Tinnitus is the condition when you hear sounds that do not actually exist. Normal people may hear a faint buzzing sound in a quiet environment, but a tinnitus patient would notice a sound large enough to interfere with daily life. While tinnitus itself may not affect the patient much, a serious underlying condition may be hidden👂🏻.
What is Tinnitus? Types of Tinnitus?
Tinnitus is the condition that makes you hear sounds from inside your body instead of from an external source. Physiologically speaking, it is when the hair cells are damaged and it gives the brain a wrong signal that there is a sound, thus giving tinnitus. When the noises are too exaggerated and bother you much, medical help should be sought. Sounds heard by tinnitus patients may be present in multiple possible forms, such as:
- Ringing sound: The low-pitched ones are possibly due to Meniere’s Disease, otosclerosis or ear canal blockages whereas the high-pitched ones are usually due to loud noises, hearing loss, acoustic neuroma or medications.
- Hissing sound
- Buzzing sound
- Humming sound: It may be caused by high blood pressure.
- Clicking sound: It is probably caused by muscle contractions around your ear.
- Roaring sound
- Grinding sound
- Whistling sound
Types of tinnitus
Tinnitus can be categorized into 3 major types:
- Subjective tinnitus: The noises of tinnitus can only be heard by the patient himself or herself.
- Objective tinnitus: The noises of tinnitus may be heard by some other people like the physician doing a thorough examination.
- Pulsatile tinnitus: The occurrence of pulsatile tinnitus follows a certain rhythm similar to the heartbeat.
The duration of tinnitus is variable, it may last for a minute to a week. It may occur in a single or both of the ears. Usually, tinnitus is a condition with minor consequences, but it can be the symptom of something severe behind the scene sometimes, such as Meniere’s Disease.
Causes of Tinnitus
Tinnitus is commonly associated with inner ear damage, particularly damage to the sensitive hair cells due to ototoxic chemicals or loud noises.
Nevertheless, there is still not a very clear piece of evidence indicating the causes of tinnitus. Besides, there are many other causes of tinnitus that may not involve the injury of the inner ear, including the common ones like:
- Earwax impaction
- Middle ear infection
- Fluid buildup in the middle ear
- Perforated Eardrums
- Meniere’s Disease
- Induced by Medications: such as gentamicin, ciprofloxacin, chloroquine, carbamazepine, valproate, ibuprofen, naproxen and vancomycin.
Tinnitus itself usually does not give rise to serious consequences, but the underlying cause may lead to detrimental aftermaths. Therefore, tinnitus may get worse alongside the occurrence of its hidden problems. Timely medical help should be sought as soon as possible if these underlying health problems of tinnitus occur.
Risk Factors of Tinnitus
Tinnitus is a disease of high prevalence. There are multiple risk factors that can contribute to tinnitus, including:
- Exposure to loud noises: Such as prolonged staying at construction sites, live concerts and factories. It will increase the chance of inner ear injuries.
- Age: The degeneration of hair cells progresses with aging.
- Sex: Males have a higher chance to develop tinnitus.
- Alcohol consumption
- Concomitant diseases: Diseases like obesity, hypertension and other cardiovascular diseases may induce a higher risk of tinnitus.
Diagnosis of Tinnitus
The diagnosis of tinnitus is usually based solely on symptoms reported by patients. However, tests are required to confirm the underlying cause of tinnitus:
- Ear tests: Hearing tests (audiometry) are used for checking hearing loss. One will be asked to distinguish similar tones or if a sound is perceived. The result is then used to compare with normal people so as to rule out possible causes.
- Movement examination: One will be asked to do the movements of the eyes, jaw, neck, arms and legs. If tinnitus changes upon movement, it indicates the presence of a possible underlying cause.
- Other tests: Laboratory tests will be done to recognize an underlying cause. MRI or CT scan may be done to check if there are problems in the brain instead of the inner ears.
Treatments of Tinnitus
Although tinnitus is incurable currently owing to its unclear mechanism, it can still be managed with the following approaches to relieve or treat its underlying causes:
- Hearing function correction: By improving hearing loss, less attention will be paid to tinnitus as symptoms are relieved. It can be improved with devices like hearing aid or by surgery.
- Sound therapy: The principle of the therapy is to generate neutral sounds that will not disturb one much in a quiet environment. It is because tinnitus is best perceived under a tranquil environment. Acts like opening a window, leaving a radio on at a low volume can reduce the impact of tinnitus. Nowadays, there are even pillows and hearing aids that can generate soothing sounds.
- Cognitive-behavioral therapy: It focuses on dealing with the mental aspects of tinnitus. Therapists will alter your original beliefs and infuse new ideas into you to reduce the negative emotions and learn how to cope with tinnitus, thus relieving the negative mental impacts brought by tinnitus.
- Tinnitus retraining therapy: It is similar to cognitive behavioral therapy. It alters the response of the brain to tinnitus instead of altering beliefs. It relieves the impacts brought by tinnitus.
There are no medications that will help tinnitus go away. However, there are multiple things that can help tinnitus to go away. Firstly, treat the underlying causes. If there are no organic reasons causing tinnitus, you can try using a white noise machine, playing soft music or turning on the radio at low volume. It may relieve tinnitus, but if not, seek medical help as soon as possible.
This article was medically reviewed by Dr. David Ho 何志謙醫生. Dr. Ho graduated from the University of Melbourne Medical School and obtained Otorhinolaryngology (Ear, Nose & Throat) Specialist training under the Royal Australasian College of Surgeons. Before returning to Hong Kong, he worked at Royal Children’s Hospitals in Melbourne, the biggest pediatric medical center in the Southern Hemisphere and was a specialist ENT consultant at Royal Melbourne, Alfred and Austin Hospitals. He obtained post-fellowship training in New York, Hong Kong, London and Canada. He is now an honorary assistant professor at the University of Hong Kong and an honorary Specialist ENT Consultant for the Matilda International Hospital.
This article was independently written by Healthy Matters and is not sponsored. It is informative only and not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be relied upon for specific medical advice.