Ringing in the ear, or tinnitus, is a widespread condition that affects an estimated 50 million Americans. Some people describe it as a hissing, roaring, whooshing or buzzing sound instead of ringing. It may be sporadic or constant, and is a symptom of an underlying condition rather than a disease itself. For most people, the tinnitus is a benign condition to which a person will adjust. In extreme cases, tinnitus can disrupt daily life activities, such as working, reading, and sleeping. There are many factors that can cause tinnitus.
What Are the Causes of Tinnitus?
Tinnitus is categorized as being either nonpulsatile or pulsatile.
Nonpulsatile tinnitus – ringing in the ears not accompanied by any type of rhythm – is the most common type of tinnitus. It can be caused by a variety of conditions including:
- Presbycusis (age-related hearing loss).
- Noise exposure.
- Impacted earwax.
- Otosclerosis (stiffening of the bones in the middle ear).
- Meniere’s disease.
- TMJ disorders.
- Ototoxic medications.
- Thyroid conditions.
- Head or neck trauma.
- Acoustic neuromas.
People who suffer from pulsatile tinnitus report hearing the sound of their own pulse. It is caused by abnormal blood flow within the arteries of the neck or inside the ear, and is fairly rare. If you experience pulsatile tinnitus, you should see your physician right away. The cure rates for pulsatile tinnitus are quite high once the problem has been identified. Possible causes include:
- Fluid in the middle ear.
- Ear infections.
- High blood pressure.
- Head and neck tumors.
- Blocked arteries.
Tinnitus is also classified as being either subjective (heard only by the patient) or objective (ringing can be heard by an impartial observer, such as a doctor). Most cases of tinnitus are subjective in nature.
How Is Tinnitus Treated?
Tinnitus can’t be cured, but there are treatments that make it less of a distraction. The approach taken depends on the underlying condition responsible for the ringing in your ears. Sometimes, simple steps like removing built-up earwax or switching to a new medication can markedly decrease symptoms.
Others benefit from noise suppression therapy or masking techniques designed to cover up the ringing noise. White noise machines, fans, air conditioners and humidifiers are all popular, easy to use options.
Hearing aids can often decrease the level (loudness) of the tinnitus, as well as alter the pitch to a more tolerable sound. The hearing aids are stimulating the nerves of the brain and can cause the brain to not “notice” the tinnitus as much.
Tinnitus retraining devices, which rely on patterned tones, are a newer technique that has proven beneficial to many patients.
Acoustic Therapy
Sounds are used to cover up, or mask, the tinnitus. This distracts your brain and helps you “tune out” the ringing in your ears. Electronic devices that produce white noise such as air conditioners, fans, soft music, etc., can all be employed.
Tinnitus Retraining Therapy
Similar in concept to acoustic therapy, tinnitus retraining therapy utilizes a portable sound generator that produces soft patterned tones to help desensitize the brain to the sounds of tinnitus.
Steroid Injections
Meniere’s disease (also known as endolympatic hydrops) has a triad of symptoms (hearing loss, tinnitus, vertigo) that fluctuate due to increased fluid pressures in the ear organs.
Surgery
If you have an acoustic neuroma and suffer from tinnitus, the tinnitus may be resolved through a surgical removal of the acoustic neuroma. However, for a number of people, this surgery can make the tinnitus worse. If you develop this condition, your physician will discuss all of your options.
Hearing Aids
Hearing loss causes maladaptive neuroplastic changes in the brain. Hearing aids are used to stimulate the auditory pathways received by the brain. Background sounds can mask tinnitus. Hearing aids can also help the patient better distinguish one sound from another, improving communication and helping with focus and concentration difficulties. Many devices also come packaged with noise generators to replace ambient sounds if amplification alone does not reduce tinnitus.
Counseling
Counseling, sleep and cognitive behavioral or relaxation methods can be practical in helping you manage your tinnitus symptoms by reducing the stress, anxiety and sleeplessness that are often associated with tinnitus.
Medication
There is no definitive empirical research indicating that certain medications or supplements will treat tinnitus successfully. In fact, some supplements contain ingredients that can make your tinnitus worse. However, in cases where the tinnitus causes disruption to life activities, a physician may prescribe medication to treat any anxiety, sleeping disorders, or depression related to the tinnitus.
