Tinnitus Diagnosis and Treatment at University Hospitals
Tinnitus is the perception of sound in the human ear in the absence of any external sound. It can be perceived in one or both ears, or in the head. It can be described in many different ways such as a high-pitched ringing, buzzing, hissing, humming, whistling, ticking, roaring, clicking, crickets, tunes, songs, whooshing, or the sound of wind or waves.
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How Many People Have Tinnitus?
The American Tinnitus Association (ATA) estimates that over 50 million Americans experience tinnitus to some degree. Of these, about 12 million have severe enough tinnitus to seek medical attention. And, about two million patients are so seriously debilitated that they cannot function on a “normal” day-to-day basis.
What Causes Tinnitus?
The exact physiological cause of tinnitus is unknown. There are several likely sources that are known to trigger or worsen tinnitus.
- Noise-induced hearing loss (NIHL)
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This is the most common cause of tinnitus. Either a single intense event (acoustic trauma), or long-term noise exposure (factory or construction work) can damage hearing. With exposure to loud noise, hair cells in the inner ear become damaged or destroyed. Once damaged, these hair cells cannot be renewed or replaced. Up to 90 percent of all tinnitus patients have some level of hearing loss.
- Wax build-up
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Everyone produces different amounts of earwax (cerumen). When a significant amount of earwax becomes built up in the ear canal, hearing can be compromised and tinnitus may seem louder. Earwax should not be removed with a cotton swab. You should speak to your physician or ear, nose and throat doctor (ENT).
- Certain medications
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Some medications are ototoxic (toxic to ears). Some medications can produce tinnitus as a side effect. Effects depend on the dosage of the medication and can be temporary or permanent.
- Ear or sinus infections
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Many people, including children, experience tinnitus along with an ear or sinus infection. This will generally lessen and gradually go away once the infection is healed.
- TMJ
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Temporomandibular jaw misalignment can induce tinnitus.
- Cardiovascular disease
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Approximately 3 percent of tinnitus patients experience pulsatile tinnitus (often in time with a heartbeat). This can indicate the presence of a vascular condition where the blood flow through the veins and arteries is compromised – like a heart murmur, hypertension or hardening of the arteries.
- Certain types of tumors
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Very rarely, a person will have a benign, slow-growing tumor on their auditory, vestibular or facial nerves. These tumors can cause tinnitus, deafness, facial paralysis and loss of balance.
- Head and neck trauma
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Physical trauma to the head and neck can induce tinnitus.
- Certain disorders
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Such as hypo- or hyperthyroidism, Lyme disease, fibromyalgia and thoracic outlet syndrome can have tinnitus as a symptom.
If You Have Tinnitus: The First Steps to Take
- Take note of the details surrounding your tinnitus.
- Did you begin a new medication?
- Were you exposed to excessive noise right before it started?
- Were you injured?
- Is the tinnitus in one or both ears?
- Does it fluctuate or is it constant?
- Do you have a hearing loss?
- Visit your medical doctor or ENT. Make sure you bring a list of your symptoms, copies of any previous hearing tests, and a written list of all medications you are currently taking or have just recently taken.
- Have your hearing checked by an audiologist.
Living With Tinnitus
Most patients who seek medical help for their tinnitus learn that there is no serious medical problem causing their condition. This knowledge alone is often enough to allow some to adapt to the sounds they hear. Other people experience tinnitus as disruptive and stress-inducing and need help learning how to cope with the sounds.
What Can I Do?
Most patients who seek medical help for their tinnitus learn that there is no serious medical problem causing their condition. This knowledge alone is often enough to allow some to adapt to the sounds they hear. Other people experience tinnitus as disruptive and stress-inducing and need help learning how to cope with the sounds.
- Avoid silence
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Tinnitus can sound louder when you are in total silence. Listening to soothing music or nature sounds can promote a comfortable state of relaxation. Other soothing sound suggestions are an aquarium, dehumidifier or electric fan.
- Amplification
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If a patient has hearing loss AND tinnitus, a hearing aid will help the patient hear ambient sounds that can take the focus away from the tinnitus.
- Maskers
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A device that resembles a hearing aid and produces a “shhh” sound to cover the tinnitus.
- Retraining therapy
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Attempts to retrain the brain to ignore the tinnitus sounds. The duration of this treatment can be more than one year.
- Cognitive behavior therapy
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Helps patients identify and alter maladaptive thoughts and behaviors and achieve relief.
- Biofeedback
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Teaches stress management and how to control your blood pressure, heart rate and skin temperature.
- Drug therapy
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Some medications have been investigated for use in relieving tinnitus; however, medications are primarily used to help with anxiety, depression and sleep difficulties that can be associated with tinnitus. Treating these problems can indirectly help the tinnitus patient.
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