HealthyCanada.com

Tinnitus is the medical term for the perception of sound in one or both ears or in the head when no external sound is present. It is often referred to as "ringing in the ears" although some people hear other noises. Tinnitus can be intermittent or constant and its perceived volume can range from subtle to shattering. More than 360000 Canadians have tinnitus that is so severe as to be annoying. About half of these are so debilitated by the condition that it impairs the quality of their lives.

Most people who have this condition describe the sound they hear as a constant ringing. However according to the Tinnitus Association of Canada fifty different sounds have been reported from high-pitched hissing sizzling ringing and buzzing to chirping clicking and low rushing booming roaring and engine-like sounds; also pulsing and thumping sensations. Several noises may be heard simultaneously. If you have tinnitus you may hear noise in one or both of your ears. Having tinnitus doesn't mean that you will lose your hearing although in severe cases you may find it hard to hear or concentrate.

To understand why tinnitus occurs it's important to know how your brain interprets sound. There are thousands of auditory cells located inside your inner ear. The surface of each cell is covered with tiny hairs that constantly maintain an electrical charge. When the hairs are healthy they continually move back and forth in relation to the pressure of sound waves. Every time those microscopic hairs move they tell your auditory cells to release an electrical discharge. Your brain reads those electrical signals causing you to hear sound.

However if the hairs of your auditory cells become bent or broken their movement will be erratic. When this occurs the cells won't be able to hold their electrical charge and random signals sent to your brain will cause you to hear annoying buzzing ringing or whooshing sounds.

The exact physiological cause or causes of tinnitus are not known. However there is a variety of likely sources all of which either trigger or worsen the condition. These include:

• Noise-induced hearing loss - Exposure to loud noises can damage and even destroy hair cells called cilia in the inner ear. Once damaged these hair cells cannot be renewed or replaced. Up to 90 percent of all tinnitus patients have some level of noise-induced hearing loss.
• Wax build-up in the ear canal - Sometimes people produce enough wax that their hearing can be compromised or their tinnitus can seem louder. If you produce a lot of earwax speak to your doctor about having excess wax removed.
  
  
• Certain medications - Some medications are toxic to the ear. Others will produce tinnitus as a side effect without damaging the inner ear. Effects which can depend on the dosage of the medication can be temporary or permanent. Before taking any medication make sure that your doctor knows about your tinnitus and discuss alternative medications that may be available.
  
  
• Ear or sinus infections - Many people including children experience tinnitus along with an ear or sinus infection. Generally the tinnitus will lessen and gradually go away once the infection is healed.
  
  
• Jaw misalignment - Some people have misaligned jaw joints or jaw muscles which not only induce tinnitus but also affect cranial muscles and nerves and shock absorbers in the jaw joint.
  
  
• Cardiovascular disease - Approximately 3 percent of tinnitus patients experience pulsatile tinnitus and typically hear a rhythmic pulsing often in time with a heartbeat. Pulsatile tinnitus can indicate the presence of a vascular condition-where the blood flow through veins and arteries is compromised-like a heart murmur hypertension or hardening of the arteries.
  
  
• Certain types of tumors - Very rarely people have a benign and slow-growing tumor on their auditory vestibular or facial nerves. These tumors can cause tinnitus deafness facial paralysis and loss of balance.
  
  
• Head and neck trauma - Physical trauma to the head and neck can induce tinnitus. Other symptoms include headaches vertigo and memory loss.

Although there is no cure for tinnitus there are treatments that may give you some relief. Not every treatment works for everyone so you may need to try several to find the ones that help. Possible treatments include:

Hearing aids. Many people with tinnitus also have a hearing loss. Wearing a hearing aid makes it easier for some people to hear the sounds they need to hear by making them louder. The better you hear other people talking or the music you like the less you notice your tinnitus.

Maskers. Maskers are small electronic devices that use sound to make tinnitus less noticeable. Many people find "background noise" such as fans or other machines actually make them less aware of their tinnitus. Maskers do not make tinnitus go away but they make the ringing or roaring seem softer. For some people maskers hide their tinnitus so well that they can barely hear it.

Some people sleep better when they use maskers. Listening to static at a low volume on the radio or using beside maskers may help. These are devices you can put by your bed instead of behind your ear. They can help you ignore your tinnitus and fall asleep.

Medicine or drug therapy. Some medicines although not curative may ease the burden of tinnitus. If your doctor prescribes medicine to help with your tinnitus he or she can tell you whether the medicine has any side effects.

Tinnitus retraining therapy. This treatment uses a combination of counseling and maskers. You may also use maskers to make your tinnitus less noticeable. After a while some people learn how to avoid thinking about their tinnitus. It takes time for this treatment to work but it can be very helpful.

Counseling. People with tinnitus may become depressed. Talking with a counselor or people in tinnitus support groups may be helpful.

Relaxing. Learning how to relax is very helpful if the noise in your ears frustrates you. Stress makes tinnitus seem worse. By relaxing you have a chance to rest and better deal with the sound.

Additional Resources:

Tinnitus Association of Canada

American Tinnitus Association

Children: Can Loud Music Hurt My Ears? (Nemours Foundation)