By Melanie Lewis, RHAD, MSHAA / LipreadingMom.com Guest Blogger
Tinnitus, often described as ‘ringing in the ears,’ is the perception of a sound which has no tangible, external source. According to the ATA (American Tinnitus Association), 50 million Americans experience tinnitus. Data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) suggests that of this figure as many as 16 million experience tinnitus to such an extent that medical attention is required.
What Is Tinnitus?
Although tinnitus is largely associated with a ‘ringing’ sound it can be experienced as a range of sound sensations, from roaring, hissing or whistling to chirping or clicking. Tinnitus may be experienced as an isolated episode (as little as a few seconds) or may be a persistent presence, perceived in one or both ears. The volume or intensity level of tinnitus can also vary markedly from a dull, barely perceptible noise, to one which may be heard over external sound sources.
Of the 16 million Americans that require medical attention to manage the condition, an estimated 2 million, typically those with persistent and high intensity tinnitus, struggle to cope with their daily lives.
Due to the complex relationship between the hearing system and the brain the precise cause of tinnitus is still unclear. Various theories have been expounded with researchers and medical staff isolating ‘likely’ culprits, including but not limited to:
NIHL (Noise Induced Hearing Loss)
Exposure to harmful sounds’ will lead to the degradation of hair cells in the cochlea of the inner ear. Accelerating factors such as duration of exposure, proximity to the sound source and sound intensity level can all impact on an individual’s hearing level. Tinnitus is often cited as a spontaneous by-product of high intensity noise exposure and can signal a temporary threshold shift in one’s hearing. Many people with long-term, noise-induced hearing loss notice a corollary between the onset of tinnitus and subsequent hearing difficulties.
Head trauma can cause a range of cognitive deficits in speed of information processing, attention and memory. It has also been linked to tinnitus, often as a direct result of the trauma or as a consequence of certain medications used to address the injury (see below).
Certain medications, such as aminoglycosides, are considered “ototoxic,” and can have a toxic reaction to structures of the inner ear. The severity of the condition will depend upon the dosage and duration of use, but may cause temporary or long-lasting tinnitus and/or hearing loss.
Hypo or hyperthyroidism, Lyme disease, fibromyalgia, and thoracic outlet syndrome, cite tinnitus as a possible symptom.
A host of conditions, physical and psychological, are often linked to tinnitus. Certain types of tumors, a build-up of cerumen (wax) in the ear canal, jaw misalignment, cardiovascular disease to anxiety or depression, are just a few examples.
Treatment of Tinnitus
Although tinnitus is often compartmentalized with hearing loss there are a number of possible causes, as detailed. In order to identify the underlying cause referral to a specialist such as an ENT (ear, nose and throat) surgeon or an audio-vestibular physician may be required. Further blood tests and CT/ MRI scans can help to detect associated problems.
How to Manage Tinnitus
In recent years there has been a move within the medical community, not only to understand, but also to offer solutions to “manage” the condition. While there are no confirmed cures, there are strategies and technologies in place which can help to alleviate symptoms. Your family doctor or hearing healthcare professional may discuss one of the following:
Hearing aids : Those with a hearing impairment may find that wearing a hearing aid can help mask their tinnitus by occupying the brain with external sound information.
Sound therapy is the use of sound to reduce the perception or awareness of tinnitus. Sound therapy can be used as a self-help technique, using background noise (just below the sound of tinnitus) to divert attention away from the tinnitus or can be part of a broader tinnitus management programme at a hospital or clinic. Of the options, sound therapy is perhaps the most accessible with a number of products available on the market to compliment this form of therapy:
• White noise generators worn in or on the ear itself (generally for people with normal hearing).
• Sound generator devices producing a range of holistic sounds such as rain, the sea, wind chimes etc.
• Pillow speakers or sound pillows which can be connected to sound generators or an existing sound system.
Unless tinnitus is directly related to a physical anomaly, such as a non-cancerous tumour (acoustic neuroma), surgery is rarely an option to treat tinnitus. Generally ‘treatment’ is a combination of sound therapy and complementary therapies, designed to divert attention away from tinnitus and promote relaxation and well-being. Habituation is the ultimate goal. By learning to accept and adopt various coping strategies those who suffer with the condition will, hopefully, find a way of mitigating its impact.