Who gets tinnitus?

Tinnitus is ear ringing. The most effective treatments for tinnitus involve noise-canceling headphones, cognitive behavioral therapy, background music and lifestyle changes.
Tinnitus is ear ringing. The most effective treatments for tinnitus involve noise-canceling headphones, cognitive behavioral therapy, background music and lifestyle changes.

Tinnitus (pronounced either “TIN-uh-tus” or “tin-NY-tus”) is a sound in the ears, like ringing, buzzing, whistling, or even roaring. It can come and go or can be continuous. It can also range in pitch from low to high.

With over 45 million Americans experiencing tinnitus, it is a common health condition, especially in men over 40. It is also common in veterans who were exposed to bomb blasts that damaged their brain’s auditory function.

What is tinnitus?

It is not clear why the brain hears sounds that do not exist. There are two forms of tinnitus — subjective and objective. With subjective tinnitus only you can hear the sounds. With objective tinnitus, which is rare, others can also hear the sounds. 

Tinnitus usually starts in the inner ear, often from damage to the hair cells in the cochlea.

The subjective variety occurs in over 99% of cases. It usually starts in the inner ear, often from damage to the hair cells in the cochlea. Some tinnitus is chronic (ongoing) while some people experience acute episodes of tinnitus.

Pulsatile tinnitus is where you can hear your heartbeat inside the ear, usually at night when it is quiet.

Tinnitus is not a disease, but rather a symptom of some other underlying health condition such as:

The condition can occur anywhere from the outer ear, the inner ear, or even in the brain where it tries to compensate for hearing loss {Harvard Health Publishing: “Tinnitus: Ringing in the ears and what to do about it.”}. It is common in veterans who were exposed to bomb blasts that damaged their brain’s auditory function.

Tinnitus can also be a side effect of taking an ototoxic prescription. Over 200 medications can cause ringing in the ears when beginning or ending a prescription. 

Other causes of tinnitus may include:

  • Hearing loss due to age
  • Excessive noise
  • Middle ear obstruction
  • Build-up of earwax
  • Congestion
  • Dirt or foreign objects in the ear canal
  • Head or neck trauma
  • Scuba diving or snorkeling
  • Extreme elevation changes while flying
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Certain antibiotics
  • Certain cancer medications
  • Diuretics

Of people experiencing tinnitus, 40%  have a lower tolerance or dislike for environmental sounds.

Diagnosis for tinnitus

Your doctor can examine you for problems with medications or hypertension or can refer you to a specialist for further testing. Tests for tinnitus can include:

  • An audiogram to measure hearing across frequencies
  • A tympanogram to measure the eardrum’s flexibility
  • An otoacoustic emission test to measure hair cell functionality
  • An auditory brainstem response test to measure how sound signals travel to the brain
  • An electrocochleography test to measure how sound signals travel to the hearing nerve

Treatments for tinnitus

Chronic tinnitus has no cure, but treatment is available to minimize the noise. It also often gets better on its own with time.

The first step is to evaluate your overall health and treat any underlying problems. Evaluate your diet, your exercise routine, and sleep pattern. If you are experiencing depression or anxiety you might consider seeking treatment for those first.

Avoid loud noises by using ear protectors.

Sometimes a hearing aid that is correctly adjusted to cancel ambient sounds can help you hear better, which in turn makes the tinnitus less noticeable.

You can seek cognitive behavioral therapy (CBT) to better understand what it is that is happening in the brain and how to make the sound less noticeable.

You can also try sound therapy using background music or an ear-level masker.

Other things you can try to reduce the impact include:

  • Check your blood pressure, and get it under control if it is too high.
  • Start a daily exercise routine.
  • Get plenty of sleep.
  • Reduce stress.
  • Stop smoking.
  • Use aspirin or other anti-inflammatory drugs sparingly.
  • Try to ignore the sound by directing your attention to other things.
  • Practice meditation or yoga
  • Cut back on caffeine and alcohol.

You can also try going to sleep with a fan or a humidifier running.


 

Possible complications and side effects

Tinnitus can have a distressing impact on a person’s well-being. It can lead to:

Some drugs can make tinnitus worse. They include certain antibiotics, antimalarial drugs, and certain cancer drugs.

You should seek medical attention if you notice any of the following:

  • Severe hearing loss
  • Vertigo
  • Vomiting or Nausea
  • Sounds limited to one ear 
  • Difficulty with coordination
  • Numbness on one side of the face or body 

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Medically Reviewed on 2/4/2021
References
SOURCES:

American Academy of Otolaryngology–Head and Neck Surgery: "How Can I Lessen the Impact of Tinnitus?

American Academy of Otolaryngology–Head and Neck Surgery: "Tinnitus.

American Tinnitus Association: "Understanding the Facts.

Harvard Health Publishing: "Tinnitus: Ringing in the ears and what to do about it.

Michigan Medicine: "Ringing in the Ears (Tinnitus).

National Institute of Deafness and Other Communication Disorders: "Tinnitus.

Vestibular Disorders Association: "Tinnitus

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