Tinnitus is a perception of sound in the absence of an external source. Although it is often referred to as "ringing in the ears," tinnitus can be perceived as many different sounds including hissing, clicking or whistling.
Tinnitus affects approximately 1 in every 10 adults and is more likely in those over age 60. Common causes are excessive or cumulative noise exposure, head and neck injuries and ear infections. In a small number of individuals, tinnitus is a sign of a serious underlying medical condition.
There is no cure for tinnitus, although there are many options for managing it. The majority of individuals with chronic tinnitus adjust to the ringing over time. For others, tinnitus can be debilitating, and may lead to insomnia, difficulty with concentration, poor work or school performance, irritability, anxiety and depression.
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Fast facts on tinnitus
Here are some key points about tinnitus. More detail and supporting information is in the main article.
- Around 45 million Americans experience some form of tinnitus.
- Approximately 90% of persons with chronic tinnitus have some form of hearing loss.
- Most tinnitus is due to damage to the cochlea (inner ear).
- Tinnitus is Latin for "to tinkle" or "to ring like a bell."
- There are no studies to support the effectiveness of herbal remedies for tinnitus therapy.
- Large doses of aspirin can cause tinnitus.
- Stimulants such as nicotine and alcohol can worsen tinnitus.
- Although it is heard in the ears, the source of tinnitus is really in the networks of brain cells.
- People with tinnitus are over-sensitive to loud noise.
- In rare cases (less than 1% of cases), tinnitus noises can be heard by others.
What is tinnitus?
Tinnitus is consciously hearing a sound that is not generated by any source outside the body. It is not a disease, but a symptom of an underlying problem.
In almost all cases, tinnitus is a subjective noise, meaning that only the person who has tinnitus can hear it. The most common form of tinnitus is a high-pitched steady ringing. Although tinnitus can be annoying, it is not usually a sign of a more serious problem.
Causes of tinnitus
Damage and loss of the tiny sensory hair cells in the cochlea of the inner ear is the most common reason for tinnitus. This damage typically occurs as a result of the normal aging process, and from prolonged exposure to excessively loud noise. Hearing loss coincides with tinnitus.
Tinnitus can be caused by damage to the inner ear due to the aging process and exposure to excessively loud noise.
Research also suggests that the sensory loss of certain sound frequencies leads to changes in how the brain processes sound. As the brain receives less external stimuli around a specific frequency, it begins to adapt and change. Tinnitus may be the brain's way of filling in the missing sound frequencies it no longer receives from its own auditory system.
Some medications such as aspirin, ibuprofen, certain antibiotics and diuretics can be "ototoxic" or can damage the inner ear, resulting in tinnitus.
Other possible causes of tinnitus are head and neck injuries, ear infections, a foreign object or earwax touching the eardrum, Eustachian tube (middle ear) problems, temporomandibular joint (TMJ) disorders, stiffening of the middle ear bones, traumatic brain injury, cardiovascular diseases and diabetes.
A potentially more serious form of tinnitus can sound like a heartbeat (pulsatile); it could indicate the presence of a tumor in the head and neck or the ear. This type of tinnitus requires a medical evaluation as soon as possible.
Risk factors for tinnitus
Tinnitus is a common problem in the general population with notable risk factors that increase one's risk of developing the condition. Some of these are modifiable while others are not. These include:
- Noise exposure from work, headphones, concerts, explosives
- Inadequate sleep (less than 6 hours nightly)
- Hearing loss
- Thyroid disease.
Symptoms of tinnitus
Tinnitus is a non-auditory, internal sound that can be intermittent or continuous, in one or both ears, and either a low- or high-pitch squeal. The varying sounds of tinnitus have been described as whistling, chirping, clicking, screeching, hissing, static, roaring, buzzing, pulsing, whooshing or musical.
The volume of the sound can fluctuate and is often most noticeable at night or during periods of quiet. Tinnitus is often also accompanied by a certain amount of hearing loss.
On the next page, we look at tests and diagnosis of tinnitus and the available treatment options for the condition.