Tinnitus Management

Tinnitus Assessment and Management

Tinnitus is the perception of sound in the ears or head where no external source is present.

Tinnitus can be perceived in one or both ears or in the head. It is usually described as a ringing noise, but in some patients it takes the form of a high pitched whining, buzzing, hissing, humming, or whistling sound, or as ticking, clicking, roaring, “crickets” or “tree frogs” or “locusts”, tunes, songs, or beeping. It has also been described as a “whooshing” sound, as of wind or waves. The sound can also be a combination of sounds. Tinnitus can be intermittent or it can be continuous.

Pulsatile tinnitus is a form of tinnitus whereby the noise has a pulsing quality. The rhythm of the pulsatile tinnitus may correspond exactly with the person’s heartbeat or the rhythm may be much faster than the person’s heartbeat.

The exact physiological cause (or causes) of tinnitus is (are) not known. Tinnitus is a symptom, not a disease. Some of the things which are known to trigger or worsen tinnitus are:

• Noise-induced hearing loss

  When someone is exposed to a sudden, loud sound this may cause acoustic trauma. Acoustic trauma may cause destruction of the hair cells, called cilia, in the inner ear. Once damaged, these hair cells cannot be renewed or replaced. Noise-induced hearing loss may also be the result of chronic or repeated noise exposure.

• Hearing loss

  Up to 90 % of all tinnitus patients have some level of hearing loss.

• Wax build-up in the ear canal

  The amount of wax ears produce varies by individual. Sometimes, people produce enough wax to completely block the outer ear canal. If so, hearing may be compromised and a person’s existing tinnitus may seem louder. Removal of the wax by an ear doctor (otologist or otolaryngologist) may reduce the loudness of the tinnitus.

• Certain medications

  Some medications are ototoxic-that is, the medications permanently damage the hearing and/or balance portion of the ear. There are also medications that are not ototoxic, but produce tinnitus as a side effect without damaging the inner ear. Effects, which can depend on the dosage of the medication, can be temporary or permanent.

• Ear or sinus infections

  Many people, including children, experience tinnitus along with an ear or sinus infection. Generally, the tinnitus will lessen and gradually go away once the infection is healed.

• Certain types of tumors

  Very rarely, people have a benign and slow-growing tumor in the middle ear, or on their auditory, vestibular, or facial nerves. These tumors can cause tinnitus, deafness, facial paralysis, and loss of balance.

• Head and neck trauma

  Physical trauma to the head and neck can induce tinnitus. Other symptoms include headaches, vertigo, and memory loss.

Tinnitus assessment includes a comprehensive hearing assessment including otoacoustic emissions, tinnitus pitch and loudness matching, tinnitus questionnaires, and counseling time. The assessment will determine which other professionals should be involved in the case, such as Primary care physicians, Ear Nose and Throat physicians, Neurotologists, Psychologists, etc.

When tinnitus is linked to hearing loss, hearing aids have proven to be one of the most used and successful ways to address tinnitus to decrease the perception. Remember tinnitus is not a disease, it is a symptom, and if linked to hearing loss, our main concern is your perception of it. If we can work to decrease this perception, minimizing it, then you would be able to continue with your activities without concerns, stress or the feeling of being overwhelmed due to this noise in your life.

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