Introduction

Tinnitus for what everyone call “ringing in the ears” is a symptom of hearing a sound which originates in the head in the absence of any perceivable external sound. It means ringing, but is used to describe sounds that are buzzing, roaring, pulsatile, or clicking in nature. The sound may be heard in one or both ears. Tinnitus may be the first or only symptom of a disease process which threatens the patient’s health or well being.

One third of population might experience tinnitus sometime in their lives. The quality of life of one percent of them might seriously affected by this symptoms. The prevalence is highest in 40 – 70 year-olds and it is more common in men than in women.

Signs & symptoms

Tinnitus is a symptom and not a disease.

One or both ears may be affected.

It may be pulsatile or nonpulsatile in nature and can be related with the sound of the heartbeat.

The symptom(s) may be short or long in duration.

It may be constant or intermittent.

Associated Symptoms :

• hearing loss
• headache
• dizziness (vertigo)

Causes

There are a number of causes of tinnitus, and in many cases we can’t really pinpoint a specific one. Possible causes :

• Abnormalities of blood vessels.
• Eustachian tube dysfunction (tube that connecting the nose and middle ear for pressure equilibrium).
• Any ear disease ; impacted ear wax, CSOM (Chronic Suppurative Otitis Media), Otosclerosis, presbyacusis (hearing loss due to aging), hearing loss due to noise.
• Head injury.
• Ear injury such as expose to sudden loud noise.
• Medications ( mostly pain killer and antibiotics).
• Tumour in inner ear (Acoustic neuroma).
• Psychological factors such as depression, stress and anxiety.
• Hypertension (high blood pressure) & artherosclerosis.
• Severe anaemia and renal failure.

In most instances, tinnitus probably results from the cumulative effect of lots of different factors. The following symptoms require attention :

• Constant tinnitus in one ear can sometimes be an early sign of a benign tumor in the inner ear and brain.
• Pulsatile tinnitus in one side also has a slightly higher likelihood of representing something more serious.
• New onset of tinnitus that is accompanied by other symptoms or is getting worse.

Complications

• People with severe cases of ringing in the ear may find it difficult to hear, work, or even sleep.
• Some can lead to serious psychological impact.

Treatment

Tinnitus is a poorly understood problem with multiple causes, thus the treatment is generally not always satisfied. The ear and other medical problems should be treated accordingly either with medications or surgery.

• Medications
  The only medications that have proved usefull are drug that reduce anxiety, improved sleep pattern and antidepression effect.

• Masking
  • Hearing aid for those have associated hearing loss
  • Tinnitus masker for those don’t have (or without) hearing loss
  • Tinnitus instrument : combination of both

(This treatment is by a trained Audiologist)

• Surgery is Currently has no role in treating tinnitus except in tumour of ear

Prevention

Soft sounds can relieve some of the sounds associated with Tinnitus. Listening to the sound such as buzzing in between radio channel during episodes of tinnitus for one to two hours would help relieve Tinnitus until fall asleep.

• Avoid from taking a stimulants such as coffee, tea, chocolate, cola, alcohol and other caffeine containing medications.
• Stop smoking.
• Avoid medications, which are known to cause tinnitus such as aspirin and NSAIDs. Aspirin may worsen the affects of Tinnitus in some people.
• Do not take a medication which is known to potentially cause damage to the hearing system, unless the situation is life-threatening and no acceptable alternative can be found.
• Avoid exposure to loud or disturbing noise (If the sound in a room is so loud that a person affected by tinnitus must raise his or her voice in order to be heard).
• No harm to be exposed to all kinds of sound that is not excessively loud. In very quiet environment, tinnitus will be unnecessarily magnified.
• Stress would increase tinnitus. Try to avoid stress and learn to handle it. Distraction by focusing on something other than the tinnitus sound is another way of receiving some relief.