Tinnitus

·         What is the noise I hear in my head called?
This noise is common and is known as tinnitus.
 

·         Am I imagining this noise?
No this noise is real.
 

·         What is tinnitus?
Tinnitus is not a diagnosis, but a symptom of an underlying problem.
It is the perception of a noise in the head or ear (both or one sided).
 

·         Can other people hear my tinnitus?
Generally speaking, tinnitus is a subjective perception, that is, it cannot be heard by others. However, there are rare forms of tinnitus that can be objectively confirmed.
 

·         Where do all the noises come from?
We can divide tinnitus into two types.
The first type is caused by structures in the middle ear. It presents as clicking and fluttering most likely resulting from the tiny muscles in the middle ear twitching or the jaw clicking. They can also be heard as pulsating sounds in time with your heartbeat and represent sound from the blood vessels.
The second type is more common and presents as a buzzing or ringing sound. The pitch of this is usually high, but it can have a low pitch. This type of tinnitus is called auditory or subjective tinnitus and is caused by damage anywhere along the hearing pathway, from the cochlear to the nerve to the brain.
 

·         What are the types of tinnitus and their causes?
The first type of tinnitus (middle ear sounds and blood vessels) is usually normal. We become more aware of them when we have middle ear and eustachian tube problems. Pulsatile tinnitus can be a sign of abnormal blood vessels in the middle ear.
The 2nd type, auditory tinnitus, is caused by damage, from any cause, to the cochlear and nerve structures. These include congenital hearing defects, viral and bacterial infections, medications and chemicals (ear-toxic or not), noise-induced damage, vitamin and mineral deficiencies, age related damage, medical conditions (diabetes, hypertension etc), Meniers disease and even tumours rarely.
They are also aggravated by depression and anxiety.
 

·         Why do we hear the tinnitus?
We don’t really know the actual source of the noise. There are many theories. Some people theorize that some types of tinnitus are caused by increased neural activity in response to the initial damage. It’s useful to imagine tinnitus as being “pins and needles” of the hearing nerve.
 

·         Is tinnitus common?
Up to 90% of people will experience tinnitus at some point in their lifetime.
  

·         If it’s so common, why do only some people “suffer”?
The reason that only a percentage of tinnitus “experiences” become tinnitus “sufferers” is not known. This may be due to the underlying cause or the subsequent anxiety that models the tinnitus into a more “permanent or serious” type. There is no doubt that the worse the hearing damage the more likely the tinnitus is to be louder.
 

·         Do I have to see an ENT or Specialist?
Because the potential cause of pulsatile tinnitus and auditory tinnitus is serious, ALL people experiencing persistent tinnitus MUST be evaluated by a specialist especially if there is associated vertigo or hearing loss.
 

·         What can I do to prevent tinnitus?
Tinnitus can be prevented by preventing damage to the cochlear. The most obvious way is to avoid noise induced damage eg. Clubs, Gym, I-pods, Loud sound systems in the car etc.
 

·         Tinnitus at night really bothers me. What can I do?
Here we recommend distracting the brain with a competing sound. Play a radio between stations (white noise), or soft baroque music. Tinnitus is definitely more noticeable when it is “quiet” or when situations are filled with stress.
 

·         Is there a cure for tinnitus?
Because the actual cause is unknown, there are many medications (allopathic and alternative) to try. My experience is that whenever there are so many options, it usually means that none work well enough to make the others redundant. Try them all! Included in this long list are herbal remedies e.g. rehmannia, feverfew and hawthorn, reflexology, ginkgo biloba, red rice yeast extract. Serc works well for tinnitus associated with Meniers disease. 
 

·         Are there any devices that can be used?
Tinnitus maskers are useful in some cases. They distract the brain from the noise. Slowly over time, the noise can be eliminated. This together with good counselling is the most effective way to managing tinnitus.
Hearing aids similarly work well if there is an associated hearing loss. They help you hear louder than the tinnitus, thereby reducing it.
 

·         What is the role of sound therapy?
There are specific therapies, e.g., auditive stimulation and destimulation therapy or behavioural therapies that are being investigated. Here you have to consult a specialist.
  

·         What are the dietary recommendations?
Diet recommendation would be the inclusion of a vitamin and mineral enriched diet (Potassium, magnesium, zinc, vitamins A and C, manganese, panthothenic acid and bioflavonoids).
Avoid alcohol, caffeine and smoking.
Low sodium diet also helps since salt causes fluid to build up and this affects the circulation of the cochlear.
 

·         What else can we do?
Physiotherapy of the neck, cervical spine, ears, feet and hands have shown relief in some. Relaxation techniques such as meditation are also recommended. 
 

Tinnitus becomes a problem once your quality of life becomes affected! Everyone deserves a full evaluation and a chance to remediate the problem.

Ear,Nose and Throat Specialists