Tinnitus means ringing in the ears but in practice it can include almost any type of sound that appears to come from the head rather than from the outside world.
Ringing is the most frequently experienced sound but sufferers can also hear buzzing, humming, hissing and whistling. Tinnitus is distinct from voices in the head which can be due to some kinds of mental disorder or temporal lobe epilepsy.
It is common and increasingly so with age. The British Tinnitus Association reckons that one in ten UK citizens suffer from the problem whereas authorities in the United States suggest the figure might be one in seven.
Objective and Subjective Tinnitus
Tinnitus is divided into two major classes. The objective form of the condition arises from structures within the head so that noise is being picked up by the ear but from the inside rather than outside as is normally the case. Such sounds may be heard by another person. Examples of this are:
- Movement of blood through partially blocked vessels
- Rapid blood flow through tumours
- Spasms in muscles around the ear
- Problems with the eustachian tube (the tube that runs from behind the ear drum to the throat)
Tinnitus is described as subjective when there is no stimulus to the hearing apparatus. Common examples are listed below.
- Meniere’s disease
- Impacted wax in the ear
- Infections of the ear and brain
- Neurological: degenerative disease, head injury, acoustic neuroma
- Age-related deafness
- Noise induced: in those exposed to loud noises such as gunfire, explosion and very loud music.
- Drugs: medicinal drugs such as salicylates and other non-steroidal anti-inflammatories.
Management of Tinnitus
With the objective form of the condition the aim is to remove the cause: resection of the tumour, improvement of blood flow and so on.
And in some cases of the subjective form also the cause can be dealt with: treatment of the infection, withdrawal of the drug, and removal of the neuroma. However in many instances such as tinnitus due to ear damage, hearing loss or Meniere’s disease the problem is more difficult and the condition has to be managed rather than cured. The following are the methods currently in use.
- Tinnitus masking: masking devices create a low level constant noise. These can be worn during the day and at night. Some sufferers find that playing a radio which is just off station will produce a background static sound to mask the tinnitus.
- Reassurance: it helps to explain to the patient that the tinnitus is not due to anything sinister. Since anxiety generally makes tinnitus worse anything to lessen this is worth trying.
- Retraining therapy: this teaches the patient to get used to the tinnitus and adapt to it. Although the therapy takes time it can be very effective.
- Drugs: antidepressants are sometimes used to treat depression associated with tinnitus. Some drugs used to reduce anxiety have been found to help.
- Alternative therapy: it has been suggested that taking supplements of vitamin A and C can be helpful. Also the herb ginkgo biloba has been tried as a remedy for tinnitus but as yet there are insufficient studies available to be able to say whether it works or not. Acupuncture is also used to treat tinnitus but again there are too few studies to show efficacy.
Transcranial Magnetic Stimulation
This is an interesting development in the treatment of tinnitus based on studies using magnetic fields for pain control. It consists of passing a magnetic field through part of the brain – the temporoparietal cortex (at the side of the head above the ear).
A recent study by Khedr et al reported in the Journal of Neurology, Neurosurgery and Psychiatry found lasting improvement in the majority of subjects.
This article is for information only. If you have any health concerns you should consult your doctor.
Resource
Journal of Neurology, Neurosurgery and Psychiatry 2008; 79. Khedr et al.
A Dictionary of Symptoms by Joan Gomez. Pub. Granada
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