Ringing in Your Ears? | NIH News in Health

August 2011

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Tinnitus is commonly described as a ringing in the ears, but some people also hear it as a roaring, clicking, hissing or buzzing. It may be soft or loud, and it might affect both of your ears or only one. For some people, it’s a minor annoyance. For others, it can interfere with sleep and grow to be a source of mental and emotional anguish.

Each year about 1 in 10 adults nationwide has an episode of tinnitus that lasts longer than 3 months. Tinnitus isn’t a disease. Instead, it’s a symptom that something is wrong with your auditory system. The problem may exist somewhere in your ear, in the nerve that connects the inner ear to the brain or in the parts of the brain that make sense of sounds.

Scientists still aren’t entirely sure what happens in the auditory system to cause tinnitus. But somehow, the networks of nerve cells that process sounds have been thrown out of balance in a way that creates the illusion of sound where there is none.

Because tinnitus can arise from so many conditions, ranging from hearing loss to high blood pressure to medications, diagnosing the cause or causes can be a challenge. For many people, the ringing in their ears begins for no obvious reason.

Although there’s no cure for tinnitus, several treatments can make it easier to cope. Hearing aids may help those who have hearing loss along with tinnitus. Behavioral therapy with counseling helps people learn how to live with the noise. Wearable sound generators—small electronic devices that fit in the ear—use a soft, pleasant sound to help mask the tinnitus and offer relief.

Some people with tinnitus use tabletop sound generators to help them relax or fall asleep. Antidepressants and antianxiety drugs may be prescribed to improve mood and sleep patterns. Most doctors offer a combination of these treatments, depending on the severity of the tinnitus and the daily activities it affects the most.

Researchers have been working on new ways to treat tinnitus. One NIH-sponsored study has just begun recruiting active and retired military personnel of the U.S. Armed Forces to test the effectiveness of an experimental tinnitus therapy. Soldiers exposed to loud noise, including bomb blasts, can develop tinnitus due to tissue damage in hearing-related areas of the brain and ear. In fact, tinnitus is one of the most common service-related injuries among military personnel returning from Iraq and Afghanistan. The experimental treatment in this study combines educational counseling with a sound-generation device.

Called tinnitus retraining therapy, the approach has shown promise in earlier trials and appears to ease the annoyance of tinnitus and its impact on people’s lives. Learn more about the study at clinicaltrials.gov/ct2/show/NCT01177137.

Talk to your doctor if you’ve had ringing in your ears for more than 3 months. Your physician will ask about your symptoms and look into your ear to search for possible causes. You may be referred to an otolaryngologist (a doctor who specializes in conditions of the ear, nose and throat) for further evaluation.

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Tinnitus (Ringing in Ears): Types, Causes, Treatment, Prevention

Ear damage and exposure to loud noises are common causes of ringing or humming sounds in your ear (tinnitus). Lesser-known causes include medications and thyroid disease.

Tinnitus is the medical term for “ringing in the ears.”

It’s not a condition in and of itself. Instead, it can be a symptom of a medical condition or another issue. For many people, though, tinnitus appears on its own and isn’t accompanied by other symptoms or issues.

If you have tinnitus, you may hear more than just ringing. You may also hear:

• buzzing
• roaring
• clicking
• whistling
• hissing

Although you hear these sounds in your ears, there’s no external source of the sounds. For this reason, the sounds of tinnitus are also known as phantom sounds.

Tinnitus can be frustrating. Sometimes, the sounds of tinnitus can interfere with other sounds around you. In addition, anxiety and stress can aggravate tinnitus, which can make you feel worse all around.

You may experience tinnitus in one ear or both ears. People of all ages can develop tinnitus, but it’s more common in older adults.

Tinnitus can be either objective or subjective.

If other people can also hear certain noises in your ears, then you have objective tinnitus. Objective tinnitus is rare.

Subjective tinnitus is much more common. You’re the only one who can hear the ringing, roaring, and other sounds of subjective tinnitus.

Pulsatile tinnitus is one form of subjective tinnitus. It may result from abnormal blood vessels in and around your ears. The sounds may have the same rhythm as your heartbeat.

Damage to the inner ear is a common cause of tinnitus.

Your middle ear picks up sound waves. The conduction of those sound waves prompts your inner ear to transmit electrical impulses to your brain.

You can only hear these sounds after your brain accepts the electrical signals and translates them into sound. Sometimes, your inner ear sustains damage, altering how your brain processes sound.

Damage to the tiny bones in your middle ear or your eardrums can also interfere with the proper conduction of sound. Tumors in the ear or on the auditory nerve may cause tinnitus as well.

Regular exposure to very loud sounds can cause tinnitus in some people. People who use jackhammers, chainsaws, or other heavy equipment are more likely to have it.

Listening to loud music through headphones or earbuds or at a concert may lead to temporary tinnitus.

Medical conditions

Medical conditions that can cause tinnitus include:

• ear infections
• an overabundance of earwax, which alters the way you hear
• age-related hearing loss
• muscle spasms in your middle ear
• Meniere’s disease, which is an inner ear condition that affects hearing and balance
• thyroid disease
• high blood pressure
• high cholesterol
• head and neck injuries
• temporomandibular joint (TMJ) disorders, which also cause chronic pain in your head and jaw

Rare causes include aneurysms and palatal myoclonus (muscle spasms in the roof of the mouth).

Medications that cause tinnitus

Medication use can also cause tinnitus and hearing damage. This is known as ototoxicity (ear poisoning).

These medications include:

• very large doses of aspirin
• loop diuretic medications, such as bumetanide (Bumex)
• antimalarial drugs, such as chloroquine
• certain antibiotics, such as erythromycin (Eryc, Ery-Tab) and gentamicin
• certain anticancer drugs, such as vincristine

Diagnosing tinnitus can be tricky. This is because you’re typically the only person who can hear the sounds it creates.

A primary care physician or a specialist called an audiologist will attempt to diagnose tinnitus by examining your ears and conducting a hearing test.

The doctor will transmit sounds — to one ear at a time — through a set of headphones. You’ll respond by raising your hand or making a similar gesture when you hear each sound.

The doctor may be able to diagnose any hearing loss by comparing what you can hear to what people of your age and sex should be able to hear.

The doctor may also use imaging tests, such as CT scans or MRIs, to see if you have irregularities or damage. Standard plain film X-rays don’t always show tumors, blood vessel disorders, or other abnormalities that can affect your hearing.

In some cases, a doctor may not be able to identify what’s causing your tinnitus.

The doctor will treat any underlying medical conditions causing your tinnitus. If medications are contributing to your tinnitus, the doctor may have you switch to different ones to restore your hearing.

They’ll also remove any excess earwax and address any blood vessel issues.

There are various other tinnitus treatments and remedies. Some are described below.

Sound-based therapies

Noise-canceling machines can help dull the ringing, buzzing, or roaring by providing relaxing noises to mask your ear sounds. You can also try a masking device that is inserted into your ear and works similarly to a hearing aid.

Lifestyle changes

Reducing your stress can also help you manage tinnitus. Stress doesn’t cause ringing in the ears but can make it worse. Engaging in a hobby or talking with a trusted friend or family member are just a few ways to reduce stress.

Also, avoid exposure to loud noises. This will help lessen the severity of your tinnitus.

Drug therapy

Drug therapy can help reduce those pesky sounds in your ears, too.

In some cases, anti-anxiety medications or tricyclic antidepressants can reduce the sounds.

This is because these medications alter your nervous system and brain signals, which can affect your hearing. They can also help you manage other effects of tinnitus, such as insomnia and emotional problems.

Examples of these medications include:

• alprazolam (Xanax)
• amitriptyline
• nortriptyline (Pamelor)

Medications are typically reserved for people with more severe symptoms that are affecting their quality of life.

Not everyone responds to drug therapy, and the side effects can be bothersome.

Side effects of medications used to treat tinnitus may include:

• nausea
• fatigue
• constipation
• blurry vision
• heart problems, in rare cases

When people take these medications to treat tinnitus, it’s known as off-label drug use.

Off-label drug use

Off-label drug use means a drug that’s approved by the Food and Drug Administration (FDA) for one purpose is used for a different purpose that hasn’t yet been approved.

However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs but not how doctors use drugs to treat their patients. So your doctor can prescribe a drug however they think is best for your care.

Hearing aids

People who have hearing loss in addition to tinnitus may use hearing aids. The sound amplification can help you if you’re having trouble hearing normal noises.

There are a few steps you can take to help prevent tinnitus.

To start, try to protect your ears from loud noises.

Keep a close eye on the volume levels of your television, radio, and personal music player. Wear ear protection around noises louder than 85 decibels (dBA), which is the noise level associated with city traffic.

Cover your ears if you’re surrounded by loud music or construction noise and you don’t have proper ear protection (such as earplugs).

In addition, avoid medications that may cause your tinnitus symptoms to recur.

Also, schedule regular hearing tests with a doctor so they can promptly detect and diagnose any structural problems in your inner or middle ear.

Noise in the ears and head (tinnitus)

What is tinnitus like

Tinnitus (tinnitus) is the sensation of sound in the ear that occurs without any external stimuli.

Noise can appear in one ear or both at once, be permanent or temporary, loud or muffled, monotonous or pulsating.

Up to 45% of adults experience tinnitus from time to time, and 8% experience it constantly.

For some people, buzzing or ringing in the ears does not cause discomfort: it appears and disappears, and the person may not even pay attention to it. But sometimes the noise is so intrusive that it becomes difficult to concentrate on work tasks, communicate with people or fall asleep.

Depending on the cause, tinnitus can be completely cured or corrected so that it does not interfere with normal life.

Objective and subjective tinnitus

Distinguish between objective (vibratory) and subjective (non-vibratory) tinnitus.

Objective tinnitus is rare. It occurs against the background of diseases that provoke vibrations in certain parts of the body: involuntary contractions of the muscles of the middle ear, tremor of the soft palate. Objective noise is called because it can be heard by other people, such as a doctor during a physical examination.

Subjective noise not heard by others. It occurs against the background of irritation of the hearing organs, deterioration of the blood supply to the inner ear, as a result of acute inflammation, cerebrovascular accidents, some chronic diseases (including inflammatory ones), medication or injuries. This is the most common form of tinnitus, accounting for up to 99% of cases.

Causes of tinnitus

Most often, tinnitus occurs due to damage to the elements of the ear (inner, middle or outer), damage to the nerve cells of the brain that perceive and decipher sound, or a malfunction of the auditory nerve, through which information about sound is transmitted from the ear to the brain.

Tinnitus can be caused by damage to the elements of the ear, the auditory nerve, or to the part of the brain responsible for sound perception

Up to 85% of patients reporting tinnitus have documented hearing loss. This means that most of the cases of tinnitus are associated with ear pathology.

At the same time, hearing loss may be less noticeable, especially if the damage is not very strong or develops gradually over several months, so tinnitus is often the first sign of such pathologies.

Quite often, tinnitus appears against the background of age-related hearing impairment.

But the symptom may not be associated (or not directly associated) with pathologies of the hearing organs: for example, it may occur with vascular, neuromuscular, endocrine and other disorders, as well as with head and neck injuries.

Pathologies of the inner ear

Injuries, inflammations, neoplasms and other pathologies can disrupt the functioning of the inner ear, the auditory nerve or the part of the brain responsible for recognizing sound – this leads to hearing loss, distorted perception of sounds and tinnitus.

If tinnitus is accompanied by dizziness or sound distortion, the cause is most likely a malfunction of the inner ear, the vestibulocochlear nerve, or its centers in the brain.

Pathologies of the inner ear causing tinnitus:

• sensorineural hearing loss – hearing impairment (including imperceptible to the patient) caused by damage to the elements of the inner ear, auditory nerve or part of the brain responsible for the perception of sound;
• acoustic neuroma — a small, benign tumor that irritates the auditory nerve;
• acoustic injury – damage caused by exposure to very loud sounds (over 120 dB) on the ear, which is accompanied by hemorrhage in the cochlea, displacement or deformation of the elements of the inner ear;
• vibration injury – damage caused by prolonged or strong vibration exposure – in production, construction or transport – which provokes degenerative processes in the cochlea and other elements of the inner ear;
• otosclerosis – damage to the labyrinth of the inner ear, caused by the growth of bone tissue due to metabolic disorders;
• Meniere’s disease – non-infectious inflammation, which is accompanied by excessive accumulation of fluid in the inner ear;
• labyrinthitis – inflammation of the elements of the inner ear caused by a bacterial or viral infection.

Pathologies of the middle ear

Tinnitus can be caused by trauma, inflammation or growths in the middle ear.

Most often, the symptom occurs in connection with damage to the eardrum or a violation of intra-ear pressure.

Immersion in water can cause damage to the inner or middle ear due to pressure changes

Middle ear disorders causing tinnitus:

• barotrauma – damage to the middle or inner ear due to a sudden change in pressure – can occur during flight in an airplane, diving to great depths, when a palm strikes the ear, or an explosion nearby;
• Eustachian tube dysfunction (connects the middle ear to the nasopharynx) – a pathology in which there is increased pressure and noise in the ear;
• blockage of the ear canal by wax build-up or cerumen, foreign objects or water leads to increased pressure inside the ear;
• otitis media and other ear infections lead to swelling of the tissues, narrowing of the ear canals and changes in pressure inside the ear;
• otosclerosis – hardening and growth of bone tissue, as a result of which the mobility of the elements of the middle ear is impaired;
• Tumors of the tympanic cavity – benign or malignant neoplasms in the middle ear can disrupt the functioning of the elements of the middle ear, lead to increased intra-ear pressure or defects in the tympanic membrane;
• myoclonus – short-term contraction of the muscles of the middle ear due to neuromuscular diseases (for example, trigeminal neuralgia or epilepsy). This pathology leads to objective tinnitus.

Pathologies of the external ear

Disturbances at the level of the outer ear, as a rule, are accompanied by muscular pathologies or narrowing of the ear canal.

External ear disorders causing tinnitus:

• neoplasms of a benign or malignant nature in the outer part of the ear canal can cause tissue destruction and distortion of the perceived sound;
• exostoses – bony growths in the external auditory canal – may interfere with the penetration of sound into the ear or distort it;
• otitis externa is an acute infectious disease, which is accompanied by severe swelling of the ear canal, closing its lumen.

Other possible causes of tinnitus

Tinnitus can be caused by pathologies that are not directly related to the organs that are responsible for hearing. It can be circulatory disorders, metabolism, work of the musculoskeletal system. In this case, the noise is caused by a deterioration in tissue nutrition, an increase in pressure on the walls of blood vessels, or muscle spasms.

Non-ear causes of noise:

• benign or malignant tumors of the head and neck – can disrupt the nutrition and circulation of the elements of the hearing organ or cause their irritation, leading to incorrect operation
• head and neck injuries – can lead to damage to the auditory nerve or the area of ​​the brain responsible for recognizing sounds. Injuries are characterized by the development of noise in one ear;
• neuropsychiatric disorders , including schizophrenia. Depressive states are accompanied by an imbalance of neurotransmitters – substances responsible for the correct transmission of nerve impulses. This can lead to the appearance of subjective extraneous sounds. In addition, tinnitus in some mental disorders may be part of auditory hallucinations;
• neurodegenerative and demyelinating diseases of the central nervous system: multisystem atrophy, chronic encephalopathy of various nature, multiple sclerosis may be accompanied by disruption of the hearing centers;
• pathologies of the temporomandibular joint , which connects the lower jaw to the skull, can also cause noise because the joint is very close to the ear;
• vascular disorders – hypertension or, conversely, a tendency to hypotension, atherosclerosis, impaired straightness of the course of blood vessels – all these conditions disrupt the blood supply to the inner ear, which leads to the appearance of pathological impulses from the auditory nerve;
• certain chronic diseases – diabetes mellitus, thyroid disorders, migraine, anemia, rheumatoid arthritis or lupus;
• taking certain medications – non-steroidal anti-inflammatory drugs, antibiotics, chemotherapy, decongestants and antidepressants. As a rule, the noise disappears after the drug is discontinued.

Head trauma can lead to damage to the auditory nerve

Noise or ringing in the head does not always indicate systemic disorders in the body. Under certain circumstances, a local functional impairment occurs on the part of the hearing organ, or a person can more clearly hear blood flow, muscle contractions or joint movements.

Complications. What does constant tinnitus lead to

Depending on the form, tinnitus can occur episodically without causing discomfort, or it can greatly affect the quality of life, causing irritability, cognitive decline, insomnia and other undesirable consequences.

Complications that tinnitus can cause:

• fatigue,
• irritability,
• insomnia,
• inability to concentrate on tasks,
• memory impairment,
• depressions,
• anxiety,
• headache.

Diagnosis of pathologies accompanied by tinnitus

Tinnitus is not always dangerous: it can talk about anatomical features or accompany natural physiological processes in the body, such as aging. But in some cases, hum, ringing, whistling, squeaking or rustling in the ears indicates serious pathologies – degenerative, inflammatory processes in the hearing organs, tumor neoplasms, vascular and heart disorders, or neurological diseases. In this case, timely diagnosis will help to start treatment sooner, prevent dangerous malfunctions of systems and organs, or even save a life.

Since tinnitus can be a symptom of a variety of pathologies, finding its cause can be difficult. Diagnostics includes work with one or more specialists, laboratory and instrumental methods of examination.

Which doctors to contact

In most cases, the symptom is associated with ear pathology, so it is recommended to start the examination with an otolaryngologist (ENT doctor) – this is especially true if tinnitus is accompanied by hearing loss. If tinnitus is combined with dizziness, it is better to contact an otoneurologist – a specialist working at the junction of two specialties (ENT and neurology).

The doctor will perform a physical exam and a series of tests to look for or rule out damage to the outer, middle, and inner ear, as well as to the auditory nerve and the area of ​​the brain responsible for hearing sound. If ear pathologies are not detected, the doctor will refer to other specialists – a neurologist, cardiologist, endocrinologist, maxillofacial surgeon.

Physical examination

The purpose of the examination is to exclude manifestations of certain pathologies. Each specialist is responsible for his area.

An ENT doctor examines the ear and surrounding areas for visible abnormalities.

A cardiologist identifies external signs of diseases of the cardiovascular system (for example, calculates body mass index and evaluates waist circumference), measures pulse and pressure.

A neurologist evaluates the functions of systems directly or indirectly related to the organ of hearing: balance, eye movements, the muscular frame and the musculoskeletal system, detects or excludes muscle spasms, curvature, checks reflexes, the work of cranial nerves.

An endocrinologist examines a patient for manifestations of endocrine pathologies – diabetes mellitus, thyroid dysfunction, and others.

Dentist or oral surgeon checks temporomandibular joint (TMJ) function.

A psychotherapist tests for anxiety, depression, and other mental disorders.

Laboratory diagnostics

To diagnose ear pathologies and disorders of the main organs and systems, general and biochemical blood tests are prescribed. They allow you to exclude the inflammatory process and evaluate the state of metabolism, the function of internal organs.

Clinical blood test with leukocyte formula and ESR (with microscopy of a blood smear in case of pathological changes) (venous blood)

430 ₽

₽

Add to cart

To exclude autoimmune pathologies, an erythrocyte sedimentation rate test, a hemostasiogram, tests for antinuclear antibodies, rheumatoid factor are prescribed.

ESR according to Westergren (venous blood)

140 ₽

Add to cart

Antinuclear antibodies, IgG (n/col. )

580 ₽

Add to cart

Rheumatoid factor

900 04 350 ₽

Add to cart

Hemostasiogram (Coagulogram)

730 ₽

Add to cart

The doctor may prescribe additional tests to exclude pathologies of the cardiovascular system, to evaluate the functioning of the thyroid gland.

Lipid Complex

900 ₽

Add to cart

Thyroid gland

2 670 ₽

Add to cart

Diagnostics of diabetes mellitus

1 050 ₽ 900 05 Add to cart

Instrumental diagnostics

To identify ear pathologies and determine the nature of the disorders, the doctor prescribes instrumental studies: audiometry, magnetic resonance imaging (MRI), computed tomography (CT).

Audiometry is a test performed using a special device (audiometer) that allows you to evaluate the conduction of sound in all parts of the ear and determine the nature and degree of hearing loss in a patient. Based on the results, an audiogram is formed.

Audiometry is one of the hardware methods for diagnosing hearing loss

Magnetic resonance imaging (MRI) and computed tomography (CT) of the temporal bones allow you to assess the condition of the mastoid processes, internal auditory canals, cochlea and auditory nerve. Magnetic resonance imaging (MRI) and computed tomography (CT) of the brain, including those using special scanning modes, help to assess the safety and blood supply of the hearing centers.

Additionally, the doctor may prescribe dopplerography of the vessels of the head and neck – this is necessary to exclude hearing pathologies associated with circulatory disorders.

Also instrumental methods of research (MRI, CT, ultrasound) can be used to exclude disturbances in the functioning of internal organs, the development of tumor processes.

Treatment. What to do about tinnitus

Treatment for tinnitus depends on what caused the pathology. One-time or long-term drug therapy, surgery, or even prosthetics may be required.

The most common treatment for tinnitus is symptomatic.

Conservative therapy

If ear damage is detected during diagnosis, it is important to start treatment as soon as possible: this will stop or slow down the development of destructive processes and prevent tinnitus from progressing.

Depending on the diagnosis and the affected area, the doctor may prescribe antibiotics and painkillers to relieve inflammation, corticosteroid tablets or injections to stop destructive processes, as well as drugs that help improve blood circulation and tissue nutrition. Topical application of non-hormonal and hormonal drugs in the form of drops is also possible.

If acute or chronic processes in the body are identified that could provoke tinnitus, the doctor will prescribe their treatment or correction: antidepressants in case of depression, antispasmodics for muscle spasms, drugs that reduce blood pressure, for hypertension, or hormone therapy for impaired thyroid function.

In some cases, physiotherapy is prescribed – electrophoresis (administration of drugs through the skin using direct electric current), magnetotherapy (impact on tissues using a magnetic field). Mud applications on the ear area and acupuncture are also used. These measures help to normalize the functioning of the ear and neighboring regions and reduce the severity of tinnitus.

Regardless of the origin of tinnitus, sedative drugs, anti-anxiety drugs, antidepressants are effective in reducing it. The specific drug is selected by the doctor.

Surgical treatment

Surgical treatment of tinnitus is used if the pathology is caused by benign or malignant neoplasms. In this case, the removal of an overgrown tissue area can normalize the functioning of the ear and save the patient from noise.

Cochlear Implant

If tinnitus is caused by significant hearing loss, a cochlear implant may be indicated. The therapeutic effect is achieved through direct electrical stimulation of the auditory nerve and acoustic masking.

A cochlear implant has an external (receiving) and an internal (analyzing) element: in fact, it replenishes the function of the ear

Rehabilitation and psychotherapy

Tinnitus can quite strongly affect all areas of the patient’s life – prevent them from concentrating on work tasks, make it more difficult to communicate with other people, interfere with sleep or enjoy usual activities. Therefore, if a symptom cannot be corrected, a person needs to undergo special “training” in order to adapt to new conditions.

Psychotherapy, including cognitive behavioral therapy, plays an important role in this matter. It allows you to smooth out the negative impact of tinnitus on quality of life, reduce anxiety and the risk or severity of panic attacks, and also helps you accept your new features and learn to live with them without getting angry or giving up your usual activities.

In parallel with psychotherapy, it is recommended to add background noise to everyday life: turn on soft music during the day, and fall asleep to white noise or audio recordings with the sounds of the forest, sea or rain. If music distracts from work, devices like a mini fountain or humidifier can help mask the noise. Gradually, the psyche adapts and the person stops noticing tinnitus.

Prevention. Risk factors for tinnitus

There is no specific prevention of noise or tinnitus: many diseases, including genetic ones, cannot be prevented. But there are a number of factors that a person can influence in order to prevent the development of pathology.

Factors that increase the likelihood of tinnitus:

• loud sound : short-term or long-term exposure of the ear to loud sounds (above 120 dB) may cause acoustic injury and provoke the development of tinnitus;
• vibration : similar to acoustic trauma, prolonged exposure to vibration can lead to the development of ear pathologies and tinnitus;
• alcohol abuse and smoking : cause spasms, vasoconstriction and greatly increase the risk of tinnitus;
• unhealthy lifestyle : if a person sleeps poorly, eats junk food, sits a lot and moves little, his blood pressure rises, muscle tone is disturbed, immunity decreases – all this increases the likelihood of developing tinnitus;
• past infectious and inflammatory diseases (purulent otitis media, meningitis, influenza).

Prognosis for tinnitus

In most cases, timely and adequate treatment leads to the fact that tinnitus ceases to disturb the patient and he returns to normal life – he can again concentrate on work, communicate with friends, fall asleep normally.

As a rule, treatment and adaptation take from 3 months to 1.5 years. At the same time, the success of treatment directly depends on how soon it was started.

Even with minor tinnitus, it is important to see a doctor and start therapy to prevent deterioration.

Factors affecting treatment outcome:

• early initiation of therapy: the sooner the pathology is identified and treatment initiated, the more likely it is to be effective;
• age: the treatment of hearing pathologies in the elderly can be difficult due to age-related changes in tissues and organs;
• cause of tinnitus: some pathologies are treatable, while others can only be corrected or the patient can adapt to new conditions;
• gender: tinnitus occurs more frequently in men than in women.

Sources

1. Tinnitus: Ringing in the ears and what to do about it / Harvard Health Publishing. 2022.
2. Krasyuk A.A., Kunelskaya N.L., Levina Yu.V. Correction
   psychosomatic disorders caused by cochleovestibular disorders / materials of the 3rd International Congress “Restorative Medicine and Rehabilitation – 2006”. M., 2006. S. 114.
3. Yanov Yu. K., Korneenkov A. A., Levina E. A., Serova E. E., Levin S. V., Kuzovkov V. E., Astashchenko S. V. Effect of cochlear implantation on the severity of tinnitus and patients with profound hearing loss and deafness / St. Petersburg Research Institute of Ear, Throat, Nose and Speech of the Ministry of Health of Russia. 2017.
4. Rocha A. V., Mondelli F. C. G. Tinnitus masker combined with tinnitus therapy counseling: evaluation of effectiveness. Braz J Otorhinolaryngol. 2017 Vol. 83(3). P. 249–255. doi:10.1016/j.bjorl.2016.03.021

Causes of tinnitus. Why does tinnitus occur?

Here is information about some of the points that may affect its occurrence.

Tinnitus, or persistent ringing in the ears, affects the lives of millions of people . It can also sound like a whistle, a hum, and even a chirp. Some notice this state of theirs only when they actively think about it. Others are much less fortunate – tinnitus prevents them from concentrating, relaxing and often even falling asleep.

Before starting to treat tinnitus, it is necessary to find out its cause in each specific case. Here are some of them.

Wax buildup

This blockage in the ear can cause pain, hearing problems and even tinnitus. Tinnitus caused by this cause is temporary and will go away after the ear canal is cleared. The ENT doctor can quickly and painlessly remove the blockage formed by sulfur; do not try to solve this issue yourself. Otherwise, you can severely damage your ears, which will lead to permanent hearing loss and tinnitus.

Ambient noise-induced hearing loss

Hearing loss is the most common cause of tinnitus. Many people around the world have hearing loss, especially those who have been in situations of excessive acoustic stress. Noisy productions, shootings, musical events are all risk factors. Also, many people have acquired hearing loss and tinnitus after listening to loud music with headphones for a long time.

Hearing loss due to prolonged exposure to intense noise often manifests as tinnitus. This problem is activated in silence; then tinnitus is especially noticeable. In such cases, the best solution recommended by audiologists is to find a way to correct the hearing loss. Hearing aids are here to help.

Temporomandibular joint (TMJ) problems

The joint in question is a small disc in your jaw that helps you open and close your mouth. It can be damaged or deformed for a number of reasons, including trauma to the face or neck.

TMJ problems are not only about discomfort, pain and jaw issues, but also that tinnitus can occur .