Doctor, Please Explain

Tinnitus

Insight into causes and treatments for tinnitus 

• What causes tinnitus? 

• How is tinnitus treated? 

• What can help me cope?  and more...

Nearly 36 million Americans suffer from tinnitus or head noises. It may be an intermittent sound or an annoying continuous sound in one or both ears. Its pitch can go from a low roar to a high squeal or whine. Prior to any treatment, it is important to undergo a thorough examination and evaluation by your otolaryngologist. An essential part of the treatment will be your understanding of tinnitus and its causes.

What causes tinnitus?

Most tinnitus comes from damage to the microscopic endings of the hearing nerve in the inner ear. The health of these nerve endings is important for acute hearing, and injury to them brings on hearing loss and often tinnitus. If you are older, advancing age is generally accompanied by a certain amount of hearing nerve impairment and tinnitus. If you are younger, exposure to loud noise is probably the leading cause of tinnitus, and often damages hearing as well.

There are many causes for “subjective tinnitus,” the noise only you can hear. Some causes are not serious (a small plug of wax in the ear canal might cause temporary tinnitus).

Tinnitus can also be a symptom of stiffening of the middle ear bones (otosclerosis). Tinnitus may also be caused by allergy, high or low blood pressure (blood circulation problems), a tumor, diabetes, thyroid problems, injury to the head or neck, and a variety of other causes including medications such as anti-inflammatories, antibiotics, sedatives, antidepressants, and aspirin. If you take aspirin and your ears ring, talk to your doctor about dosage in relation to your size.

Treatment will be quite different in each case of tinnitus. It is important to see an otolaryngologist to investigate the cause of your tinnitus so that the best treatment can be determined.

How is tinnitus treated?

In most cases, there is no specific treatment for ear and head noise. If your otolaryngologist finds a specific cause of your tinnitus, he or she may be able to eliminate the noise. But, this determination may require extensive testing including X-rays, balance tests, and laboratory work. However, most causes cannot be identified. Occasionally, medicine may help the noise. The medications used are varied, and several may be tried to see if they help.

What are some other tinnitus treatment options? 

• Alternative treatments  Amplification (hearing aids) 

• Cochlear implants or electrical stimulation 

• Cognitive therapy 

• Drug therapy 

• Sound therapy 

• TMJ treatment

Can other people hear the noise in my ears?

Not usually, but sometimes they are able to hear a certain type of tinnitus. This is called “objective tinnitus,” and it caused either by abnormalities in blood vessels around the outside of the ear or by muscle spasms, which may sound like clicks or crackling inside the middle ear.

Can children be at risk for tinnitus?

Yes, children are at risk too. However, it is not a common complaint. Like people of all ages, children who are exposed to loud noises are at a higher risk for tinnitus. High-decibel recreational events, like car races, music concerts, or sports games, can damage children’s ears. Hearing protection devices should always be worn.

Tips to lessen the severity of tinnitus 

• Avoid exposure to loud sounds and noises. 

• Get your blood pressure checked. If it is high, get your doctor’s help to control it. 

• Decrease your intake of salt. Salt impairs blood circulation. 

• Avoid stimulants such as coffee, tea, cola, and tobacco. 

• Exercise daily to improve your circulation. 

• Get adequate rest and avoid fatigue. 

• Stop worrying about the noise. Recognize your head noise as an annoyance and learn to ignore it as much as possible.

What can help me cope?

Concentration and relaxation exercises can help to control muscle groups and circulation throughout the body. The increased relaxation and circulation achieved by these exercises can reduce the intensity of tinnitus in some patients.

Masking out the head noise with a competing sound at a constant low level, such as a ticking clock or radio static (white noise), may make it less noticeable. Tinnitus is usually more bothersome in quiet surroundings. Products that generate white noise are available through catalogs and specialty stores.

Hearing aids may reduce head noise while you are wearing them and sometimes cause the noise to go away temporarily, if you have a hearing loss It is important not to set the hearing aid at excessively loud levels, as this can worsen the tinnitus in some cases. However, a thorough trial before purchase of a hearing aid is advisable if your primary purpose is the relief of tinnitus.

Tinnitus maskers can be combined within hearing aids. They emit a competitive but pleasant sound that can distract you from head noise. Some people find that a tinnitus masker may even suppress the head noise for several hours after it is used, but this is not true for all users.