Tinnitus - What Causes It?

Tinnitus is the ringing in the ears in the absence of any external sound and the ringing heard is not related to any external source. Tinnitus is a symptom due to underlying ear disease.

Epidemiology

Worldwide 10%-15% of the population suffer from tinnitus and those suffering from ear-related problems are 85% of the population.

How do we know whether it is subjective or objective tinnitus?

Subjective tinnitus is the sound which only the patient hears and objective tinnitus is the sound which others can hear as well along with the patient. Ninety-five percent of the people suffer from subjective tinnitus due to problems in the inner, middle, and outer ear whereas rest 5% suffer from objective tinnitus which is due to any structural defect in the ear, neuromuscular condition, or a tumor in the head, neck, and brain.

Causes

• Prolonged exposure to loud sound for a long duration can cause permanent damage to the ear, whereas exposure to a sound for short duration may restore hearing back.
• Middle ear infection.
• Injury to ear.
• Age-related hearing loss: Hearing gets hampered with age which starts around 60 years of age. Hearing loss can lead to tinnitus.
• Meniere’s disease: It is an inner ear disease; tinnitus is an early symptom
• Earwax: Normally earwax protects ear canal from dirt. When it accumulates, wax gets built up causing blockage leading to hearing loss.
• Emotional stress Diseases of the heart
• Drugs, such as aspirin, antidepressants, quinine, cancer medications, and diuretics.
• Temporomandibular joint disorder
• Acoustic neuroma

How to deal with it?

First, treat the underlying cause.A patient suffering from tinnitus should be counseled every 15 days. It reduces the stress onto those who are suffering from tinnitus and will boost up the patient.Tinnitus maskers/hearing aid is helpful in ignoring tinnitus frequency. Maintain your cardiovascular health with regular exercise, yoga, meditation, and medicines which control blood pressure. All these factors can help prevent tinnitus.

Can tinnitus be fatal?

It can vary from mild to severe which can cause distress such as interference with sleep and normal day to day routine activities. It can affect patient psychologically so much that patient goes into depression and can commit suicide.

How to evaluate tinnitus?

It can include an audiogram (hearing test), measurement of acoustic parameters and some of the imaging studies to be performed.

1. A pure tone hearing test is to be performed to find out the cause. Acoustic measurement of tinnitus includes measuring several parameters like frequency, the range of frequency, bandwidth, and loudness in dB above hearing threshold.
2. Residual inhibition helps indicate how useful tinnitus maskers would be.
3. Imaging studies like magnetic resonance angiography and Transcranial Doppler are to be performed to find out the underlying cause.