Tinnitus (Ringing in the ears)

Tiresome Ringing in the Ears

Tinnitus is a ringing, swishing, or other type of noise that seems to originate in the ear or head. Most people will experience tinnitus or sounds in the ears at some time or another.

Tinnitus can be extremely disturbin. In many cases it is not a serious problem, but rather a nuisance that may go away. However, some people with tinnitus may require medical or surgical treatment.

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

Some tinnitus or "head noise" is normal. 

A number of techniques and treatments may be of help, depending on the cause:

1. Some of the most common include a sound of crickets or roaring, buzzing, hissing, whistling, and high-pitched ringing
2. Other types of tinnitus include a clicking or pulsatile tinnitus (the noise accompanies your heartbeat).
3. The most common type of tinnitus is known as subjective tinnitus, meaning that you hear a sound but it cannot be heard by others. 
4. A much more uncommon sort is called objective tinnitus, meaning your doctor may sometimes actually hear a sound when he or she is carefully listening for it.

Tinnitus Causes 

Tinnitus is not a disease in itself but rather a reflection of something else that is going on in the hearing system or brain.

Probably the most common cause for tinnitus is hearing loss. 

• As we age, or because of trauma to the ear (through noise, drugs, or chemicals), the portion of the ear that allows us to hear, the cochlea, becomes damaged. This tinnitus can be made worse by ear infection or excess wax in the ear. 
• Tinnitus caused by ear trauma is usually noticed in both ears, because both ears are usually exposed to the same noises, drugs, and other influences
• Loud noise exposure is a very common cause of tinnitus today, and it often damages hearing as well. Unfortunately, many people are unconcerned about the harmful effects of excessively loud noise from firearms, high intensity music, or other sources.
• Other causes of tinnitus include drugs such as aspirin (if overused), aminoglycoside antibiotics (a powerful form of infection-fighting drug), and quinine.
• Meniere's disease includes dizziness, tinnitus, and fullness in the ear or hearing loss that can last for hours, but then goes away. This disease is actually caused by a problem in the ear itself. The tinnitus is merely a symptom.
• A rare cause of subjective tinnitus includes a certain type of brain tumor known as an acoustic neuroma. The tumors grow on the nerve that supplies hearing and can cause tinnitus.
• Causes of objective tinnitus are usually easier to find.
• Pulsatile tinnitus is usually related to blood flow, either through normal or abnormal blood vessels near the ear. Causes of pulsatile tinnitus include pregnancy, anemia (lack of blood cells), overactive thyroid, or tumors involving blood vessels near the ear.

When to Seek Medical Care

Most newly noticed tinnitus should be evaluated by a physician. Because tinnitus is usually a symptom of something else, if it begins suddenly, visit a doctor. This is particularly important if the tinnitus is only heard on one side. 

Although the majority of cases of tinnitus are not caused by any acute problems, certain symptoms need to be evaluated to determine whether or not a more serious medical condition is causing the symptoms.

Any time that tinnitus comes on suddenly, particularly in one ear or is associated with hearing loss, seek an immediate evaluation. Sudden hearing loss is often accompanied by tinnitus, and there are medications that may help to restore that hearing. Also certain types of tumors can cause sudden hearing loss and tinnitus that warrant an evaluation.

Medical Treatment
Treatment for tinnitus depends on the underlying cause of the problem.

In the majority of cases, tinnitus is caused by damage to the hearing organ. In these cases, there is normally no need for treatment other than reassurance that the tinnitus is not being caused by another treatable illness.
In the very rare instance where the tinnitus is extremely bothersome, there are a number of treatment options:

• Some of the most helpful include antianxiety or antidepressant medication and sometimes maskers-small devices like hearing aids that help to block out the sound of the tinnitus with "white noise."
• For people who are bothered by tinnitus only when trying to sleep, the sound of a fan, radio, or white noise machine is usually all that is required to relieve the problem.
• Most people with tinnitus find that their symptoms are worse when under stress, so relaxation techniques can be helpful.
• Avoiding caffeine is advised, as it may worsen symptoms.
• Biofeedback may help or diminish tinnitus in some patients.
• Avoid aspirin or aspirin products in large quantities
• Hearing loss worsens the effect of tinnitus, so protection of hearing and avoiding loud noises is very important in preventing worsening of the symptoms.

In cases where the tinnitus is caused by one of the other rare problems (such as a tumor or aneurysm), treatment of the tinnitus involves fixing the main issue. Although this does not always resolve the tinnitus, some people note relief of their symptoms. Only a very few cases of tinnitus are caused by identifiable, repairable medical conditions.