Tinnitus

Tinnitus is the term for hearing noises such as a ringing in the ears that is not caused by external factors.  It is a common problem, affecting around 15 – 20% of people and is not usually the sign of anything serious.

Although it can deteriorate with age, for many people, it can improve with treatment.  Tinnitus is not a condition in itself; it is a symptom of an underlying condition, such as age-related hearing loss.

There are two types of tinnitus:

Subjective Tinnitus

This is the most common type of tinnitus, and only you can hear it.  It can be triggered by ear problems in your outer, middle or inner ear.  It can also be caused by complications with the hearing (auditory) nerves or the part of your brain that translates nerve signals as sound (auditory pathways).

Objective Tinnitus

This is a form of tinnitus that your doctor can hear when they carry out an examination.  This rare type of the condition may be triggered by a blood vessel problem, a middle ear bone condition or muscle contractions.

Causes

Tinnitus can develop gradually over time or occur suddenly.  A number of health conditions can trigger or worsen the condition.  In many cases, an exact cause is never found.

Possible causes include:

• Hearing loss.  In many cases, hearing worsens with age, typically starting around 60.

• Ménière’s disease. Ménière’s disease is a condition that causes hearing loss and vertigo (a spinning sensation)

• Otosclerosis. Otosclerosis is a genetic condition where hearing loss is caused by an abnormal bone growth

• Conditions such as diabetes, multiple sclerosis and thyroid disorders

• Anxiety or depression

• Certain medications. Some antibiotics, chemotherapy medicine, non-steroidal-anti-inflammatory drugs and aspirin can trigger tinnitus.

• A middle ear infection. An ear infection is a common bacterial or viral infection of the middle ear (the space behind the eardrum that contains the small vibrating bones of the ear).

• Loud noises. Exposure to loud noises such as chainsaws and music played loudly in earphones, for a long period can result in noise-related hearing loss. Tinnitus triggered by short-term exposure, i.e. going to a concert, generally goes away. Both long and short-term exposure can result in permanent damage.

• Build-up of earwax. Earwax protects your ear canal by catching dirt and reducing the growth of bacteria. When excess earwax accumulates, it becomes difficult to wash away naturally, resulting in hearing loss or irritation of the eardrum, which can lead to tinnitus.

Symptoms 

Tinnitus involves the sensation of hearing noises when no external sound is present.  Symptoms may include types of phantom noises in your ears, including:

• Ringing
• Grinding
• Buzzing
• Roaring
• Clicking
• Hissing
• Whistling
• Humming

You may hear sounds in one or both ears, or in your head.  They may come and go or you may constantly hear it.
Phantom noise can vary in pitch from a high squeal to a low roar.  Occasionally, the sound can be so loud it interferes with your concentration or your ability to hear external sound.

Diagnosis

Make an appointment with your doctor if you constantly or frequently hear sounds such as humming, ringing or buzzing in your ears.

They will examine your ears to see if the problem is caused by an easily treated condition such as an ear infection or earwax build-up.  They may also perform some simple checks to assess if you have any hearing loss.  Tests include:

Hearing test
As part of the test, you will sit in a quiet environment wearing earphones that will play specific sounds into one ear at a time. You will be asked to indicate when you can hear the sound.  This can help rule out or identify potential causes of tinnitus.

Movement
Your doctor may ask you to tighten your jaw, move your eyes, or move your neck, arms and legs. If your tinnitus worsens or is affected, it may help identify an underlying condition that requires treatment.

Imaging tests
Depending on the suspected cause of your condition, you may require imaging tests such as CT or MRI scans.

Treatment
There is currently no treatment for tinnitus that works for everyone.  Your doctor will first try to identify any underlying condition that may be associated with your symptoms.  If an underlying cause can be found, effectively treating it may help improve your symptoms.  If tinnitus is due to a health condition, your doctor may be able to take steps that could reduce the noise. Examples include:

If a definite cause cannot be found, treatment will focus on helping you handle the condition on a daily basis. This may involve:

Sound Therapy
Also known as acoustic therapy; sound therapy works by listening to neutral sounds to distract you from the sound of tinnitus.  It will not cure the condition; however, it can make it easier to live with.

Counselling
Therapy aims to educate you about tinnitus and help you learn to cope with it more effectively. The therapist will provide you with advice on hearing and sleep hygiene.

Cognitive Behavioural Therapy (CBT)
CBT therapy aims to help adapt the way you think about your condition so it becomes less obvious to you.

If an underlying condition can be found, your doctor will treat that as part of the treatment for tinnitus. Treatment options may include:

• Earwax removal
• Removing obstructed earwax can ease tinnitus symptoms
• Treating a blood vessel condition

Changing your medication
If a medication you are taking appears to be the cause, your doctor may suggest stopping or reducing the dosage, or switching to a different medication.

Underlying vascular conditions may require medication, surgery.

Outlook

The outlook for tinnitus depends on its cause. In many cases, people find their symptoms improve with or without treatment. Even if it does not entirely go away, it can become less severe or less frequent.

Need Help?

If you are concerned you may have tinnitus, you can be seen by a Consultant ENT specialist at One Ashford Hospital, usually within 48 hours. 

One Ashford Hospital is well placed to see patients requiring treatment for tinnitus from Ashford, Maidstone, Canterbury, Folkestone, Dover and all surrounding villages.  To book an appointment, call the hospital direct on 01233 364 022 or email here