Tinnitus is an abnormal perception of a sound which is reported by patients that is unrelated to an external source of stimulation. Tinnitus is a very common symptom. It may be intermittent, constant or fluctuant, mild or severe, and may vary from a low roaring sensation to a high pitched type of sound. It may or may not be associated with a hearing loss. It is also classified further into subjective tinnitus (a noise perceived by the patient alone) or objective (a noise perceived by the patient as well as by another listener). Subjective tinnitus is common; however, objective tinnitus is relatively uncommon. The location of tinnitus may be in the ear(s) and/or in the head.
Tinnitus is a symptom much like a headache, pain, temperature, hearing loss or vertigo. With tinnitus, the reported distress is usually subjective and difficult to record and appreciate by others.
The quality of the tinnitus refers to the description by the patient of the tinnitus: It may be a ringing, buzzing, clicking, cricket, ocean, etc., type of sound. The quality may be multiple sounds or a singular sound.
Tinnitus may be produced in one or more locations, called its site of lesion. The cause of tinnitus may be singular or multiple. A peripheral (i.e., auditory nerve or cochlea) site of lesion includes dysfunction established within the auditory system that extends up to but not involving the brainstem. A central site of lesion refers to involvement of the central auditory pathways, beginning at the brainstem and involving other portions of the central nervous system. Tinnitus is, therefore, a symptom of neurotologic disease. It may occur with a hearing loss, vertigo or pressure symptoms in the ear or it may occur alone.
Treatment of Tinnitus
Generally, most patients will not need any medical treatment for their tinnitus. For patients who are greatly bothered by tinnitus but do not have hearing loss, they may use some masking techniques such as listening to a fan or radio which would mask some of their tinnitus. Some patients will choose to wear ear-level masters. In patients with hearing loss and tinnitus, a hearing device that has a built-in tinnitus masking program is recommended. Masking is based on the principle that most individuals with tinnitus can better tolerate outside noise than they can their own inner head noise.
Biofeedback training or relaxation techniques are effective in reducing the perception of tinnitus in some patients. They consist of exercises in which the patient learns to control the various parts of the body and relax the muscles. When a patient is able to accomplish this type of relaxation, tinnitus generally subsides. Most patients have expressed that the biofeedback offers them better coping skills.
Other measures to control tinnitus include making every attempt to avoid anxiety, as this will increase your tinnitus. You should make every attempt to obtain adequate rest and avoid over fatigue because generally patients who are tired seem to notice their tinnitus more. The use of nerve stimulants is to be avoided. Therefore, excessive amounts of coffee and smoking should be avoided. Tinnitus will not cause you to go deaf and statistically, 50 percent of patients may express that their tinnitus with time decreases or is hardly perceptible.
There are other medications which have been utilized to suppress tinnitus. Some patients benefit with these drugs and others do not. Each patient has an individual response to medication, and what may work for one patient may not work for another. Some of these medications have been proven, however, to decrease the intensity of the tinnitus and make it much less noticeable to the patient. There is, however, no drug anywhere which will remove tinnitus completely and forever. There are some drugs which will also cause tinnitus. If you have tinnitus and are on medication, you should discuss the symptom of tinnitus with your physician. In many instances, once the drug is discontinued the tinnitus will no longer be present.