleep. You can also use headphones, television, music, or even a fan.

3. Tinnitus Retraining Therapy

Tinnitus is associated with a high level of emotional stress. Depression, anxiety, and insomnia are not uncommon in people with tinnitus. Cognitive behavioral therapy (CBT) is a type of talk therapy that helps people with tinnitus learn to live with their condition. Rather than reducing the sound itself, CBT teaches you how to accept it. The goal is to improve your quality of life and prevent tinnitus from driving you crazy. CBT involves working with a therapist or counselor, typically once per week, to identify and change negative thought patterns.

4. Antidepressants and antianxiety drugs

Tinnitus treatment often involves a combination of approaches. Your doctor may recommend medication as part of your treatment. These drugs may help make your tinnitus symptoms less annoying, thereby improving your quality of life. Antianxiety drugs are also an effective treatment for insomnia.

5. Treating dysfunctions and obstructions

•If the cause of your tinnitus is excessive earwax, your doctor will clean out your ears by suction with a small curved instrument called a curette, or gently flush it out with warm water. If you have an ear infection, you may be given prescription ear drops containing steroid to help relieve the itching and an antibiotic to fight the infection..

•If your tinnitus is the result of temporomandibular joint syndrome, your doctor will probably refer you to an orthodontist or other dental specialist for appropriate treatment.

• Fluctuation of hearing and resulting tinnitus can be treated with a series of injections of Dexamethasone (a potent steroid) with an 85 percent chance of reduction in tinnitus symptoms.

• Although tinnitus is not a surgical disease for the most part, tinnitus due to a surgical lesion in the ear usually responds to treatment of that lesion. Typical lesions amenable to surgery include those caused by glomus tumors, sigmoid sinus diverticulum, arteriovenous malformation, and conductive hearing loss.

6. Exercise

Exercise contributes significantly to your overall well-being. Tinnitus can be aggravated by stress, depression, anxiety, lack of sleep, and illness. Regular exercise will help you manage stress, sleep better, and stay healthier.

7. Alternative treatments

There are several alternative or complementary tinnitus treatment options, including:

· nutritional supplements

· homeopathic remedies

· acupuncture

· hypnosis