Tinnitus

Do you hear hissing, roaring, whistling, chirping, or clicking? If you suspect you suffer from hissing or other noises, treat it as a warning signal that you might be developing a hearing loss and make an appointment to see an audiologist for a hearing test.

What is Tinnitus?

It is the term for the perception of sound when no external sound is present. It is a physical condition experienced as noises in the ears or head, usually perceived as a ringing sound (and the condition is often referred to as ‘ringing in the ears’), although some people hear hissing, roaring, whistling, chirping, or clicking. It can be intermittent or constant, with single or multiple tones. Its perceived volume can range from very soft to extremely loud.

People with the condition may suffer from:

  • Extreme distress
  • Tension, irritability or frustration
  • Depression
  • Frequent mood swings or anxiety attacks
  • Poor concentration
  • Sleep problems

If you suspect you suffer from these symptoms, treat it as a warning signal that you might be developing a hearing loss and make an appointment to see an audiologist for a hearing test.

How common is it?

Research suggests that approximately 17-30 per cent of Australian’s suffer from the condition to some degree, varying from mild to severe. 15 per cent suffer constant annoyance as a result of the condition and one per cent reporting severe symptoms that affect the quality of their lives.

What are the Causes?

The more common causes include:

  • Noise-induced hearing loss
  • Age-related hearing loss
  • Ear diseases and disorders
  • Extreme stress or trauma
  • Degeneration of the hair cells in the cochlear
  • Ear problems, such as otosclerosis (fixation of the tiny stirrup bone in the middle ear)
  • Meniere’s disease (swelling of a duct in the ear)
  • Some medications.
age related hearing loss
child with ear infection

Other causes

  • Head trauma
  • Large doses of certain drugs such as aspirin (always check with your doctor whether the medication they are prescribing has a side effect of causing or exacerbating the condition)
  • Compacted ear wax
  • Middle ear infections
  • Jaw misalignment (specifically, dysfunction of the joint connecting the jaw to the bone under the ear)
  • Perilymph fistula (a hole in the inner ear, allowing fluid to escape)
  • Certain types of tumours
  • Cardiovascular disease
  • Thyroid disorders

Of these factors, exposure to loud noise and hearing loss are the most probable causes of tinnitus. When you first discover you have tinnitus you should consult your Doctor, an Audiologist and/or an Ear, Nose and Throat Specialist to check that you do not have an underlying medical condition.

What can make it worse?

There are a number of likely factors which may make an existing condition worse.

 

Loud Noise

Working in noisy surroundings, listening to loud music (both at concerts and through headphones), playing musical instruments, and exposure to other loud noises without using special protective equipment increases the risk of developing the condition as well as hearing loss. Even a single incident of exposure to an extremely loud noise (such as fireworks or other explosions, or a gunshot fired close to the ear) can result in tinnitus or hearing loss.

Earplugs or other hearing protection often prevents tinnitus that otherwise would be caused by excessive noise. You should always wear hearing protection when subjected to loud noise, even if you do not find the noise uncomfortable. Hearing loss at higher frequencies is often painless, and the most common result is tinnitus.

 

loud noise at concert can lead to tinnitus

Avoid nicotine as smoking narrows your blood vessels which supply vital oxygen to your ears and their sensory cells.

Stress & Fatigue

There is some evidence that stress makes the condition worse. Although stress is part of everyday life, you can take steps to reduce stress levels by using relaxation and stress management techniques that help you stay calm, think positively, and focus your energies outward and away from the tinnitus.

Hypnotherapy can help with relaxation, and cognitive behavioural therapy offered by clinical psychologists can help you to change the way you think about the condition, learn ways to focus your attention away from your tinnitus and control the stress associated with the condition.

tinnitus due to stress
tinnitus can be caused by medication

 

Medications & Other Substances

It is essential to tell your family doctor about your tinnitus; some common medications cause it as a side effect or make your existing condition worse. Take special care with medications for arthritis, rheumatic diseases, some antibiotics, and anti-depressants. Excessive use of aspirin can also create issues; ask your doctor about alternatives.

Some foods and substances are also suspected of making tinnitus worse, although this has not been scientifically proven. While you don’t have to avoid them altogether, try easing off caffeine, quinine (tonic water) and alcohol as they can temporarily worsen tinnitus for some people. Carbohydrate-rich meals, like pasta, can have a calming or sedating effect, which can be helpful. However, give yourself time to digest your meal before you go to bed to avoid disturbed sleep.

 

Is there a cure?

There is no definitive cure for tinnitus, however people affected can learn how to manage their tinnitus to the point where it is no longer a problem for them and they can go back to leading full and productive lives.

Tinnitus does not have to dramatically affect your quality of life. You should avoid focusing too much attention on your tinnitus and take steps to manage the condition. Avoid excessive noise, and find relaxation and stress management techniques that work for you, for example, sport and exercise, hobbies, yoga, reflexology, or massage.

Treatment Options

There are a variety of treatment options available that may help relieve your tinnitus symptoms ranging from physical products like hearing aids, to counselling to help deal with adverse emotional side effects such as depression and anxiety. Discuss with your audiologist what the best course of action is for your specific case of tinnitus.

 

Tinnitus Retraining Therapy (TRT)

Tinnitus Retraining Therapy (TRT) aims to reduce and ultimately eliminate tinnitus perception. It combines auditory therapy (hearing aids and/or therapeutic noise generators), to provide the brain with maximum environmental sounds to reduce tinnitus perception. Directive counselling or cognitive behavioural therapy helps to change negative beliefs about tinnitus, distract you from focusing too much on the condition, and reduce stress.

 

Therapeutic Noise Generators

Therapeutic Noise Generator devices which look like hearing aids and are recommended for people with no hearing loss. These devices produce a blend of external sounds which stimulate most fibres of the hearing nerve, helping to deviate attention away from the tinnitus.

 

Tinnitus Retraining Therapy

Surgery

For the vast majority of people, there is no specific surgical treatment for tinnitus. However, following successful surgical treatment for some ear problems (e.g. otosclerosis, Meniere’s disease, middle ear infection) an existing tinnitus problem may sometimes disappear.

Do you suffer from Tinnitus? Make a Tinnitus consultation appointment to find out more about your Tinnitus and discuss treatment options with one of our Audiologists.

Medications

There are no specific medications for the treatment of tinnitus. Sedatives and some other medications may prove helpful in the early stages for some people depending on the cause of the tinnitus. Vitamin B12 may be helpful and herbal remedies, if taken under medical supervision, may be of some use.

Inspecting ear

Hearing Aids

Good quality and properly fitted hearing aids reduce and even eliminate most tinnitus associated with hearing losses. Hearing aids take away the strain of listening and distract from the tinnitus by bringing you more environmental sounds from the outside world. Click here to view some of the available styles from Oticon and Phonak.

 

Tinnitus Frequently Asked Questions

Can hearing aids make tinnitus worse?

Providing the hearing aids are fitted professionally, it is unlikely that the use of hearing aids will make your tinnitus worse. In fact, hearing aids are a popular treatment option when managing tinnitus that works by increasing meaningful auditory stimulation to the brain, making your tinnitus less noticeable.

If you believe that your hearing aids are making your tinnitus worse, then you may need to have them re-adjusted. Changes in hearing levels over time can mean that you are not getting the right level of sound stimulation causing your tinnitus to appear louder than before.

Which hearing aid is best for or helps tinnitus?

All types of hearing aids can be helpful for your tinnitus (if you can benefit from sound therapy, which usually is the case). This is because all hearing aids are designed to amplify external sounds and stimulate the hearing pathway. This shifts the brain’s focus from internal, somatic sounds to the more important external environment, reducing the presence of your tinnitus.

Some hearing aids also include tinnitus features to help mask the sound of tinnitus during the daytime when a hearing aid is worn. These special masking sounds can provide additional relief without cutting off sound from the external world. It is best to chat with your audiologist to decide whether additional tinnitus features are right for you.

Can hearing aids help tinnitus?

Ringing in the ears, or tinnitus, is caused by inadequate stimulation of the hearing pathway, resulting in abnormal neural activity which causes the perception of sound known as tinnitus. A hearing aid can help minimise ringing by amplifying external sounds and allowing the hearing pathway to be adequately stimulated. This shifts the brain’s focus from internal, somatic sounds to the more important external environment, reducing the presence of your tinnitus.

It is important to know that tinnitus does not have an on/off switch. Everyone experiences tinnitus to some degree throughout their lifetime. However, by managing the loudness of the tinnitus through hearing aids, you can start to gain a better sense of control and empowerment.

Will a hearing aid reduce tinnitus?

Hearing aids can help reduce tinnitus by amplifying external sounds and providing adequate stimulation of the hearing pathway. This shift’s the brain’s focus from internal, somatic sounds such as your tinnitus to the more important external environment. Many hearing aid users often report a reduction in tinnitus as one of the secondary benefits of using amplification. However, it is important to remember that tinnitus does not have an on/off switch. Everyone experiences tinnitus to some degree throughout their lifetime. The goal of using hearing aids is to better manage your tinnitus, and help you gain a better sense of control.

Hearing aid and tinnitus

The most common cause of tinnitus is due to damage to sensory hair cells in the cochlea of the inner ear. People with hearing loss, both age related and noise induced, are more likely to suffer from tinnitus than others. Hearing aids have been found to be an effective measure in managing tinnitus, as increased amplification of external sounds provided by hearing aids allows the hearing pathway to be more adequately stimulated. This in turn, shifts the brain’s focus from internal, somatic sounds to the more important external environment, reducing the volume of the tinnitus.

Some hearing aids also include tinnitus features to help mask the sound of tinnitus during the daytime when a hearing aid is worn. These special masking sounds can provide additional relief without cutting off sound from the external world. It is best to chat with your audiologist to decide whether additional tinnitus features are right for you.

What is Tinnitus?

Tinnitus is the term for the perception of sound when no external sound is present. It is often referred to as ”ringing in the ears,” although some people hear hissing, roaring, whistling, chirping, or clicking. Tinnitus can be intermittent or constant, with single or multiple tones. Its’ perceived volume can range from very soft to extremely loud.

What causes Tinnitus?

The exact cause (or causes) of tinnitus is not known in every case. It is believed that the ringing is due to spontaneous activity in the cochlea. The most common cause of tinnitus is hearing loss and in particular sensorineural hearing loss. This is probably because the majority of patients with sensorineural hearing loss have some damage in the cochlea that is causing the hearing loss. It is these damaged sections that are presumed to be producing spontaneous signals.

There are a number of likely factors which may cause tinnitus or make existing tinnitus worse: noise-induced hearing loss, age-related hearing loss, ear diseases and disorders, wax build-up in the ear canal, certain medications, ear infections, jaw misalignment, cardiovascular disease, certain types of tumours, thyroid disorders and many others. Of these factors, exposure to loud noises and hearing loss are the most probable causes of tinnitus. I strongly recommend that an Audiologist and a Physician should evaluate all presentations of tinnitus.

What are the options for Tinnitus management and treatment?

There are many options for people who experience tinnitus. Some wear hearing aids to help cover up their tinnitus, some wear tinnitus maskers. Additionally, there are combined tinnitus maskers and hearing aids – all in one unit! Some patients require counselling to help them develop strategies to manage their tinnitus. If you’ve been told ”learn to live with it,” there are many additional options to explore. Your Audiologist is an excellent resource for issues and answers related to tinnitus.