Tinnitus, What is it & What Causes it?

What is tinnitus?

Tinnitus (pronounced ti-ni-tis) is the perception of hearing sounds such as ringing, buzzing, crickets, and rushing. Pulsatile tinnitus is a heartbeat-like sound of any combination of these. The noise can be intermittent or continuous, and can vary in volume. It is often worse when background noise is low, so you may be most aware of it at night when you’re trying to fall asleep in a quiet room.

The most common form of tinnitus is known as Subjective Tinnitus where only the person perceiving the tinnitus can hear it. It can be localised to one ear more than another, or seem central within the head. In most cases, Tinnitus accompanies hearing loss, and the pitch that the tinnitus is perceived at, is usually around the frequency range that the hearing is most diminished.

A rarer type of tinnitus, Objective Tinnitus, can occur where a sound audible to the individual, could be amplified to also be heard by others. This could occur as a pulsatile tinnitus where blood flow in vessels close to the skin in the ear canal is impeded and the pulsing or rushing sounds can be heard.

What causes tinnitus?

Prolonged exposure to loud sounds is the most common cause of tinnitus. Up to 90% of people with tinnitus have some level of noise-induced hearing loss. The noise causes permanent damage to the sound-sensitive cells of the cochlea, a spiral-shaped organ in the inner ear. The outer hair cells of the inner ear are said to be electro motile. Some people are more susceptible than others due to their jobs.

Carpenters, pilots, rock musicians, street repair workers, and landscapers are among those whose jobs put them at risk, as are people who work with chainsaws, guns, or repeatedly listen to loud music. A single exposure to a sudden extremely loud noise can also cause tinnitus.

There are also a variety of other conditions and illnesses that are considered causes of tinnitus, these include:

• Blockages of the ear due to a build-up of wax, an ear infection, or rarely, a benign tumour of the auditory nerve that allows us to hear.
• Certain drugs — most notably aspirin, several types of antibiotics, anti-inflammatories, sedatives, and antidepressants as well as quinine medications. Tinnitus is cited as a potential side effect for about 200 prescription and non-prescription drugs.
• The natural ageing process can result in a deterioration of the cochlea or other parts of the ear.
• Meniere’s disease, which affects the inner part of the ear.
• Otosclerosis, a disease that results in stiffening of the small bones in the middle ear.
• Other medical conditions such as high blood pressure, cardiovascular disease, circulatory problems, anaemia, allergies, an underactive thyroid gland, and diabetes.
• Neck or jaw problems, such as temporomandibular joint (TMJ) syndrome.
• Injuries to the head and neck.

Tinnitus can worsen in some people if they drink alcohol and caffeinated beverages, smoke cigarettes, or eat certain foods. For reasons not yet entirely clear to researchers, stress and fatigue seem to worsen tinnitus.

How does it start?

Tinnitus is unique to each individual and can arise in any part of the interconnected auditory system, which means the holistic and individualised treatment approach is best. The onset of tinnitus appears with some level of hearing loss, damage or change to the auditory system. If there is hearing loss, usually the pitch of the tinnitus is around the frequency range in which the hearing is most diminished. Putting back the sound around the frequency range that has diminished can often have an inhibiting effect and provide relief from the tinnitus.

How common is tinnitus?

Tinnitus is very common, affecting just about everyone at some stage of their lives. For most people, the condition is merely an annoyance. In severe cases, however, tinnitus can cause people to have difficulty concentrating and sleeping. It may eventually interfere with work and personal relationships resulting in psychological distress. About 12 million people in the United States seek medical help for tinnitus every year.

Although tinnitus is often associated with hearing loss, it does not cause the loss, nor does hearing loss cause tinnitus. In fact, some people with tinnitus experience no difficulty hearing, and in a few cases they even become so acutely sensitive to sound (Hyperacusis) that they must take steps to muffle or mask external noises.