Tinnitus

What is tinnitus?

Tinnitus ("TIN-a-tus" or "Tin-EYE-tus") is the perception of sound in the head when no outside sound is present. It is typically referred to as "ringing in the ears," but other forms of sound such as hissing, roaring, pulsing, whooshing, chirping, whistling and clicking have been described.

Tinnitus can occur in one ear or both ears, and can be perceived to be occurring inside or outside the ear. Tinnitus can be a symptom of a condition that causes hearing loss, or it can exist without any hearing loss.

Is tinnitus a common problem?

Yes. Almost everyone at one time or another has experienced brief periods of mild ring or other sound in the ear. Some people have more annoying and constant types of tinnitus. One third of all adults report experiencing tinnitus at some time in their lives. Ten percent to 15% of adults have prolonged tinnitus requiring medical evaluation (1). Prevalence estimates of individuals with tinnitus vary widely, from 7.9 million (2) to more than 37 million (3).

Is tinnitus a disease?

No. Just as fever or headache accompanies many different illnesses, tinnitus is a symptom common to many problems, both physiological and psychological.

What causes my tinnitus?

Chances are the cause of your tinnitus will remain a mystery. Only when a specific factor is linked to the appearance or disappearance of the tinnitus can a cause be stated with certainty. Blows to the head, large doses of certain drugs such as aspirin, anemia, hypertension, noise exposure, stress, impacted ear wax and certain types of tumors are examples of conditions that might cause tinnitus.

What happens in my head to produce tinnitus?

Although there are many theories about how sounds in the head are produced, the exact process is not known. One thing is certain. Tinnitus is not imaginary.

Why is my tinnitus worse at night?

During the day, the distraction of activities and the sounds around you make your tinnitus less obvious. When your surroundings are quiet, your tinnitus may seem louder and more constant. Fatigue may also make your tinnitus worse.

What should I do about my tinnitus?

Since tinnitus is a symptom, the first step should be to try to diagnose the underlying cause. You should have a medical examination with special attention given to checking for factors sometimes associated with the tinnitus such as blood pressure, kidney function, drug intake, diet and allergies. Your hearing should be evaluated by an audiologist certified by the American Speech-Language-Hearing Association to determine if hearing loss is present.

What is the treatment for tinnitus?

The most effective treatment for tinnitus is to eliminate the underlying cause. Unfortunately, the cause often cannot be identified so, in some cases, the tinnitus itself may need to be treated. Drug therapy, vitamin therapy, biofeedback, hypnosis and tinnitus maskers are types of treatments that have been helpful for some people. For more information visit our Tinnitus Management page in the Treatment & Rehabilitation section of our site.

The American Tinnitus Association (ATA) Web site has information on various treatment options. Visit http://www.ata.org or write them at PO Box 5, Portland, Oregon 97207.

"Self-help" groups are available in many communities for sharing information and coping strategies for living and tinnitus. People with mild tinnitus generally do not require treatment. If they can be reassured that they do not have a rare disease or serious brain disorder or are not going deaf, they usually find they can cope with or ignore their tinnitus.

What is a tinnitus masker?

Tinnitus maskers look like hearing aids and produce sound that "mask" or cover up tinnitus. Some people find such external sounds preferable to the sound in their heads. The characteristics of the tinnitus, such as pitch and loudness, determine what kind of noise brings relief. When a person has a hearing loss as well as tinnitus, the masker and the hearing aid may operate together as one instrument. Like other treatments for tinnitus, maskers are useful for some, but not all people. As with a hearing aid, a careful evaluation by an audiologist will help decide if a tinnitus masker will help you.

Will a hearing aid help my tinnitus?

If you have a hearing loss, there is a good chance that a hearing aid will both relieve your tinnitus and help you hear. Contact an ASHA certified audiologist to determine if you will benefit from using a hearing aid. The audiologist can assist with the selection, fitting and purchase of the most appropriate aid and help with training to use the aid effective.

References

• Heller, A.J. (2003, April). Classification and epidemiology of tinnitus. Otolaryngology Clinics of North America, 36(2): 239-248.
• Adams, P.F., Hendershot, G.E., & Marano, M.A. (1999, October). Current estimates from the National Health Interview Survey, 1996. National Center for Health Statistics. Vital Health Stat, 10(200).
• Noell, C.A., & Meyerhoff, W.L. (2003, February). Tinnitus: Diagnosis and treatment of this elusive symptom. Geriatrics, 58(2): 28-34.