Wednesday, September 15, 2010

To Your Health Wednesday - Understanding Tinnitus

I am dealing with a subject today that is near and dear to my heart....and not in the fondest sense either.  The subject is Tinnitus.  Many of you may be familiar with it having dealt with it yourself or perhaps you have a friend or loved one with this issue. 

It is a little understood problem, as it is something that only the patient can hear.  Tinnitus is a ringing, swishing or other type of noise that seems to originate in the ear or head.  I've heard people talk about roaring, clicking, or other variety of sounds in their ears that never seems to go away.  Doctors have many theories on what causes tinnitus, many of them very plausible.  Exposure to loud noises for instance, is a leading cause of tinnitus in many people.  Often these things happen over time so it isn't readily apparent that you are damaging your hearing by going to the shooting range, hunting, seeing your favorite band in concert or working in a loud environment unprotected.

Read this article on tinnitus by
(Ringing and Other Ear Noise)
Medical Author: John P. Cunha, DO
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

What is tinnitus?

Tinnitus is a ringing, swishing, or other type of noise that seems to originate in the ear or head. In many cases it is not a serious problem, but rather a nuisance that eventually resolves.

It is not a single disease, but a symptom of an underlying condition. Nearly 36 million Americans suffer from this disorder. In almost all cases, only the patient can hear the noise.

What causes tinnitus?

Tinnitus can arise in any of the following areas: the outer ear, the middle ear, the inner ear, or by abnormailities in the brain. Some tinnitus or head noise is normal. If one goes into a sound proof booth and normal outside noise is diminished, one becomes aware of these normal sounds. We are usually not aware of these normal body sounds, because outside noise masks them. Anything, such as wax or a foreign body in the external ear, that blocks these background sounds will cause us to be more aware of our own head sounds. Fluid, infection, or disease of the middle ear bones or ear drum (tympanic membrane) can also cause tinnitus.

One of the most common causes of tinnitus is damage to the microscopic endings of the hearing nerve in the inner ear. Advancing age is generally accompanied by a certain amount of hearing nerve impairment, and consequently tinnitus. Today, loud noise exposure is a very common cause of tinnitus, and it often damages hearing as well. Unfortunately, many people are unconcerned about the harmful effects of excessively loud noise, firearms, and high intensity music. Some medications (for example, aspirin) and other diseases of the inner ear (Meniere's syndrome) can cause tinnitus. Tinnitus can in very rare situations be a symptom of such serious problems as an aneurysm or a brain tumor (acoustic tumor).

How is tinnitus evaluated?

A medical history, physical examination, and a series of special tests can help determine precisely where the tinnitus is originating. It is helpful for the doctor to know if the tinnitus is constant, intermittent or pulsating (synchronous with the heart beat), or is it associated with hearing loss or loss of balance (vertigo). All patients with persisting unexplained tinnitus need a hearing test (audiogram). Patterns of hearing loss may lead the doctor to the diagnosis.

Other tests, such as the auditory brain stem response (ABR), a computerized test of the hearing nerves and brain pathways, computer tomography scan (CT scan) or, magnetic resonance imaging (MRI scan) may be needed to rule out a tumor occurring on the hearing or balance nerve. These tumors are rare, but they can cause tinnitus.

What is the treatment of tinnitus?

After a careful evaluation, your doctor may find an identifiable cause and be able to treat or make recommendations to treat the tinnitus. Once you have had a thorough evaluation, an essential part of treatment is your own understanding of the tinnitus (what has caused it, and your options for treatment).

In many cases, there is no specific treatment for tinnitus. It may simply go away on its own, or it may be a permanent disability that the patient will have to "live with." Some otolaryngologists have recommended niacin to treat tinnitus. However, there is no scientific evidence to suggest that niacin helps reduce tinnitus, and it may cause problems with skin flushing.

Can tinnitus be prevented?

Do not place objects in your ear such as cotton swabs (Q-tips) to clean your ear. This can cause a wax impaction against your eardrum which can cause tinnitus. Take blood pressure medicines and other prescribed medications as they are ordered by your doctor.

According to the American Tinnitus Association there are several things you can do to protect yourself from excessive noise related tinnitus:

  • Protect your hearing at work. Your work place should follow Occupational Safety & Health Administration (OSHA) regulations. Wear ear plugs or earmuffs and follow hearing conservation guidelines set by your employer.

  • When around any noise that bothers your ears (a concert, sporting event, hunting) wear hearing protection or reduce noise levels.

  • Even everyday noises, such as blow drying your hair or using a lawnmower, can require protection. Keep ear plugs or earmuffs handy for these activities.

    Is there anything to do to lessen intensity of the tinnitus?

    It is important to realize that the hearing system is one of the most delicate and sensitive mechanisms in the body. Since it is a part of the general nervous system, it is sensitive, to some degree, by anything that affects the overall health of the individual (both physical and psychological). Therefore, in order to lessen the intensity of tinnitus, it is advisable to make every effort to:

  • Avoid exposure to loud sounds and noises.

  • Control blood pressure.

  • Decrease salt intake.

  • Avoid nerve stimulants such as coffee and colas (caffeine) and tobacco (nicotine).

  • Reduce anxiety.

  • Try to stop worrying about the tinnitus. Often, the more you worry and concentrate on the noise, the louder it will become.

  • Get adequate rest and avoid fatigue.

  • Exercise.

  • Utilize masking noise. Tinnitus is usually more bothersome when the surroundings are quiet, especially when you are in bed. A competing sound such as a ticking clock, a radio, a fan or white noise machine may help mask tinnitus. Small hearing aid like devices which generate a competitive sound may help reduce the awareness of the tinnitus.

  • Biofeedback may help or diminish tinnitus in some patients.

  • Avoid aspirin or aspirin products in large quantities.

    Tinnitus At A Glance

  • Tinnitus is abnormal ear noise.

  • Tinnitus can arise in any of the four sections of the ear: the outer ear, the middle ear, the inner ear, and the brain.

  • Persisting unexplained tinnitus is evaluated with a hearing test (audiogram).

  • Measures can be taken to lessen the intensity of tinnitus.

  • I've read absolutely everything I can find on tinnitus over the past few months and haven't found any definitive answers to this point.  It started about 3 months ago with a light ringing in my left ear.  I'd describe it as the same thing you would experience after shooting an extremely loud firearm or going to a rock concert and having seats next to the 6' tall speakers.  At first it was minor, but as time went on it has become very intense and now has affected my right ear to a lesser degree.

    I've excercised regularly for the past 4 years and increased that to no effect.  Changes in diet, medicines, sleeping habits and most everything I could think of hasn't given me any relief.  I do however, have a few more things to try, one of them being to candle my ears.  I am going to try it tonight and will let you know if I have relief.  Believe me, if this works, I will be shouting it from the rooftop!! 

    Do you have tinnitus?  Do you still have it or did you find relief?  If so, tell your story!!  I'd love to hear it!

    1 comment:

    Satya said...

    tinnitus ... never heard of it but i will surely take care of my ears now...thanks for the informative post