Silverstein Institute
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What is Tinnitus?

Written by Silverstein Institute
Published: 12 May 2014

tinnitus.jpgTinnitus is typically characterized by a ringing sound in the ears. It can also create “swish” sound as well as a wide variety of other noises. Thirty-six million Americans have tinnitus, representing 17 percent of the total population. Most tinnitus sufferers are between the ages of 40 and 70. Anyone can develop tinnitus though it is more common in Caucasians, men, the elderly and those who have been consistently exposed to loud noises.

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In the majority of situations, tinnitus is not dangerous. It usually occurs as a symptom of another biological problem. Common causes often include ear injuries, circulatory issues, blood vessel disorders, earwax blockages, allergies, the presence of a foreign object in the ear, fatigue, stress, depression, and hearing loss due to old age. Medications like antibiotics, diuretics, quinine, chloroquine and those used to treat cancer can also cause tinnitus. However, it could also be caused by more serious conditions like brain tumors and acoustic neuromas.

Two Types: Subjective and Objective

Although it might come as a surprise, tinnitus is not always completely subjective to the patient. Sometimes it can also be heard by a doctor during his examination. This is known as objective tinnitus.

Symptoms and Diagnosis of Tinnitus

Tinnitus symptoms include the hearing of sounds even though there are no audible stimuli occurring outside of the body. The sound is both high and low in pitch, depending on the individual. Oftentimes, the sound is so annoying that it prevents the individual from focusing for extended periods of time. It is diagnosed by way of a physical examination, a review of the patient's medical history and a series of tests like audiograms, computerized tomography (CT), auditory brainstem response (ABR) and magnetic resonance imaging (MRI).

Other Possible Causes of Tinnitus

Aside from the usual tinnitus causes noted above, there are several less common causes. One is changes in the ear bone. Sometimes the bones in the center of the ear will stiffen over time, causing tinnitus to develop. This typically occurs when bones grow in an abnormal manner, a condition that is usually genetic. Aside from causing tinnitus, these abnormal ear bones, called otosclerosis, will alter the individual's ability to hear.

Sometimes tinnitus is an early indicator that the patient has Meniere's disease. Meniere's disease is a disorder of the inside portion of the ear caused by a change in the fluid pressure.

Issues with the temporomandibular joint (TMJ disorders) also cause tinnitus, though very infrequently. This is the joint on both sides of the human head where the bottom part of the jaw connects to the skull. Head and neck injuries can impact hearing nerves, the inside of the ear and also how the brain functions. Each affects hearing, so when they are damaged, tinnitus can result.

Another uncommon but legitimate cause of tinnitus is acoustic neuroma, or the presence of a benign tumor on the 8th cranial nerve - the nerve for hearing and balance - that stretches from the brain to the inside of the ear. This nerve maintains hearing abilities and equilibrium.

Treatment of Tinnitus

Tinnitus is treated in a variety of ways. Most doctors attempt to remove earwax that might be rubbing against the eardrum, change the patient's medications or medication regimen and treat the patient if they have a blood vessel disorder. Though there is no single foolproof treatment for tinnitus. Different solutions will work for different patients.

Other methods of treatment include attempts to quiet the sound through masking devices and noise machines. Sometimes special types of hearing aids are capable of decreasing the volume of the ringing sound. Physicians have gone as far as attempting to reduce the noise by prescribing certain drugs like acamprosate, alprazolam and tricyclic antidepressants.

Tinnitus retraining therapy programs also exist. They employ habituation to combat tinnitus and the noise level perceived by the patient. Tinnitus retraining therapy works in about three quarters of situations where it is attempted.

Methods of Prevention

To prevent tinnitus from happening in the first place, people who work in loud environments should wear ear plugs. Those who attend loud sporting events and rock concerts on a frequent basis should also wear ear plugs. Partaking in cardiovascular intensive exercise can also decrease the odds of tinnitus as it will keep the blood vessels working as designed. People should also avoid cleaning the ears with cotton swabs as they will press ear wax against the eardrum. 

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