Tinnitus 101: What Patients Need to Know

Most people have experienced a ringing in their ears at some point, often after being exposed to loud noises. The condition, known medically as tinnitus, is generally temporary and goes away on its own. In some cases, though, people can develop chronic tinnitus, which can have a dramatic negative impact on their quality of life.

There is no permanent cure for tinnitus, but that doesn’t mean people who struggle with this common symptom should give up hope. Instead, read on to find out about the causes of this unpleasant and sometimes debilitating issue and learn how to find tinnitus solutions.

What Is Tinnitus?

Tinnitus is usually described as a constant ringing in the ears. However, some people experience it more as a buzzing, hissing, clicking, or even roaring sound. The sound may be quiet or loud, can be at any pitch, and may affect either one or both ears.

The Types of Tinnitus

Most people don’t realize it, but there are actually two major types of tinnitus: subjective and objective. The majority of patients who experience this symptom have subjective tinnitus, which means that only they can hear the sounds. Subjective tinnitus is more difficult to diagnose since it can’t be heard by others. Instead, patients must report their symptoms using questionnaires.

People with objective tinnitus, on the other hand, can be diagnosed using a stethoscope since doctors will also be able to hear the tinnitus sounds. Pulsatile tinnitus can also be considered a type of objective tinnitus. People with this comparatively rare symptom hear sounds that resemble rhythmic pulsing in time with their heartbeats. Doctors can usually hear the sounds with the help of a tiny microphone placed inside the ear canal.

Causes of Tinnitus

Tinnitus is a symptom rather than a disease. It occurs as a result of other underlying auditory or neurological problems. In some cases, the explanation for a patient’s tinnitus is as simple as earwax blocking the ear canal. In others, it’s a symptom of a more serious health condition. The causes of tinnitus include:

• Exposure to loud sounds
• Ear infections
• Sinus infections
• Heart disease
• Issues with the circulatory system
• Meniere’s disease
• Hormonal changes
• Thyroid abnormalities
• Brain tumors

There are also over 200 prescription drugs that can cause tinnitus as a side effect. To complicate matters even further, some people also develop tinnitus for no clear reason.

Underlying Auditory and Neurological Mechanisms

Modern science explains how human ears and brains work together to process sound. There are certain neural circuits that help to make sense of the things people hear, and it’s often disruptions to those networks of brain cells that are to blame for tinnitus. This problem may begin in the ear, but it continues in a patient’s brain.

What modern science can’t quite explain is what, exactly, happens in the brain that creates the illusion of sound. Some researchers liken tinnitus to chronic pain syndromes that cause pain to persist after wounds have healed. Others believe it’s a result of neural circuits attempting to adapt to the loss of sensory hairs by increasing a person’s sensitivity to sound. This theory is supported by the fact that some people who have tinnitus also experience sensitivity to loud noises.

Finally, some researchers now believe that tinnitus is a result of an imbalance of the sound-processing neural circuits that results from signals indicating damage being transmitted from the ear to the auditory cortex. This theory is also partially supported by evidence. The neural circuits that process sound are also in communication with other parts of a patient’s brain, including those that regulate mood, which would help to explain some of the secondary issues people develop when dealing with chronic tinnitus.

Who Is Most Likely to Develop Tinnitus?

Older people are more likely than their younger peers to develop tinnitus, usually as a symptom of either medication use or noise-related hearing loss. Some people are more at risk of developing tinnitus early in life than others.

People who work in loud environments tend to develop tinnitus earlier in life. When that’s the case, it’s a symptom of noise-induced hearing loss. The constant exposure to loud sounds damages the sensory hairs that help transmit sound to the brain, which causes hearing loss. The tinnitus just comes along with it.
Tinnitus is also more common among service members who were exposed to bomb blasts. The shock wave created by the explosion can squeeze the skull and cause damage to the areas of the brain that process sound. In this case, tinnitus is a neurological rather than an audiological symptom.

Tinnitus Complications

Tinnitus rarely indicates a serious underlying health problem, but that doesn’t mean it isn’t worth seeing a specialist. Chronic tinnitus that’s loud enough to interrupt daily life can cause not just disruptions in concentration but also anxiety, depression, fatigue, and even memory loss.

Treatments for Tinnitus

There is no cure for tinnitus, but that doesn’t mean people suffering from this troubling symptom must suffer alone. Audiologists can offer a variety of treatment options, which vary based on the severity of a patient’s tinnitus and its underlying causes. These treatment options can include:

• Hearing aids
• Cognitive-behavioral therapy
• Wearable sound generators
• Tabletop sound generators
• Acoustic neural stimulation
• Cochlear implants

Medications to manage secondary symptoms like depression and anxiety

Research into tinnitus is ongoing, and doctors are developing new therapeutic interventions all the time. Audiologists make it their job to stay up-to-date with modern research, so don’t be afraid to ask for their help with understanding treatment options.

Don’t Suffer in Silence

Patients who struggle with chronic tinnitus don’t need to learn how to just grin and bear it. They can get help with both identifying the underlying causes of their symptoms and finding ways to manage them more effectively by visiting audiologists. The first step is always to schedule a full exam and a hearing test. Patients can request referrals from their primary care doctors or reach out directly to a nearby audiology clinic to schedule a visit.