Tinnitus

Tinnitus can arise in any of the following areas: the outer ear, the middle ear, the inner ear, or by abnormalities in the brain. Some tinnitus or head noise is normal. If one goes into a sound proof booth and normal outside noise is diminished, one becomes aware of these normal sounds. We are usually not aware of these normal body sounds, because outside noise masks them. Anything, such as ear wac or a foreign body in the external ear, that blocks these background sounds will cause us to be more aware of our own head sounds. Fluid, infection, or disease of the middle ear bones or ear drum (tympanic membrane) can also cause tinnitus.

One of the most common causes of tinnitus is damage to the microscopic endings of the hearing nerve in the inner ear. Advancing age is generally accompanied by a certain amount of hearing nerve impairment, and consequently chronic tinnitus.

Tinnitus, (pronounced tih-NIGHT-us or TIN-ih-tus) is a ringing, swishing, or other type of noise that seems to originate in the ear or head. Most of us will experience tinnitus or sounds in the ears at some time or another. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), almost 12 percent of men who are 65 to 74 years of age are affected by tinnitus. Tinnitus is identified more frequently in white individuals, and the prevalence of tinnitus in the U.S. is almost twice as frequent in the South as in the Northeast.
Tinnitus can be extremely disturbing to people who have it. In many cases it is not a serious problem, but rather a nuisance that may go away. However, some people with tinnitus may require medical or surgical treatment. Twelve million Americans have tinnitus, and one million experience it so severely it interferes with their daily activities.
Tinnitus can arise in any of the four sections of the hearing system: the outer ear, the middle ear, the inner ear, and the brain. Some tinnitus or "head noise" is normal. A number of techniques and treatments may be of help, depending on the cause.
Some of the most common include a sound of crickets or roaring, buzzing, hissing, whistling, and high-pitched ringing.

Other types of tinnitus include a clicking or pulsatile tinnitus (the noise accompanies your heartbeat).

The most common type of tinnitus is known as subjective tinnitus, meaning that you hear a sound but it cannot be heard by others.

A much more uncommon sort is called objective tinnitus, meaning your doctor may sometimes actually hear a sound when he or she is carefully listening for it.

Exams and Tests
Initial evaluation will include a complete history and physical examination of the head and neck including the various nerves in the area.
A complete hearing test (audiogram) will also be performed. Depending on the type of tinnitus, either a special audiogram known as an auditory brainstem response (ABR) or a brain scan such as a computerized tomography (CT) scan or magnetic resonance imaging (MRI) may also be required.
In some cases, your blood pressure and possibly some blood tests for hyperthyroidism may be taken. In very rare instances, a spinal tap may be performed to measure the fluid pressure in the skull and spinal cord.

Tinnitus Treatment

Self-Care at Home
Most cases of tinnitus should be evaluated by an ear, nose, and throat physician before home treatment begins to be sure that the tinnitus is not caused by another treatable problem.


Medical Treatment
Treatment for tinnitus depends on the underlying cause of the problem.
In the majority of cases, tinnitus is caused by damage to the hearing organ. In these cases, there is normally no need for treatment other than reassurance that the tinnitus is not being caused by another treatable illness.
In the very rare instance where the tinnitus is extremely bothersome, there are a number of treatment options.
Some of the most helpful include antianxiety or antidepressant medication and sometimes maskers-small devices like hearing aids that help to block out the sound of the tinnitus with "white noise."
For people who are bothered by tinnitus only when trying to sleep, the sound of a fan, radio, or white noise machine is usually all that is required to relieve the problem.
Most people with tinnitus find that their symptoms are worse when under stress, so relaxation techniques can be helpful.
Avoiding caffeine is advised, as it may worsen symptoms.

Biofeedback may help or diminish tinnitus in some patients.

Avoid aspirin or aspirin products in large quantities
Hearing loss worsens the effect of tinnitus, so protection of hearing and avoiding loud noises is very important in preventing worsening of the symptoms.
In cases where the tinnitus is caused by one of the other rare problems (such as a tumor or aneurysm), treatment of the tinnitus involves fixing the main issue. Although this does not always resolve the tinnitus, some people note relief of their symptoms. Only a very few cases of tinnitus are caused by identifiable, repairable medical conditions.

Prevention
The only real prevention for tinnitus is to avoid damaging your hearing. Most causes other than hearing loss do not have prevention strategies.
According to the American Tinnitus Association, there are several things you can do to protect yourself from excessive noise-related tinnitus:
Protect your hearing at work. Your work place should follow Occupational Safety & Health Administration (OSHA) regulations. Wear ear plugs or earmuffs and follow hearing conservation guidelines set by your employer.

When around any noise that bothers your ears (a concert, sporting event, hunting) wear hearing protection or reduce noise levels.

Even everyday noises such as blow drying your hair or using a lawnmower can require protection. Keep ear plugs or earmuffs handy for these activities.

When to Seek Medical Care
Most newly noticed tinnitus should be evaluated by a physician. Because tinnitus is usually a symptom of something else, if it begins suddenly, see your doctor. This is particularly important if the tinnitus is only heard on one side.
Although the majority of cases of tinnitus are not caused by any acute problems, certain symptoms need to be evaluated to determine whether or not a more serious medical condition is causing the symptoms.
Any time that tinnitus comes on suddenly, particularly in one ear or is associated with hearing loss, seek an immediate evaluation. Sudden hearing loss is often accompanied by tinnitus, and there are medications that may help to restore that hearing. Also certain types of tumors can cause sudden hearing loss and tinnitus that warrant an evaluation.
Tinnitus that is pulsatile (in rhythm with your heartbeat) and comes on suddenly should also be checked relatively rapidly. In very rare instances, this sort of tinnitus can develop because of an aneurysm (a bulging of the wall of a blood vessel) near the ear or because of the sudden onset of very high blood pressure.
Any time tinnitus is noticed in association with changes in personality, difficulty speaking or walking, or with any other movement problem, you should be evaluated for the possibility of a stroke.
Tinnitus Symptoms

With tinnitus, you hear a noise that no one around you hears. This noise is usually a buzzing or ringing type sound, but it may be a clicking or rushing sound that goes along with your heartbeat. The sound is sometimes accompanied by hearing loss and dizziness in a syndrome known as Meniere's disease.