Your overall health can affect your hearing. At Hearing Health USA we understand the association between your health and conditions such as tinnitus. We take the time to ask important questions about your health and fully evaluate your hearing. When tinnitus is present our experts perform additional testing to create a treatment plan specifically for you.
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What is Tinnitus?
(Ear)Tinnitus is a constant or intermittent sound heard in the ears and/or head that does not have an outside source. Tinnitus sound differs widely among tinnitus patients with many people describing it as ringing, humming, or buzzing. Tinnitus affects nearly 50 million Americans making it one of the most common health conditions in the country. The U.S. Centers for Disease Control estimates that nearly 15% of the general public experience some form of tinnitus.
Tinnitus can be perceived in many individual ways. It can be an intense ringing: buzzing or hissing, which can be high or low-pitched and vary in frequency of occurrence. Some even experience a pulsing noise that coincides with their heartbeat. While the symptoms vary significantly, tinnitus is rarely a sign of a significant medical problem.
Severity and Frequency
Tinnitus can be in one ear (monaural) or both ears (binaural) and can be either mild or severe. 30% of people with tinnitus report their condition as “moderate” to a “very big problem” in their life with 26% reporting that they have constant tinnitus. Tinnitus is more prevalent in individuals with hearing impairment than it is among the non-hearing impaired population and can occur with any degree or type hearing loss. The severity of tinnitus does not appear to be related to the degree of hearing loss. Additionally, tinnitus onset can be sudden or gradual depending on the causality and related conditions.
Depression and Anxiety
Tinnitus can exist to a debilitating degree in some cases causing depression and/or anxiety. Current estimates suggest that 48-78% of patients with severe tinnitus also experience depression, anxiety or other behavior disorders(1) which can lead to social isolation and despair.
Types of Tinnitus
There are two different types of tinnitus: subjective and objective. Subjective tinnitus is by far the more common type affecting nearly 95% of those with tinnitus. It is audible only to the patient. Objective tinnitus on the other hand, affects less than 5 percent of overall tinnitus patients and is audible with either a stethoscope or simply by listening in close proximity to the ear. Pulsatile tinnitus is an example of objective tinnitus. It causes the sensation of hearing a rhythmic noise such as a heartbeat or swooshing which others can hear.
Causes of Tinnitus
The exact physiological mechanism of tinnitus is unknown. However, researchers have shown there are several likely causes or triggers. These triggers include certain diseases and health problems, medications, and head and neck injury. Specifically, hearing loss, blockage within the middle-ear, head or neck trauma, TMJ disorder, nasal congestion from a severe cold, flu or sinus infection, acute barometric trauma, traumatic brain injury (TBI), ototoxic drugs, other medical conditions including balance disorders.
Common aggravators of tinnitus include caffeine, alcohol, high doses of aspirin, salt, noise exposure and stress or anxiety.
Sensorineural hearing loss is the most common type of hearing loss associated with tinnitus. While the exact biological process by which hearing and tinnitus are connected is still being investigated, researchers have shown that certain frequencies lead to changes in how the brain processes sound. These changes ultimately create an auditory pattern in the brain, which is why the majority of treatment approaches focus on the brain.
Over exposure to noise is the most frequent cause of tinnitus. A single traumatic experience or repeated exposure over time can damage the inner ear structures. The damage may be temporary (acute tinnitus) or longer term (chronic tinnitus) and having accompanying hearing loss.
Hearing health professionals can perform tests to evaluate and diagnose your tinnitus. Because hearing loss is often strongly linked to tinnitus, a comprehensive hearing exam is generally where the evaluation begins.
Once a comprehensive hearing test is completed, the hearing care professional will proceed with specific tinnitus testing. The impact of tinnitus can cause many negative mental, cognitive, and physical consequences (1), therefore, understanding the individual subjective burden that tinnitus has is very important in creating a successful tinnitus treatment plan. When tinnitus and vertigo (dizziness) occur together additional diagnostic testing is required to rule out the presence of inner ear disease.
Protocols including questionnaires and inventories are used in conjunction with tinnitus sound testing to fully address the disease. These include:
- Tinnitus Handicap Inventory
- Tinnitus Reaction Questionnaire
- Tinnitus Functional Index
- Tinnitus Primary Functions Questionnaire
- Tinnitus Handicap Questionnaire
- Visual Analog Scales
There is no cure for chronic tinnitus, however it often becomes less noticeable over time and there are many treatment options to help make it more manageable. The best defense against tinnitus is to prevent it if possible. Since noise exposure is the most significant risk to developing tinnitus, if you’re exposed to loud sounds you should protect your hearing by using hearing protection.
The most effective approaches to treating tinnitus include:
- Cognitive behavioral therapy
- Tinnitus retraining therapy/tinnitus sound therapy
- Tinnitus maskers
- Biofeedback and stress management
- Amplification (hearing aids)
Hearing Aids Tinnitus Remedies
While hearing aids cannot stop tinnitus, they can provide significant tinnitus relief when a hearing loss is present. Using hearing aids for tinnitus can help redirect your brain to process incoming sound and decrease the focus on the tinnitus. The best hearing aids for tinnitus relief are those with integrated software that not only amplifies sound to compensate for your hearing loss but helps to suppress the ringing, buzzing sounds generated by tinnitus.
Some home remedies for treating tinnitus includes decreasing your intake of caffeine, reducing your stress and practicing relaxation techniques.
Almost anyone can experience tinnitus for a short time, however if you experience tinnitus frequently or in conjunction with other medical problems, you should consult with a hearing professional to have your hearing evaluated.
- American Tinnitus Associations
- Center for Disease Control
- UCSF Health