In light of recent tragic events in the community, I felt that it was my duty as an audiologist to talk about tinnitus.
In this article, I’ll focus on three areas.
1) What is tinnitus?
2) What can cause tinnitus?
3) What can be done to make it better?
What Is Tinnitus?
Tinnitus is the medical term for hearing sound(s) that are not present in the environment. While many people will call it “ringing in the ears,” there may be many different types of sounds reported, including hissing, buzzing, roaring, wooshing, and sometimes even music.
The American Tinnitus Association (ATA) reports that 50 million Americans have tinnitus.1 Of those 50 million Americans, around 20 million will have bothersome/burdensome tinnitus. Of those, 2 million will have extreme/debilitating tinnitus, which is about 4% of the 50 million.
What Can Cause Tinnitus?
Tinnitus is the symptom of other conditions. Honestly, many times we will not be able to definitively determine the cause of a person’s tinnitus; however, listed below are some known contributors.
- Hearing loss – we do know that it is often secondary to hearing loss. The biological process of this is still heavily researched. A fascinating study in 1981 looked at people with tinnitus who had surgery to cut their auditory. This means no more hearing ability, and 45% said their tinnitus improved post-surgery, but 55% said it stayed the same or even worsened. This helped to identify that the culprit was not totally the ear and that the brain was a significant factor in this. 2
- Middle ear disorder, cerumen impaction (wax blockage), foreign body in the ear canal, middle ear fluid
- Temporal mandibular joint (TMJ) disorder
- Ototoxic medications
- Pharmaceutical effects
- High blood pressure and atherosclerosis
- Stress/increased anxiety is a significant exacerbator of tinnitus
- …and more
I Have Tinnitus; What Can Be Done?
First and foremost, tinnitus affects people differently and can be the symptom of many different things.
I have had countless people over the years who have brought up the bothersome effects of tinnitus to their medical specialist and told them there was nothing that can be done and to learn to live with it.
Many people have never even been evaluated medically or audiometrically to try to identify the cause. However, some of the underlying medical causes of tinnitus can be treated. For example, if a middle ear infection is medically resolved, the tinnitus may likely also be completely resolved.
How many people dealing with bothersome tinnitus have had a complete audiometric workup to determine hearing levels? Why bother with a hearing test if you are told there’s nothing that can be done! Remediation is, however, a team approach involving a physician, audiologist, and other specialists as directed.
Potential remediation options:
- Talk to your physician. Get an audiological evaluation by an audiologist.
- Medical resolution of the underlying problem (i.e., treat a middle ear issue)
- Amplification devices – if hearing loss is present, research has shown that amplification devices (i.e., hearing aids) may significantly reduce the severity of tinnitus but increase ambient sound that will distract the brain. Completely silent environments are the enemy of those who experiences tinnitus because that is when the brain can really lock onto it.
- Sound therapy – masking devices, masking settings in hearing aids, apps, sound generators, etc., can also help distract the brain and, with proper counseling, help reduce the negative emotional association associated with the bothersome tinnitus.
- Diet, exercise, and self care – a ton of research is being done on diet and exercise and the effects on-ear and brain health. For example, we know that improving diet and increasing exercise has been shown to reduce some underlying conditions that can cause tinnitus (i.e., stress, hypertension, etc.).
- Consider seeing a behavioral health therapist – ATA reports that 48%-78% of patients with severe tinnitus experience depression, anxiety, or other behavioral disorder.
- American Tinnitus Association. 2019, accessed August 20, 2021, <ata.org>
- House JW, Brackmann DE. Tinnitus: surgical treatment. Ciba Found Symp. 1981;85:204-16. doi: 10.1002/9780470720677.ch12. PMID: 6915835.