All About Tinnitus
What is tinnitus?
Known more commonly as “ringing of the ears,” tinnitus is a condition in which people experience sounds where there is no external stimulus. The American Tinnitus Association (ATA) estimates that millions of Americans “experience tinnitus, often to a debilitating degree, making it one of the most common health conditions in the country.” Approximately 15% of Americans – over 50 million people – experience tinnitus, whether it is temporary or chronic. Approximately 20 million Americans experience chronic tinnitus, with 2 million experiencing debilitating cases.
An estimated 80% of tinnitus cases go hand in hand with hearing loss. This is due to the relationship between hearing and inner ear hair cells. With presbycusis (age-related hearing loss) and noise-induced hearing loss, there may be degeneration to inner ear hair cells. Inner ear hair cells are responsible for translating sound vibrations into neural signals recognized by our brains as sound. Hearing specialists suggest that tinnitus may result from the degeneration of these hair cells, as they may send phantom signals to the brain, which is then registered as sound.
Types and Causes of Tinnitus
Tinnitus is usually not an isolated condition in and of itself. The appearance of tinnitus often points to other underlying health conditions. Identifying and treating tinnitus may lead to a reduction or elimination of the symptoms. The ATA notes, “While tinnitus is most often triggered by hearing loss, there are roughly 200 different health disorders that can generate tinnitus as a symptom.”
Objective tinnitus creates a sound that can be heard by people who sit nearby. Objective tinnitus comprises less than 1% of cases, and has been linked to circulatory or somatic systems in the body. Objective tinnitus takes the form of pulsatile tinnitus, in which increased blood flow or muscle spasms affect hearing. In some cases, pulsatile tinnitus is synchronous with the beating of the heart. Other cases of pulsatile tinnitus indicate a problem with the small muscles of the middle ear or the bones of the inner ear. Conditions such as high blood pressure and others that affect blood flow may lead to objective tinnitus. In these cases, by treating related medical conditions, people may find relief from tinnitus.
With subjective tinnitus, only the person experiencing tinnitus can hear the sound. Because our bodies and nervous systems differ from person to person, these sounds take many diverse forms. Subjective tinnitus is the most common form, comprising 99% of reported cases. Causes of subjective tinnitus include sensorineural hearing loss due to damage of inner ear hair cells (aging, exposure to loud noise, and even certain classes of ototoxic medication); Meniere’s disease; impacted earwax; or another related medical condition.
Everyone reacts to tinnitus differently which means everyone needs an individualized treatment plan tailored specifically to them. Some patients, just upon being educated on tinnitus, find relief. Others find more targeted strategies such as environmental distractors, sound therapy, group rehabilitation, and cognitive behavioral therapy beneficial. Many patients benefit from a combination of several of these strategies. Occasionally tinnitus can be treated medically and when this is discovered during the evaluation, a medical referral is given.
Tinnitus has the potential to contribute to increased levels of stress, anxiety, and depression. Tinnitus has been linked to memory problems, the ability to concentrate, and fatigue. Tinnitus has been known to affect a person’s emotional well-being, interfering with social interaction and employment.
There is no cure for tinnitus, but there is effective treatment. Because the majority of tinnitus cases are linked with hearing, seeking a hearing exam and consultation might be the first step to finding a solution. If your tinnitus is linked with hearing loss, Dr. Ivory will provide options for hearing aids that will address both issues.
How do we help manage your tinnitus?
If you have hearing loss, treating your hearing loss will be recommended as part of your tinnitus management plan. Period. It is like having a broken arm. If you go to the doctor and get medication for your broken arm it may feel a little better for a period of time but you still have a broken arm. We must treat the hearing loss so that we can begin to successfully manage the tinnitus. Tinnitus is also commonly treated with the use of sound masking, available on hearing aid tinnitus therapy features. Hearing aid manufacturers also offer standalone devices to generate sound masking for tinnitus.
Many hearing aid manufacturers offer hearing aids with tinnitus therapy. Tinnitus therapy is most commonly sound masking – using tones or nature sounds to mask the frustrating sounds of tinnitus. There are also exercises available to provide relief and to train the brain away from hearing the sounds of tinnitus.