Understanding tinnitus

Tinnitus is an auditory perception that is not directly produced by an external sound. Tinnitus is commonly described as a “ringing, buzzing or roaring.” It can sound like a low-pitched, medium-pitched or high-pitched tone, or it can sound like noise. Tinnitus may be constant, intermittent, or pulse-like. Its onset may be sudden or gradual, and can be perceived in one or both ears, or in the head.

As many as 50 million adults experience tinnitus, and approximately 20 percent of them seek professional help for the condition. Tinnitus, like pain, is subjective, so two people may report similar tinnitus characteristics yet be affected in significantly different ways.

The severity of tinnitus is largely influenced by the person’s reaction to the tinnitus. Many tinnitus sufferers report interference with sleep, concentration, and attention. Psychological issues such as depression and anxiety may compound the distress caused by tinnitus. Many people with tinnitus also suffer from hyperacusis, which is an inability to tolerate even “normal” sound levels.

The onset of tinnitus often coincides with a stressful emotional, physical, or social change in one’s life. Therefore, tinnitus has both a physiological and psychological component.

The exact mechanism underlying tinnitus is unknown. It is likely that there are many mechanisms. Some of the potential causes are:

  • Disorders in the outer ear canal, such as ear wax, hair or a foreign body touching the eardrum.
  • Disorders in the middle ear, such as vascular abnormalities, infections, otosclerosis, muscle spasms, Eustachian tube dysfunction or benign tumors.
  • Disorders of the inner ear, such as hearing damage due to noise exposure or aging, labyrinthitis (inner-ear infection) or Meniere’s disease (associated with hearing loss and dizziness).
  • Temporary effects of high dosages of medications such as anti-inflammatories (including aspirin, ibuprofen and quinine), certain sedatives and antidepressants. It’s also possible for it to be caused by permanent effects from certain antibiotics and chemotherapeutic agents.
  • Systemic disorders such as high or low blood pressure, anemia, diabetes, thyroid dysfunction, glucose metabolism abnormalities, vascular disorders, acoustic tumors, head or neck aneurysms, or hormonal changes.
  • Trauma to the head or neck, cervical (neck) problems, temporomandibular (jaw Joint) misalignment.

Because tinnitus may be a sign of a treatable disease, it is important to determine the underlying cause before deciding on the management approach. A good place to start is a comprehensive audiologic assessment performed by a doctor of audiology. As tinnitus is associated with a number of auditory conditions, the audiologic assessment can offer extensive information about the cause. The assessment can also help the clinician develop an individualized treatment plan. Fortunately, there are many effective methods to treat tinnitus, or reduce its impact.