Tinnitus is the perception of sound in the absence of external noise. Although it is often referred to as "ringing in the ears", tinnitus can manifest many different sound perceptions, such as ringing, hissing, whistling, and clicking. In some rare cases, tinnitus patients report hearing music. Tinnitus can be an acute (temporary) or chronic (continuous) condition.
There are two types of tinnitus:
Subjective tinnitus: noises in the head or ear that are perceptible only to the individual patient. Subjective tinnitus is usually due to auditory and neurological reactions to hearing loss but can also be caused by other catalysts. More than 99% of all reported tinnitus cases are subjective.
Objective tinnitus: Noises in the head or ear that are audible to others as well as to the patient. These sounds are usually produced by internal functions of the circulatory (blood flow) and somatic (musculoskeletal movement) systems of the body. Objective tinnitus is very rare and accounts for less than 1% of all tinnitus cases.
Causes
Sound as such is produced because tiny hair cells in the inner ear move when sound waves arrive. This movement causes electrical signals to be sent through the nerve from the ear to the auditory nerve in the brain, which interprets these signals as sound.
Tinnitus usually occurs as a result of an underlying cause, often related to a health condition.
For many people tinnitus can occur due to one of the following causes:
Hearing loss. Tinnitus arises when the auditory cilia in the inner ear bend or break, due to age or too much exposure to loud noise, and this can cause electrical impulses to "leak" to the brain for no reason.
Ear infection or ear canal blockage. The ear canals can become blocked by fluid build-up, infection, wax, dirt or other foreign material that can alter the pressure in the ear and cause tinnitus.
Head and neck injuries. A blow or trauma to the head or neck can affect the inner ear, the auditory nerves or a function of the brain that is linked to hearing. Sometimes these injuries can cause tinnitus in only one ear.
Medications. Some medications that can cause tinnitus are non-steroidal anti-inflammatory drugs, antibiotics, but also cancer drugs, malaria, antidepressants and even diuretics.
The way some drugs might cause tinnitus is by very high doses and it can disappear when the use of these drugs is stopped.
Other less common causes:
Tinnitus can manifest as an early symptom of Manière’s disease, where there is abnormal otic fluid pressure.
A neurinoma is a benign tumour on the cranial nerve, which runs from the brain to the ear and controls both balance and hearing. Similarly, other tumours of the head, neck or brain.
Thyroid problems, diabetes, migraines, anaemia or other autoimmune disorders such as rheumatoid arthritis and lupus, according to reports from the Mayo Clinic in the United States, have been linked to tinnitus.
Anyone Can Suffer from Tinnitus
It doesn't matter how old you are, but your lifestyle does. Risk factors that can increase the occurrence of tinnitus are:
Constant exposure to loud noises. Sounds from heavy machinery, saws, firearms, as well as frequent and loud use of portable music devices, music players can cause hearing loss related to high volume and long periods of time.
As we age, the number of functioning nerve fibres in the ears decreases, which may cause hearing problems related to tinnitus.
In general, men are more likely to develop tinnitus than women.
Certain health problems such as obesity, high blood pressure, cardiovascular conditions and even arthritis increase the risk of tinnitus.
An abnormal, rigid growth of the ossicles of the ear, which tends to be an inherited condition.
Muscle spasms of the inner ear causing plugging, tinnitus, and hearing loss. Sometimes for no reason, but sometimes due to neurological disease.
Problems with the temporomandibular joint, where the jaw meets the skull, may cause tinnitus.
Blood vessel conditions such as atherosclerosis, high blood pressure or malformed blood vessels can cause blood to move more forcefully through veins and arteries.
Hygiene and Prevention
Caring for the ears is important in many ways. Cleaning is one step, while preventing and treating infections is another. Ear care also includes taking measures to avoid unnecessary noise and monitoring for possible hearing loss.
Hygiene tips:
Clean your ears with special care. Do not clean your ears with anything smaller than a wipe on your finger. Do not use cotton buds, bobby pins, bobby pins or sharp objects to clean your ears. These objects can damage the ear canal or eardrum.
Earwax is the ear's way of cleaning itself. If you have a build-up of earwax that prevents you from hearing, have it removed by a healthcare professional. Do not try to remove it yourself.
If your ears are itchy or painful, call your doctor. He or she will examine you, advise you on appropriate treatment and help you decide if you need to see a specialist.
If you have pierced ears, regularly clean the earrings and lobes with alcohol.
Turn down the volume. Listening to loud music with or without headphones can contribute to hearing loss and tinnitus.
Wear hearing protection. Especially if your job requires exposure to loud noises such as machinery, power saws, firearms or music.
Maintain good cardiovascular health. By improving the functioning of your circulatory system through exercise, you activate blood flow to the brain and all associated areas.
Alternative Treatments
Tinnitus can improve in many people by treating the underlying cause or with treatments that reduce or block the noise so that the tinnitus is felt less.
Specialists at the Mayo Clinic in the United States suggest acupuncture and some supplements such as melatonin, ginkgo biloba or zinc supplements to counteract tinnitus.
Stress management. Stress can make tinnitus worse, so it is important to use practices such as relaxation, meditation and physical exercise that can provide relief.
In more acute cases, it is best to consult your doctor as behavioural therapies are available or prescription medication such as antidepressants may be prescribed.