Learning Center: TINNITUS

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Tinnitus

Tinnitus is the perception of sound when no corresponding external sound is present. While often described as a ringing, it may also sound like a clicking, buzzing, hiss, or roaring. Tinnitus is usually, but not always associated with hearing loss, and may be considered as a low signal-to-noise ratio from the ears.

Tinnitus may have no cure, but there are several treatments for this vexing problem. In brief, distracting noise (such as “white noise"), use of hearing aids, getting good sleep, getting daily exercise, and avoiding known dietary triggers (caffeine, ibuprofen and similar medications, apple cider vinegar, among others), alcohol, avoiding topical causes (sunscreen), and even undertaking cognitive behavioral therapy may help. Of course, prevention of tinnitus or its progression is important, and this is accomplished by avoiding excessive noise exposure and avoiding medications that hurt the inner ear (such as certain malaria medications and intravenous antibiotics called aminoglycosides).

• “How Can I Lessen the Impact of Tinnitus” at ENTHealth.org.

• Tinnitus information and resources from the American Speech and Language Association

Types of tinnitus

While people may experience various types of phantom sounds in their ears, including humming, buzzing, clicking, sound of crickets, etc., the two main categories are pulsatile tinnitus and non-pulsatile tinnitus. Pulsatile tinnitus has a rhythm that corresponds to one’s heartbeat. This can be tested at home, as shown in this video. Non-pulsatile tinnitus includes all other types of tinnitus (ringing, humming, whooshing, etc.), and is more common.

Tinnitus and hearing loss

About 70% of people with tinnitus have hearing loss, and about 70% of people with hearing loss have tinnitus. In large part, hearing loss and tinnitus may be considered two sides of the same coin, as they often relate to dysfunction of the inner ear/cochlea.

treatment and management of tinnitus

While there is not a quick and ready “cure” for most types of tinnitus, methods for minimizing the nuisance of tinnitus do exist. There is not a single “one size fits all” technique for helping tinnitus, but several options exist that may be of use to the individual. These include the following:

  • Direct your mental focus elsewhere.

  • Use some other noise in your vicinity to help mask the tinnitus. This could be a fan, music, or any other comforting sound. Several smartphone apps have been developed for this purpose.

  • Very important: Get exercise daily, especially with at least some intense exercise.

  • Very important: Get good sleep. Minimize or manage stress.

  • Avoid exposure to loud sounds and prolonged exposure to even moderately loud sounds. This is preventative.

  • Identify if any of your medications cause tinnitus, and discuss options with your prescribing physician.

  • Avoid some of the other products that can promote tinnitus, including

    • Stimulants such as caffeine and tobacco

    • Alcohol

    • Apple cider vinegar, certain sunscreens.

HEARING AIDS and tinnitus

The most effective measure to minimize tinnitus worldwide is the use of hearing aids. Since about 70% of people with tinnitus that is not due to one’s heartbeat also have hearing loss, the benefit is twofold. By amplifying the sound in one’s environment, the user hears more of the sound that is present and doing so helps minimize the perception of tinnitus. Some hearing aids also have a program within them to present mild brief static noise randomly throughout the day in order to train the brain to ignore tinnitus, which is a benefit extending to times in which the hearing aids are not in use, such as while sleeping.

ear pressure, ear infection, or Ear fluid and tinnitus

Many people have a low level of tinnitus that goes unnoticed unless something occurs to reduce hearing. When outside sounds are diminished, any low level of tinnitus may then become more apparent. Placing ear plugs or going to an especially quiet environment are scenarios this may be demonstrated. If an individual were to have fluid behind the tympanic membrane or even if the air pressure behind the tympanic membrane were significantly different from the surrounding air pressure, decreased conduction of sound waves temporarily leads to less hearing, which also can “unmask” or reveal tinnitus that is no longer out competed by other sounds.

Auditory Processing Disorder

Auditory processing disorder (APD), rarely known as King-Kopetzky syndrome or auditory disability with normal hearing (ADN), is an umbrella term for a variety of disorders that affect the way the brain processes auditory information. Individuals with APD usually have normal structure and function of the outer, middle, and inner ear (peripheral hearing). However, they cannot process the information they hear in the same way as others do, which leads to difficulties in recognizing and interpreting sounds, especially the sounds composing speech. It is thought that these difficulties arise from dysfunction in the brain.

The American Academy of Audiology notes that APD is diagnosed by difficulties in one or more auditory processes known to reflect the function of the brain. It can affect both children and adults. Its prevalence is currently estimated to be 2–7% in children in US and UK populations. APD can continue into adulthood. Cooper and Gates (1991) estimated the prevalence of adult APD to be 10 to 20%. It has been reported that males are twice as likely to be affected by the disorder as females, and that prevalence is higher in the elderly and increases with age.

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