Mayo Clinic Minute: Is tinnitus causing that ringing in your ear?

• By

  Jason Howland

  January 18, 2023

Have you ever experienced a constant ringing in your ears that you can’t pinpoint the cause? It might be tinnitus (‘tin-nĭ-tus) — the sensation of hearing a sound when no external sound is present. In most cases, tinnitus can be managed, but for some, it’s a chronic condition that can affect sleep and everyday function. Fortunately, there are options to reduce its effects.

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About 1 in 5 people experience the perception of noise or ringing in the ears. It’s called tinnitus. Dr. Gayla Poling is the director of Diagnostic Audiology at Mayo Clinic. She says tinnitus can be perceived a myriad of ways: ringing, buzzing, whistling, a cracking, a chirping. But why?

“Ninety percent of those with tinnitus have hearing loss. So that’s usually where we start as a source or a reason for the tinnitus.”

Hearing loss can be age-related, come from a one-time exposure, or exposure to loud sounds over a lifetime. Dr. Poling says the tiny hairs in our inner ear may play a role.

“Those little hair cells in our inner ear are really delicate structures. That’s what is actually damaged with noise exposure, or wear and tear on your ears across your life span. So those hair cells, that damage might be the reason or part of the cause for tinnitus for some.”

Dr. Poling says there’s no scientifically proven cure for tinnitus, but there are treatment and management options.

“That can be something as simple as getting a hearing aid to really start treating the hearing loss. And once you treat that, then you find that the tinnitus and the perception of that tinnitus is reduced.”

Other options include using a sound generator or a fan at night. And then there are more advanced treatments.

“There’s something called “tinnitus retraining therapy.” There are more ear-level masking devices where you can hear sounds throughout the day, too, that are more distracting.”

If ringing in your ears bothers you, start by seeing your health care provider for a hearing test.

For the safety of its patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was either recorded prior to COVID-19 or recorded in a nonpatient care area where other safety protocols were followed.

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Possible Reasons You Have Tinnitus (Ringing in Ears)

Written by WebMD Editorial Contributors

• Tinnitus Triggers

Tinnitus, or ringing in the ears, can be caused by many things. But it isn’t a disease. It’s a symptom of another health problem.

What causes the ringing? Usually it’s from damage to tiny hairs in your inner ear. That changes the signals they send to your brain that control how you hear sound. You might get tinnitus as a normal part of aging, but there are other causes. It could be temporary, or it might last for the rest of your life.

Age-related hearing loss: For many people, hearing gets worse as you age. This usually begins around 60. It usually affects both ears. You’ll probably notice a problem with high-frequency sounds.

Loud noises: Loud noises are a leading cause. It could be something you hear every day for years, or something that only happens once. That includes everything from concerts and sporting events to loud machinery and backfiring engines. They can affect one or both ears, and they may cause hearing loss and pain. The damage can be permanent or temporary.

Too much earwax: Your body makes this gunky stuff to trap dirt and protect your ears. But if it doesn’t wash away on its own and too much piles up, it could lead to ringing or hearing loss. Your doctor can remove the buildup gently. Don’t grab a cotton swab and try to do it yourself.

Certain medicines: Prescription and over-the-counter drugs can trigger ringing or make it louder. This includes aspirin, diuretics, nonsteroidal anti-inflammatory drugs (NSAIDs), quinine-based medication, and certain antibiotics, antidepressants, and cancer drugs. Usually the stronger the dose, the greater your chance of problems. Often if you stop the drug, your symptoms will go away. See your doctor if you think a drug may be to blame. But don’t stop taking any medication without talking to your doctor first.

Ear and sinus infections: You might notice tinnitus when you’ve had a cold. That could be due to an ear or sinus infection that affects your hearing and increases pressure in your sinuses. If that’s the cause, it shouldn’t last long. If it doesn’t get better after a week or so, see your doctor.

TMJ: Problems with your jaw or temporomandibular joint (TMJ) can cause tinnitus. You might notice popping or pain in the joint when you chew or talk. The joint shares some nerves and ligaments with your middle ear. A dentist can treat TMJ disorders and help keep ear ringing from getting worse.

Blood pressure issues: This can include high blood pressure and things that raise it in the short term, like stress, alcohol, and caffeine. Hardening of the arteries can also play a role. Blood vessels close to your middle and inner ear become less stretchy, so your blood flow is stronger and seems louder. This iwhat is known as a pulsatile tinnitus.

Other medical problems: These include changes in your inner ear bones, an inner ear disorder called Meniere’s disease, or head and neck injuries. Conditions like fibromyalgia and Lyme disease also can trigger ear ringing. Your doctor will help you figure out the cause and ease the sounds.

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Tinnitus, ringing in the ears – symptoms, causes, treatment

What is tinnitus?

The word tinnitus comes from the Latin tinnire, “to tinkle” , but tinnitus can sound more like a hum, hiss, chirp or a thin squeak.

About 40% of adults experience tinnitus from time to time. About 8% suffer from it often or constantly. For 1% of people, tinnitus is a serious problem that interferes with a normal life. It almost never affects children and very often elderly people with hearing loss.

This noise is not associated with external sounds and is “heard” better in silence than with external noise. Tinnitus lasts for a long time (more than 5 minutes) and should be distinguished from a short, transient sound that lasts a few seconds or occurs after a strong sound stimulus. Such noise is in no way connected with the mechanical processes occurring in the ear, its cause is in the nerve cells.

IMPORTANT! Information from the article cannot be used for self-diagnosis and self-treatment! Only a doctor can prescribe the necessary examinations, establish a diagnosis and draw up a treatment plan for a consultation!

Why does tinnitus occur?

There are two theories about its origin.

1) Due to the constant high level of noise in the life of a city dweller, cells in the inner ear are constantly dying, turning sounds into nerve impulses. They do not die immediately, but for some time they are in a “death” state. They can still send information to the brain, but are no longer able to generate impulses specific to each sound. The result is “noise”.

2) According to another theory, tinnitus is something like phantom pains. The auditory cortex of the brain “remembers” that information about external sounds should be transmitted through the auditory pathways, but the corresponding auditory cells have already died, and the brain “has to” find information that is similar to sound impulses. This information travels along pathways through the mood center, which is why tinnitus sufferers have such a hard time with noise. Gradually, as a result of incorrect adaptation, this path becomes the main one for the brain, and the person, as it were, gets used to hearing noise.

What can cause tinnitus?

• Tinnitus is usually caused by hearing loss from constant exposure to loud noises (tractor, lawn mower, loud music on headphones) or acoustic trauma.
• Otitis media, atherosclerosis, traumatic brain injury, cervical osteochondrosis, and hearing loss due to aging or other causes can contribute to tinnitus.
• Much less commonly, tinnitus can be a symptom of diabetes, kidney disease, or head or neck tumors.
• Some drugs cause tinnitus: quinine, non-steroidal anti-inflammatory drugs, paracetamol, diuretics (furosemide…), a number of antibiotics (gentamicin, streptomycin, etc.), certain types of chemotherapy, some psychiatric drugs (amitriptyline, sertraline, anafranil, etc.). e.)

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How to “measure” strength tinnitus?

Since this is a subjective sensation, it cannot be measured in decibels. In fact, the most important thing is how much tinnitus causes discomfort to its “happy” owner.

Therefore, a qualitative scale is used that rates tinnitus from “mild” to “catastrophic”, based on whether the person hears it all the time, whether it interferes with sleep or does something that requires silence.

Severe tinnitus leads to nervous tension, insomnia, inability to concentrate and even depression.

How to cure tinnitus?

There is no cure for tinnitus. Drugs of different groups have been studied, including antiepileptics, antidepressants, tranquilizers, but none of them is able to significantly reduce tinnitus.

Based on the theory that the brain does not adapt properly to the death of nerve cells that conduct auditory impulses, tinnitus is treated with a method called tinnitus retraining therapy (TRT). This is a type of cognitive-behavioral therapy in which a person is taught to be distracted from the noise, to relax, not to hear it. Gradually, a positive feedback is formed, the brain “unlearns” to use the wrong way of conducting impulses, and the noise level really decreases.

In addition to training, the TRT course uses sound therapy individually selected by means of noise measurement – a person is empirically selected “white noise”, which he should listen to from time to time. It can be the sound of the sea, the wind or the rustle of leaves. Such noise is evaluated in the subcortical auditory pathways as a neutral sound, its perception is quickly blocked and it does not reach the cortex, and tinnitus is blocked along with it – the patient ceases to be aware of it.

Both parts of therapy are equally important, but the first is the main one: the patient must stop paying attention to tinnitus, learn to live with it and reduce its significance. The TRT method allows you to completely remove tinnitus in terms of three months to two years.

If you suffer from nocturnal tinnitus, there are Tinnitus Therapy Pro and Tinnitus Therapy Lite mobile apps to help relieve it while you sleep. Applications offer so-called sound maskers (white noise and others), as well as sound tracks developed by doctors lasting 8 hours. There are other apps and tracks, paid and free, that can make life easier and “mask” tinnitus that occurs day or night.

causes and treatment, how to diagnose

Tinnitus (from Latin tinnītus “ringing”) is the sensation of sound in one or both ears in the absence of an external source of sound. This sensation is mostly described as ringing in the ears, but the sounds can also be hissing, humming, clicking, or buzzing. Noise, hum or ringing in the ears can be strong, mild or moderate, constant or intermittent. The perception of tinnitus is individual.

Although tinnitus is heard in the ears, it occurs in the nerve circuits of the brain, which causes us to hear sounds in the head. It is not yet known exactly what is going on in the brain to create the illusion of a sound that is not actually there. Tinnitus is the most common disorder affecting 10 to 15% of the world’s population.

Causes of noise or ringing in the ears

The appearance of tinnitus can be caused by prolonged exposure to loud noises or certain lifestyle habits. Ringing in the ears can also occur in healthy people and for no apparent reason. However, in many cases, the appearance of noise or ringing in the ears is associated with hearing loss.

Causes that can trigger tinnitus can be divided into the following groups:

Medical

• Diabetes
• Anemia
• Allergy
• Otosclerosis
• Meniere’s disease
• Earwax plug
• Head and neck tumors
• Low serotonin 9 0034
• Blood pressure problems
• Thyroid problems (hypothyroidism).
• Diseases of the outer, middle or inner ear.

Hearing impairment

According to statistics, 80-85% of patients suffering from tinnitus have some degree of hearing impairment. Despite the fact that tinnitus is not the cause of hearing impairment, but its impact negatively affects concentration, performance, because constant sounds in the head are distracting and prevent you from concentrating on really important sound information. Annoying noise distracts from daily tasks and interferes with meaningful communication with family, friends and loved ones.

Head injury and brain disease
Head injury, such as a concussion, can damage the inner ear and cause tinnitus. Also, neurological diseases, such as multiple sclerosis, can lead to tinnitus, and acoustic tumors of the auditory or vestibular nerve, by putting pressure on the nerve endings, can create tinnitus. In this case, the treatment of tinnitus should begin with an appeal to a neurologist.

Heart and blood vessel problems

If your tinnitus is pulsating, it may be due to a problem with your blood vessels.

Drugs that cause tinnitus

The most common drugs that cause tinnitus are non-steroidal anti-inflammatory drugs (eg, aspirin, gentamicin), diuretics, some antibiotics, and cancer drugs. If you experience tinnitus after starting a drug or changing its dosage, contact your healthcare provider right away to determine further treatment.

Risk factors for tinnitus

Often tinnitus occurs in people with hearing impairment of different ages, but the elderly and those whose professional activities are associated with high-level noise exposure are at risk.

Age-related hearing loss

Hearing loss due to aging is called presbycusis and begins at age 60. The greater the hearing loss, the more likely it is that tinnitus will occur. To prevent the appearance of annoying noise, you must first contact an audiologist for a hearing diagnosis in order to assess its severity (i.e., at what frequencies a decrease is observed) and then select a method for correcting the identified violations.

Loud noise exposure

Regular exposure to loud noise in professional activities (airport workers, factories, construction sites, city transport drivers, military, hunters) is a common cause of hearing loss and tinnitus. Wearing earplugs at work will help protect your hearing.

Lifestyle
Listening to music at high volumes for extended periods of time or frequent concerts can also cause permanent hearing damage. Excessive alcohol consumption, smoking, abuse of foods and drinks containing caffeine can cause tinnitus. Frequent fatigue and stress can also be risk factors.

If you have tinnitus, start your treatment journey by contacting a hearing care professional who specializes in diagnosing tinnitus to help determine the underlying cause. If common causes of tinnitus are ruled out, your doctor will refer you to another specialist for further evaluation and treatment.

How to reduce the effects of tinnitus

Since tinnitus is purely subjective, it can be difficult to diagnose, so following the advice of your hearing care professional on your own can help alleviate the condition:

• Avoid tobacco, coffee, cola, tea;
• Learn to relax, arrange a relaxing minute for yourself;
• Try to control your blood pressure, measure it regularly;
• Avoid loud noise and use earplugs for occupational protection;
• Try to eat less salt, because. its use is one of the causes of circulatory disorders;
• Exercise regularly, exercise improves blood circulation, which helps reduce tinnitus;
• Use a hearing aid. It not only helps with hearing loss, but also has a masking effect that will help you get rid of annoying tinnitus and reduce its impact on daily life.

Hearing loss and tinnitus

Noise or ringing in the ears or head often cannot be treated, but the good news is that tinnitus can be controlled. The latest technological solutions in the field of audiology and deafness come to the rescue. Clinical studies show that digital hearing aids are not only effective in addressing hearing loss, but also help reduce the impact of tinnitus and provide overall relief.
Amplification of environmental sounds through the hearing aid provides activation of the auditory part of the nervous system, which reduces the perception of tinnitus. With constant exposure to amplified environmental sounds, the auditory part of the nervous system is rebuilt, which has a beneficial effect on the function of nervous activity, restoring it and weakening hypersensitivity to auditory sensations.