WHAT IS TINNITUS?

The most common myth is that tinnitus is a disease or illness. But actually, it is a symptom where one can hear a whistling, ringing, or humming sound in the ear, the source of the sound is internal and not the outside noise.

Tinnitus originates from the Latin word “Tinnier” which in English means “Ringing”. The noises heard in the ear can be maddening and hence person suffering from it can feel vulnerable. Its cause and cure are still not clear though temporary efforts to minimize the sound are practiced. Tinnitus is a common problem affecting about 15-20% of people above the age of 40 years.

CAUSES OF TINNITUS

If the ringing sound is heard in one ear, then most probably it is the impacted or build-up wax that causes the pressure on the internal ear generating the sound.

If the tinnitus is in both the ears, then the causes maybe:

• Age-related
• Ear injury or middle ear infection
• Hearing loss
• Injuries to cervical vertebra
• Acoustic shock
• Excessive stress, anxiety, or physical illness
• Perilymphatic fistulas
• Prolonged use of medications like anti-inflammatory drugs, anti-malarial medicines or anti-depressants

SYMPTOMS AND TYPES OF TINNITUS

Anyone or more factors can be the cause of tinnitus which accompanies the following symptoms.

• Continuous ringing, humming, buzzing, or whooshing sound.
• Headaches.
• Irritability.
• Loss of focus.
• Depression and anxiety.
• Pain in the ear.

It’s still not clear what triggers tinnitus. But causes can vary in intensity, frequency, and duration. Tinnitus can be categorized as

• Acute
• Chronic
• Subjective
• Objective

• ACUTE TINNITUS:

  When the tinnitus lasts up to three to four months and is treated easily or naturally where the cause may be ear wax or some infection or exposure to loud noise.

• CHRONIC TINNITUS:

  When the tinnitus lasts more than six months. If the on and off bursts of tinnitus are observed it means, there is a good chance that over some time it will fade away but if it goes on for months and months or years then it means the condition is permanent and has become chronic.

• SUBJECTIVE TINNITUS:

  Mostly tinnitus is subjective. It is that ringing, buzzing, roaring, or clicking sound is created internally and external acoustic stimulus is absent. Mostly enlarged number of cases of tinnitus is subjective.

• OBJECTIVE TINNITUS:

  In complex cases where the tinnitus is heard by the examiner or more complex sounds are heard by auditory hallucinations the tinnitus is described as objective.

TESTS FOR TINNITUS

If the condition of tinnitus lasts over three days a visit to ENT is recommended. The diagnosis is hard to find out but certain tests and medical history help to identify the condition.

• HEARING TEST (AUDIOLOGICAL EXAM) is executed in a soundproof room wearing an earphone. The results are compared with the results considered normal for your age.
• Certain lab tests according to your medical history are also advised. Ruling out anemia, thyroid, vitamin deficiencies, or any kind of heart disease..
• Depending on the intensity and severity of tinnitus CT or MRI of the skull, examination of the cervical spine and the jaw is recommended.
• Testing the transfer of sound from the inner ear, testing balance, and objective hearing test.

Once the patient describes the kind of sound heard it becomes easier for the doctor to do the proper diagnosis.

E.g.; if the tinnitus is of clicking sound it suggests that muscle contraction in and around the ear might be causing tinnitus.

If the sound is pulsing, rushing, or humming then the cause may be vascular due to high blood pressure.

If tinnitus is giving low pitched ringing then the reason could be ear canal blockage, Meniere’s disease, or maybe otosclerosis (stiff bones of the inner ear)

If high-pitched ringing is heard then most likely it could be because of loud noise exposure, hearing loss, or hearing or prolonged medication.

With all the above understanding from above so far it is understood that those detected with tinnitus should not underestimate the symptoms. It is important to observe and understand the condition like “when does it occur?”, “What alleviates the noise?”, “Does head movements make condition tolerable in certain positions?” “Is the trouble in one ear or both ears?” All this information helps the doctor determine the type and cause of tinnitus.

TREATMENT

After examination and understanding of the underlying condition of tinnitus doctor may be able to reduce the symptoms by using the below-mentioned causes.

• Foremost important factor is the removal of ear wax which is causing the blockage.
• If the blood vessel condition is the cause then medication, surgery, or related treatment will be suggested.
• According to medical history the use of certain steroids, anti-inflammatory drugs, and anti-depressants have to be stopped or reduced, or switch to alternative medication.
• Age-related hearing loss or noise-induced tinnitus condition can be improved by using hearing aids. It is generally important to avoid noise. Hearing Aids help to markedly improve the quality of life in such cases.
• Many times effective methods to cure tinnitus fail. In such cases, white noise helps make tinnitus less noticeable. Certain devices like speakers and humidifiers can be used to create white noise and help make sleeping at night comfortably.

Certain masking devices worn in the ear produce a continuous low-level white noise that reduces tinnitus symptoms.

COUNSELLING

Drugs in away are not much helpful in curing tinnitus, so along with other remedies, behavioral treatment options aim to help live with tinnitus bothering less in routine.

• Tinnitus Retaining Therapy:

  (TRT) An audiologist designs an individualized program combining sound masking and counseling session in a tinnitus treatment center. Typically, the patient is given a device to wear in the ear that helps mask tinnitus along with directive counseling. Over some time, TRT helps tinnitus be less noticeable and the person feels less distressed.

• Cognitive Behavioural Therapy:

  A psychologist or licensed mental health professional makes you learn techniques for coping with tinnitus symptoms and you feel less bothersome. This helps cope with anxiety, stress, and depression. Group and individual sessions are available online as well.

Certain tips can help reduce symptoms of tinnitus. Few adjustments in lifestyle help in making the symptoms less troublesome. Little evidence in reducing tinnitus has been observed by acupuncture, zinc supplements, limiting alcohol and caffeine, and some Ayurveda therapies to mention.