Tinnitus: A common hearing distress

Hearing of ringing, buzzing, hissing, or roaring in one or both ears is also medically known as tinnitus. Many people have this problem. In some people, it can last months or years. Tinnitus can be annoying, but it is not usually a sign of a serious problem.

Tinnitus is often caused by damage to cells in a part of the inner ear. When these cells are damaged, they send signals to the brain that make you think you are hearing things that are not really there.

Normal hearing loss often occurs with advancing age and is frequently accompanied by tinnitus. Prolonged exposure to excessively loud noise (eg, from chainsaws, gunfire, or even loud music) may lead to temporary or permanent hearing loss and tinnitus. A short blast of loud noise also can cause severe to profound hearing loss, pain, or abnormal sensitivity to noise.

There are many hearing problems that can lead to hearing loss and tinnitus. These include use of certain medications, stiffening of the bones in the middle ear, tumors within the hearing system, blood vessels or neurologic disorders, and genetic or inherited inner ear disorders.

Occasionally tinnitus can be a result of problems not related to the hearing system such as disorders of the jaw joint, severe anxiety, and neck injuries can cause tinnitus.

Most people with tinnitus hear a high-pitched, steady ringing. Some people with the condition hear pulsing, rushing, or humming sounds. These sounds sometimes get louder or softer during movement or exercise.

It is important for anyone with tinnitus to be evaluated to ensure that there isn’t another, more serious problem. In addition, anyone with severe or worsening and continuous ringing, buzzing, or other noises in the ear should seek medical advice and be evaluated thoroughly.

Hearing tests can help provide more information about the potential cause of one’s tinnitus. Other tests, such as brain imaging with magnetic resonance imaging (MRI) or computed tomography (CT) scans may be needed, depending upon the results of the medical history and physical examination.

The management of tinnitus involves treating the cause or abnormalities as well as addressing the tinnitus itself. Although there is no cure for most cases of chronic tinnitus, there are ways to manage the condition.

Hearing aids may improve tinnitus symptoms in people with age-related hearing loss. Hearing aids work by making outside sounds clearer and louder, which may cause the tinnitus noise to be less noticeable. People with other causes of hearing loss may benefit from surgery of some parts of the ear.

Cochlear implants are devices that are implanted in the inner ear and use electrical stimulation to help improve hearing. They may be recommended for adults or children with severe to profound hearing loss who do not benefit from hearing aids. These implants may help relieve tinnitus in some cases, but they are only available in selected cases and a full evaluation of the patient by an ear specialist doctor (ENT surgeon) is required before consideration.

People who have difficulty sleeping as a result of tinnitus may be treated with medications and/or behavior changes to improve sleep.

In some developed settings, a special form of exercise called Tinnitus retraining therapy (TRT) that involves retraining the subconscious part of the hearing system to accept the sounds associated with tinnitus as normal, natural sounds rather than annoying sounds is done. The goal is for the person to become unaware of their tinnitus unless they consciously choose to focus on it. It involves counseling as well as the use of a wearable device that emits low-level noise and environmental sounds. Although TRT has demonstrated short-term success in many tinnitus sufferers, it requires a commitment to the program as the noise-generating device may need to be worn for one to two years.

In patients with auditory system damage due to use of medication, stopping the medication may improve tinnitus and prevent hearing loss from worsening. Patients should consult with a healthcare provider before starting or stopping any medications.