Copyright 2002 by Nikicj5/ and  Medical Madness Newsletter@


 

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Understanding Tinnitus -- the Basics



What Is Tinnitus?


Tinnitus (pronounced either tin-night-is or tin-it-is), or ringing in the ears, is the sensation of hearing ringing, buzzing, hissing, chirping, whistling or other sounds. The noise can be intermittent or continuous, and can vary in loudness. It is often worse when background noise is low, so you may be most aware of it at night when you're trying to fall asleep in a quiet room. In rare cases, the sound beats in sync with your heart.






Tinnitus is very common, affecting an estimated 50 million adults in the United States. For most people the condition is merely an annoyance. In severe cases, however, tinnitus can cause people to have difficulty concentrating and sleeping. It may eventually interfere with work and personal relationships, resulting in psychological distress. About 12 million people seek medical help for severe tinnitus every year.

Although tinnitus is often associated with hearing loss, it does not cause the loss; nor does a hearing loss cause tinnitus. In fact, some people with tinnitus experience no difficulty hearing, and in a few cases they even become so acutely sensitive to sound that they must take steps to muffle or mask external noises.

Some instances of tinnitus are caused by infections or blockages in the ear, and the tinnitus often disappears once the underlying cause is treated. Frequently, however, tinnitus continues after the underlying condition is treated. In such a case, other therapies -- both conventional and alternative -- may bring significant relief by either decreasing or covering up the unwanted sound.

What Causes It?

A wide variety of conditions and illnesses can lead to tinnitus. Blockages of the ear due to a buildup of wax, an ear infection, or rarely, a tumor of the nerve that allows us to hear (auditory nerve) can cause the unwanted sounds, as can a perforated eardrum.

Certain drugs -- most notably aspirin, several types of antibiotics and quinine medications -- can contribute to the condition as well. In fact, tinnitus is cited as a potential side effect for about 200 prescription and nonprescription drugs.

The natural process of aging can result in a deterioration of the cochlea or other parts of the ear and lead to tinnitus. Tinnitus is also associated with Meniere's disease, a disease that affects the inner part of the ear, and otosclerosis, a disease that destroys the small bones in the middle ear.

Other medical conditions that can cause ringing in the ears include high blood pressure, cardiovascular disease, anemia, and an underactive thyroid gland. Tinnitus can also be a symptom of a problem in the neck or jaw, such as temporomandibular joint (TMJ) syndrome.

But the most common source of long-lasting tinnitus is prolonged exposure to loud sounds. The noise causes permanent damage to the sound-sensitive cells of the cochlea, a spiral-shaped organ in the inner ear. Carpenters, pilots, rock musicians and street-repair workers are among those whose jobs put them at risk, as are people who work with chain saws, guns or other loud devices or who repeatedly listen to loud music. A single exposure to a sudden extremely loud noise can also cause tinnitus.

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 seems to worsen tinnitus.



What Are the Symptoms?

A noise in the ears, such as

* ringing,
*roaring,
*buzzing,
*hissing
*whistling;

the noise may be intermittent or continuous.
Sometimes, hearing loss.

Call Your Doctor If:


You have tinnitus; it could be a symptom of an underlying health problem, such as high blood pressure or an underactive thyroid, that can be treated.
The noise is accompanied by pain or pus in the ear; these may be signs of an ear infection. The noise is accompanied by dizziness; this may be a sign of Meniere's disease or a neurological problem.

Seek medical care immediately.



Treatment

How Can I Find Out What's Causing My Tinnitus?


To determine whether an underlying medical condition is causing your tinnitus, your doctor will give you a general physical exam, including a careful examination of your ears. Be sure to inform your doctor of all medications you are taking because tinnitus can be a side effect of some drugs.

If the source of the problem remains unclear, you may be sent to an otologist or an otolaryngologist (both ear specialists) or an audiologist (a hearing specialist) for hearing and nerve tests. As part of your examination, you may be given a balance test called an electronystagmography. An imaging technique, such as an MRI or a CT scan, may also be recommended to reveal any structural problem.

What Are the Treatments?

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 (See Masking Devices below.) Sometimes, tinnitus goes away spontaneously, without any intervention at all.

If you are having difficulty coping with your tinnitus, you may find counseling and support groups helpful. Ask your doctor for a referral.

If the cause of your tinnitus is excessive earwax, your physician will clean out your ears with a cotton-tipped probe or a suction device. If you have an ear infection, you may be given prescription eardrops containing hydrocortisone to help relieve the itching and an antibiotic to fight the infection.

In cases where otosclerosis or a tumor is diagnosed, surgery may be necessary. 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.

Medications

Many drugs have been studied for treating tinnitis. For some, treatment with anti-anxiety drugs such as Valium or antidepressants such as Elavil help. Lidocaine, a medication used for the treatment of certain types of abnormal heart rhythms, has been shown to relieve tinnitus for some people, but it must be given intravenously and its effect does not last long.

Hearing Aids

If your tinnitus is accompanied by some hearing loss, a hearing aid may be helpful.

Masking Devices

Many people have also benefited from tinnitus maskers, devices resembling hearing aids that play a sound more pleasant than the internal noise produced by the tinnitus. A newer device is a tinnitus instrument, which is a combination of hearing aid and masker.

Tinnitus Retraining Therapy

TRT depends upon the natural ability of the brain to "habituate" a signal, to filter it out on a subconscious level so that it does not reach conscious perception.  Habituation requires no conscious effort. People frequently habituate many auditory sounds we initially hear, for instance, air conditioners, computer fans, refrigerators, and gentle rain. The two elements that air conditioners, computer fans, refrigerators, and gentle rain have in common are that the signals they emit have no importance, and the signals are not perceived as "loud." Thus, the brain can screen them out.

This form of therapy has two parts:


The sufferer will play some source of neutral sound everywhere they go, including wearing in-the-ear sound generators.
Sufferers receive one-on one counseling.
This form of tinnitus treatment takes 12 to 24 months and is highly successful in experienced hands. Cognitive Therapy

This is a form of counseling that helps a person to modify their reaction to the tinnitus. It works best when combined with other forms of therapy such as masking or medication.

Biofeedback

This is a relaxation technique that helps people to manage stress by changing their reaction to it. Some people find it is helpful in reducing tinnitus.

Dental Treatment

If your tinnitus is caused by a problem with the temporomandibular joint (TMJ), a joint in the jaw, dental treatment may relieve your symptoms. This is because the muscles and nerves in the jaw are closely connected to those in the ear.

Cochlear Implants

Although these devices, implanted in the ear, are mostly used to treat near deafness, they appear to also help some people with tinnitus who have significant hearing loss. The device works by sending electrical signals from the ear to the brain.

Alternative Treatments

Although no vitamin supplements or other alternative therapies have been proven beneficial to treat tinnitus, some people try herbal preparations such as ginkgo biloba or minerals such as zinc with varying results. Others have experienced relief with acupuncture, magnets or hypnosis.

Talk to your doctor for before trying any of these treatments.


 

Additional: The information, that I provide to you is strictly for your information. I am in no way (nor do I claim to be) a Therapist or Doctor. I in no way an authority on any of these subjects just simply providing the information to you as a tool in learning about different illness and conditions. In using any of these, you are at your own risk and agree not to hold me responsible, in any way, for the outcome.NightingalesMM/ Nikicj5 is not the author of many of any articles included, and do not claim to own any copyright privileges to them. They are assumed to be in the public domain, and a best effort is taken not to use copyrighted material. If I am infringing on anyone's copyright, please contact: NightingalesMM@aol.com and I will give credit to the deserving party. Information provided in this document is provided "as is" without Warranty or liability of any kind.


The material on this site is provided for informational purposes only, and is not intended to be a substitute for a health care provider's consultation. Please consult your own physician or appropriate health care provider about your own symptoms or medical conditions. The information should not be considered complete and should not be used in place of a visit, call, consultation or advice of your physician or other health care provider.
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