Tinnitus - Causes, Symptoms, Diagnosis, Prevention & Treatment

Tinnitus

Dr.Anil H.T profile Authored by Dr.Anil H.T on 30 Oct 2014 - 11:58.

A clinical condition of hearing or experiencing characterized sound (like ringing, hissing, clicking or buzzing) in the ear even in the absence of any actual sound is termed as Tinnitus. In fact, it is a consequence of several underlying conditions such as age related hearing disabilities, trauma or damage to the ears, and ailments of circulatory system.

Although it is bothersome, usually it does not indicate any severe condition.  It has been identified that most forms of severe tinnitus have emerged as a consequence of functional alterations in the central nervous system. It is a common condition affecting almost 20 percent of the population, especially in the elderly age group. The condition can be easily tackled with the help of various approaches.

Types of Tinnitus:

Tinnitus is broadly classified into two categories: Objective or Subjective

Subjective tinnitus–It is an imaginary sound experienced in the absence of any actual sound (internal or external). It is the common condition.

Objective tinnitus – It is the actual sound emerged from the internal biological activities like vascular activities, pulses, muscle spasm, etc. It is a rare condition.

Although, it is quite tricky to identify the exact cause of the Tinnitus, following are the suspected causes that might play an important role in the development of the condition:

  • Several underlying health conditions like upper respiratory tract infections
  • Injury to the inner ear cells
  • Trauma or accidents affecting the head or neck severely
  • Various ear related diseases or problems
  • Injuries affecting nerves associated with hearing
  • Declined hearing ability with increasing age may also cause tinnitus
  • Excess or prolonged exposure to loud and intense sounds like loud music
  • Accumulation of too much of earwax forming a hard mass that creates blockages
  • Abnormal growth of middle ear bone (this may be inherited)
  • Abnormal fluid pressure like in case of Meniere's disease
  • Disability of temperomandibular joint
  • Development of noncancerous tumour on the nerve involved in hearing function
  • Several blood vessel disabilities may also cause tinnitus, but it’s quite rare. Common blood vessel disorders involved may include:
  • Development of tumours in the head or neck, exerting excess stress on the blood vessels
  • Atherosclerosis is caused loss of elasticity of the blood vessels in the ear
  • Hypertension and stress
  • Obstructed blood flow
  • Malfunctioning of blood capillaries
  • Several medications may cause tinnitus. These may include some antibiotics, anti-cancer medications, diuretic drugs, medications prescribed for malaria, medications given for depression, and high dose of aspirin.

The common symptom/s of tinnitus is hearing characterized sounds like ringing, buzzing, hissing, clicking, or roaring and so on. These noises may be low or loud and intense enough to disturb your daily routine. These sounds often are on and off in a few people, and in the rest these may be continuously heard. One may hear these noises in one or in both the ears.

When to see a doctor

It’s time to visit your doctor, if:

  • You are experiencing any of the above sounds and it's bothering you.
  • You are experiencing such sounds after a severe cold or any other respiratory infection and the characteristic sound/s persists even after a week or recovery from cold.
  • Tinnitus is accompanied by declining hearing ability or dizziness.

 

 

The diagnosis of tinnitus may involve various approaches, including physical examinations, assessment of medical history and several tests.

Physical examination and medical history assessment: To suspect the possible cause by examining the ear, neck and asking about underlying medical conditions, if any.

Discussion about the symptoms – Specific sound /s that one is experiencing, may help the doctor to predict the suspected cause. For example:

  • Clicking - Contracted muscles around the ear.
  • Murmur - Sudden vascular changes like while working out.
  • Tapping or heartbeat - Problem associated with blood vessels like hypertension.
  • Ringing (low pitch) - Meniere's disease.
  • Ringing (high pitch) - Prolonged exposure to loud and intense noise.
  • Other non-specific sounds - These may be due to accumulation of earwax or abnormal bone growth in the ear.

Assessment of hearing ability:You may be asked to sit in a special room with earphones and then particular sound will be played and results will be assessed.

Assessing the movement: The doctor may ask the patient to move the jaw, eyes, neck, arms etc. to identify and confirm if it is tinnitus.

Imaging studies: One may have to undergo certain imaging studies like MRI or CT scan, depending on the probable cause. 

 

Although tinnitus can affect anybody, the risk is higher if one belongs to any of the below mentioned categories or exposed to the risk factors mentioned below.

  • Prolonged exposure to loud and intense noise like working in the factory with loud machinery noise.
  • Aged (60 or higher)
  • Men are more prone to tinnitus as compared to women of the same age
  • Underlying heart diseases and associated risk factors like stress, smoking, alcohol and caffeine, etc.

Complications:

Prolonged and untreated tinnitus may severely affect the quality of life. In addition to this, it may also lead to following complications:

  • Irritation and discomfort
  • Disturbed sleep
  • Lack of concentration  and memory
  • Feeling tired and exhausted
  • Stress
  • Anxiety and depression

 

 

The first step towards the management of tinnitus may include treating an underlying cause that has been diagnosed.

There are several ways to reduce the intensity of sound that has been experienced due to any underlying health condition. The approaches may include:

  • Removing the accumulated and hardened earwax by experts.
  • Treatment of underlying conditions associated with blood vessels.
  • Discontinuingmedicines that are causing symptoms or replacing them with suitable options.

Electronic support devices to suppress the irritating sound:

White noise devices:It produces pleasant sounds like rainfall, waves and masks the tinnitus / disturbing sound.The tinnitus noise can also be masked with the help of fans or Dehumidifiers in the room.

Hearing device: It makes one listen to the external sounds.

Masking devices: These produce white noise that may suppress the tinnitus symptoms.

A wearable device delivering the music of matching frequency: It helps to distract from tinnitus symptoms and then eventually it can be ignored easily. It’s a part of retraining, in addition to counselling that also helps cope up with the condition.

Medications: Several different types of medications can be used to treat various clinical conditions that might be responsible for tinnitus. Also, other medications like anti-depressants and alprazolam can be used to encounter the depression and symptoms of tinnitus respectively.

Lifestyle and home remedies:

Following lifestyle changes can be helpful to cope with the tinnitus. The common recommendations are:

  • Avoid loud noise, alcohol, smoking etc.
  • Listen to soft music, avoid fan blowing in the ear.
  • Avoid stressful situations.
  • Exercise and be active.

Alternative medicine

In addition to therapeutic approaches, some alternative medicine approaches also can be implemented to experience an additional benefit and relief from the tinnitus. Common alternative options may include:

  • Acupuncture: Relieving the symptoms by the needle pricking technique at specific sites by experts
  • Hypnotherapy: To feel calm and relaxed by the technique of hypnosis by experts
  • Neuro-modulation: It is done with the help of transcranial magnetic stimulation (TMS) which aims to reduce the symptoms of tinnitus.

Diet and nutrition to support the condition

Following are diet and nutrition recommendations that may help one to manage the tinnitus:

  • Follow a healthy food recommendations for hypertension like reduced salt intake, consuming lots of fresh fruits, garlic juice and vegetables etc.
  • Avoid foods containing animal protein, sugar, high fatty foods, and limit processed foods.
  • Include banana, apricots, green vegetables etc. in your diet (good sources of magnesium and potassium).
  • Consume daily recommended dose of multi-vitamin supplements.
  • Avoid coffee, tea or similar drinks (especially B12, B6 and B5 helps to get over the tinnitus symptoms, vitamin A -strengthens the ear membranes, Vitamin E – enhances the oxygen supply).
  • Supplements containing Ginkgo biloba, choline and zinc may also help.

 

 

Not every tinnitus can be treated or prevented completely, but some measures may help to prevent it or its progression. Following are the preventive measures that may be helpful:

  • Protect your ears from loud noises, prefer soft soothing music.
  • Take care of your heart and overall health.
  • Stay healthy and relaxed.
*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.