A Guide To Tinnitus

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What is Tinnitus?

Tinnitus is noise or “ringing” in the ears. It is extremely common and can be caused by several underlying conditions. The symptoms may come and go, or they may be persistent. They may be chronic or may clear up when an underlying condition subsides.

The symptoms are often difficult to perceive in an environment where there is sufficient background noise. However, they can be upsetting in a quiet environment. For this reason, many tinnitus sufferers have trouble falling asleep or staying asleep. They may have hearing difficulties.

Tinnitus affects about 30 million Americans today, but with the high number of people suffering from the condition numerous clinical trials are introduced focused on testing new treatments.

What Conditions is Tinnitus Associated With?

Tinnitus does not arise on its own. It is caused by a variety of other health concerns. Some cases of tinnitus are spurred by relatively simple physical changes, like earwax build-up, which can be treated at home. Many are more serious and require medical care.

Infections and fluid build-up within the ear cause a large number of tinnitus cases. This can be very difficult to treat, often requiring that fluid be removed via a tube. If infections recur, then related tinnitus can develop again.

Other conditions that may lead to tinnitus include:

  • Age-related hearing loss
  • Traumatic injury of the ear
  • Other issues in the outer, middle, or inner ear
  • Some circulatory disorders
  • Damage to the auditory nerves or the brain’s auditory pathways

Most cases are subjective tinnitus. Subjective tinnitus is the most common and can be due to a number of causes including:

  • Infections and fluid build-up within the ear
  • Age-related hearing loss
  • Traumatic injury of the ear
  • Other issues in the outer, middle, or inner ear
  • Some circulatory disorders Damage to auditory nerves or brain’s auditory pathways.

Subjective tinnitus can also be caused by other factors including:

Pregnancy, high blood pressure and diabetes.

Subjective tinnitus can be associated with psychological stress or depression in some cases and is aggravated by lifestyle factors such as smoking.

The most common physical risk factor for tinnitus that we know of today is exposure to loud noise over a long period of time.

Objective tinnitus is a form of tinnitus caused by sounds a doctor can hear, such as muscle contractions or bone conditions of the middle ear. This type of tinnitus is most often due to age-related hearing loss in the range of frequencies where tinnitus is usually perceived.

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How is Tinnitus Diagnosed?

Tinnitus is usually diagnosed by a doctor after an examination. The exam includes:

  • Holding the head in different positions to see if tinnitus changes
  • Checking for other causes of hearing loss or muffling inside the ear, such as wax buildup
  • An imaging test, such as an MRI or CT scan
  • A hearing exam of the ear and a psychological evaluation to rule out depression or anxiety disorders.

How is Tinnitus Treated?

Tinnitus is treated by a variety of therapies. The approach to treating Tinnitus depends on the severity.

  • For tinnitus with no hearing loss, doctors may prescribe a treatment to reduce anxiety or depression and provide counseling for tinnitus management.
  • People who have mild tinnitus that is bothersome might try sound therapy or masking devices first before trying medication or invasive treatments like surgery.

Tinnitus medications, such as tinnitus retraining therapy, can also be used to reduce the severity of tinnitus symptoms. If you have moderate-to-severe hearing loss and bothersome Tinnitus, your doctor may recommend different therapies or treatments for both conditions simultaneously.

Invasive treatments for tinnitus can involve surgical procedures such as deep brain stimulation or a cochlear implant to control the symptoms of tinnitus in people with severe tinnitus who have bothersome Tinnitus that do not respond to other treatment methods. Surgery is only recommended if you are experiencing moderate-to-severe hearing loss and your tinnitus does not improve.

Natural tinnitus treatments include: hearing aids, tinnitus sound therapy devices, and herbal remedies. A healthy lifestyle may also help tinnitus by reducing stress, which is known to worsen symptoms.

Some cases of tinnitus can be cured by treating the underlying condition. In many cases, however, symptoms persist indefinitely. Most tinnitus causes are self-limiting and do not worsen over time. That said, tinnitus can have a profound negative effect on quality of life.

One of the most significant potential side effects of tinnitus is hearing loss. Severe hearing loss associated with tinnitus is rare. Still, patients can experience difficulty hearing sounds in both the higher and lower auditory registers. Hearing aids can offer limited help.

If your doctor identifies a precise underlying cause for your tinnitus, do what you can to protect yourself. For example, when tinnitus is associated with infections, you can take steps to protect your respiratory health and make future infections less likely.

Recently introduced treatments for tinnitus include tinnitus retraining therapy and tinnitus maskers.

Tinnitus Complications

  • Tinnitus can make it difficult to sleep, leading some patients to develop insomnia.
  • Tinnitus might also cause significant anxiety and depression due to the sense of isolation from one’s environment that often accompanies this condition.
  • Tinnitus is also associated with a higher risk for high blood pressure, cardiac arrhythmia, in addition to the increased risk for stroke, which is typically associated with hearing loss.

Tinnitus Lifestyle Changes

  • Become educated about tinnitus and speak with your doctor to learn more about possible treatments.
  • Avoid environments where you might feel stressed or anxious, such as noisy places.
  • Consider talking to an audiologist about hearing instruments that can help protect against further damage from loud noise exposure.

Tinnitus Clinical Trials

There are a number of organizations introducing clinical trials in the coming years.

  • The National Institute on Deafness and Other Communication Disorders (NIDCD) is planning to launch clinical trials for tinnitus in 2021 with a goal of finding effective treatments.
  • The American Academy of Audiology has also announced plans to conduct research into tinnitus, while other organizations are working towards additional treatments

Why Are More Tinnitus Clinical Trials Important?

Tinnitus research has begun closing in on a tinnitus cure, but so far, no one tinnitus treatment works for everyone. Current tinnitus treatments are limited to making the condition less annoying. Next generation tinnitus clinical resources may be more proactive in treating the underlying causes of the disease.

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