Introduction to Tinnitus
Tinnitus is the medical term for hearing sounds that don’t have an external source.
What is Tinnitus?
Tinnitus is the medical term for hearing sounds that don’t have an external source. These can be created internally through a range of possible mechanisms. Tinnitus can be further subdivided into subjective tinnitus which is imperceptible by a clinician, or objective tinnitus which a clinician can hear through a stethoscope.
What are the causes for Tinnitus?
Tinnitus can be caused by a range of factors depending on its classification: The simplest of these involve a build-of earwax in the ear canal or fluid in the middle ear which can affect your perception of sound. Noise-induced hearing impairments due to damage to the cochlea (the shell-like structure within the ear that converts sound waves into nervous activity) are frequently implicated.
Ménière’s disease is an inner ear condition that can affect your hearing, balance, and often causes tinnitus.
Pulsatile tinnitus can be caused by a bruit, a sound associated with a potentially more serious arterial abnormality that audibly affects blood flow. These can include blockages, aneurisms, stenoses or arteriovenous fistulas.
What are the symptoms of Tinnitus?
Many people believe that tinnitus is defined as extended ringing in the ears but in reality the sound perceived can take on a variety of forms such as grinding, hissing, whistling, sizzling etc. Some people experience sounds that vaguely resemble conversations, music or even cicadas.
Some patients present with changes in their response to sounds alongside their tinnitus: They may have hyperacusis, an increased sensitivity to certain volumes or frequencies of sound, or hypoacusia, a decreased sensitivity. Hearing loss is commonly associated if the tinnitus is caused by some form of damage to the ear howevermore than a third of tinnitus cases don’t actually present alongside other clinically significant ear conditions.
There is also a more specific characterisation of tinnitus termed pulsatile tinnitus where the sound perceived occurs in alongside your pulse.
The most serious, long-lasting cases of tinnitus can also lead to psychological symptoms more commonly associated with depression or anxiety such as an inability to concentrate for extended periods of time and poor sleep.
How is Tinnitus treated?
Treatment depends on whether the cause of the tinnitus is an identifiable condition, in which case that particular condition will be treated such as through the use of eardrops to treat earwax build-ups.
In many cases there isn’t an easily identifiable cause and the clinical approach would be to help the patient manage the symptoms of their condition as best they can. In severe cases this can include cognitive behavioural therapy, relaxation techniques, sleep hygiene improvements and conselling.
Sound therapy is a technique used to fill silences with ambient, neutral, natural sounds so as to reduce the patients’ awareness of the tinnitus. Tinnitus retraining therapy is an alternative technique aimed at training the patient to become progressively less conscious of their tinnitus by improving their response to it. This can be given in combination with sound therapy.