Tinnitus

Tinnitus is the perception of noise or ringing in the ears. The noise can be ringing, buzzing, roaring, clicking or hissing. Although it is bothersome it usually does not signify any underlying serious problem.

Causes of tinnitus
  • Age-related hearing loss – Hearing loss can cause tinnitus as one gets older. This is called presbycusis.
  • Exposure to loud noise – Long term exposure to loud noises like heavy equipment, chain saws, firearms and portable music devices can lead to hearing loss and tinnitus.
  • Earwax blockage – Too much earwax can harden and cause hearing loss and irritation of ear drum which can lead to tinnitus.
  • Ear bone changes – Called otosclerosis can run in families and cause tinnitus.
  • Meniere’s disease – An inner ear disorder caused by abnormal inner ear fluid pressure, where tinnitus can be an early indicator of the disease.
  • TMJ disorders – Problems with the temporomandibular joint can cause tinnitus.
  • Head or neck injuries – Head or neck trauma can affect the inner ear, hearing nerves or brain function linked to hearing. This usually cause tinnitus in one ear only.
  • Acoustic Neuroma – This benign tumor develops on the cranial nerve that runs from the brain to the inner ear that controls balance and hearing. Also causes tinnitus in one ear.
  • Blood vessel disorder – In rare cases pulsatile tinnitus is caused by atherosclerosis, head and neck tumors, high blood pressure, turbulent blood flow due to narrowing or kinking in neck artery, or arteriovenous malformation.
  • Medications – Certain medications can cause or worsen tinnitus. Antibiotics like Polymyxin B, erythromycin, vancomycin and neomycin, cancer medications including mechlorethamine and vincristine, diuretics such as bumetamide and furosemide, quinine medications, certain antidepressants and high dose aspirin. Often the noise disappears when you stop the drug.
Complications

Tinnitus can affect quality of life. The person may also experience fatigue, stress, sleep problems, trouble concentrating, memory problems. Depression, anxiety and irritability.

Treatment
  • Treating an underlying health condition – Earwax removal, treating a blood vessel condition and changing your medication
  • Noise suppression – Your doctor may suggest an electronic device to suppress the noise.
  • Drugs – This cannot cure the tinnitus but may reduce the severity. Possible drugs include tricyclic antidepressants and alprazolam but this have their side effects and are habit forming and should be avoided and used only as a last resort.
  • Lifestyle changes – Avoid possible irritants like loud noises, caffeine and nicotine. Cover up the noise with fan or soft music. Manage stress as stress can make tinnitus worse. Reduce alcohol consumption as this increases blood flow and worsen tinnitus.
  • Supplements – The gingko EGb 761 taken at a dose of 120 mg for three months helps in certain patients. Also can try zinc and B supplements.
  • Alternative therapies – Some people have tried acupuncture and hypnosis with varying results.
Coping and Support

Tinnitus does not always improve or go away with treatment. Some suggestions to help you cope include counseling. Support groups and educating yourself.

However if you have new onset tinnitus always first go and see a doctor and  I recommend to see an ENT specialist. Make sure it is not one of the treatable causes.

Ref: Mayo clinic

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