Tinnitus
Tinnitus is the conscious awareness of sound without an external stimulus. It can be a ringing sound, buzzing, rushing and for some people, even musical. Tinnitus can be experienced in the head or in one or both ears. It is one of the commonest physical symptoms and affects men and women equally.
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What does our anatomy tell us about tinnitus?
Our ears are only one part of the auditory system. The ear or pinna funnels sound waves from the air, through the ear canal (auditory meatus) onto the ear drum (tympanic membrane), causing it to vibrate. Behind the ear drum are the ossicles, commonly known as the hammer, anvil and stirrup that contract and relax to the vibration of the ear drum. The sound is then transferred to the inner ear. In the inner ear you have the cochlear, which has a special frequency organisation allowing us to hear high frequency sounds differently to low frequency sounds. Sound from the cochlea is then converted into electrical energy that travels up the nerve to then be processed by the central auditory system in the brain for us to interpret.
Why do we hear a sound that isn’t externally there? Some theories suggest that damage to the cells in the cochlear in our inner ear e.g. through noise exposure or ageing causes the cochlear to spontaneously fire a signal, resulting in an internal sound. When it reaches the central auditory system it is our reaction to the sound and whether we perceive it as a threat that can result in troublesome tinnitus. If we feel anxious because of it, we then focus on it more, resulting in a vicious cycle.
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Do people with tinnitus have a Hearing Loss?
Quite often, people with tinnitus have some hearing loss. The hearing loss can be a result of ageing, through trauma or even work related noise exposure. If there is a hearing loss then managing the hearing loss with a hearing aid would be one of the first steps. Generally, if you can hear sounds around you better, then you are less likely to focus on internal sounds. If you feel you are missing parts of speech or struggling to hear in some situations it is worth having your hearing assessed so that you have an understanding of your hearing levels and how it may affect your tinnitus.
Common Causes of tinnitus
Sudden hearing loss can be due to a viral infection or autoimmune disease. Damage to the cells in the inner ear has a similar effect to that of ageing.
Prolonged exposure to loud noise either through work or recreation can cause cell damage similar to that of ageing. If the sound is loud and intense enough such as gunshot or bomb blast, hearing loss can be sudden. Hearing tests results usually reveal a dip at 4KHz. You can prevent damage to your hearing and reduce the risk of tinnitus bu using custom ear protection.
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An acoustic neuroma is a benign (non-cancerous) growth on the eighth cranial nerve. Patients usually present with unilateral tinnitus and an asymmetry in hearing and can also sometimes feel dizzy.
As you get older, usually by the time you are fifty, the cells within the inner ear are damaged due to wear and tear, resulting in hearing loss. This is called Presbyacusis or Presbycusis. This might explain why tinnitus is most prevalent in those over sixty.
A condition where there is a bony overgrowth of the stapes bone (also known as the stirrup), in the middle ear. The restricted movement results in a reduction in sound energy and therefore, the sound has to be louder in order to reach the middle ear. Patients can undergo surgery- a stapedectomy. This is a relatively uncommon cause of tinnitus.
There is some suggestion that smoking increases the chances of hearing loss and tinnitus. Smoking is linked with cardiovascular disease and can reduce the amount of oxygen delivered to the cells in the inner ear, resulting in cell death. There may also be a link with higher stress levels in smokers.
Ear wax or cerumen helps to keep the ear healthy and provides lubrication. If it builds up it can cause a blockage of sound so that you hear internal sounds much more, resulting in tinnitus, though it is uncommon.
A balance condition thought to be caused by abnormal levels of sodium and postassium in the inner ear. It may be caused by a viral infection or could be autoimmune, resulting in a low frequency hearing loss which is fluctuating; this fluctuation in hearing eventually stops and the patient is left with a permanent hearing loss. Aural fullness and commonly a low frequency tinnitus sound is the warning sign that the patient is about to feel dizzy.
Tinnitus can be a result of medication such as anti-inflammatory drugs like Aspirin (in high doses) or Ibuprofen. Quinine (an anti-malarial drug), some antibiotics and chemotherapy drugs may also result in tinnitus.
What are the treatment methods for tinnitus?
At PinnaClear we offer breathing and relaxation sessions along with mindfulness behavioural therapy for tinnitus. The initial assessment involves taking a through history along with a hearing check to establish the effects of tinnitus on your daily life. The results and suitability of onward care will then be discussed with you.
Tinnitus is usually linked to anxious and negative thoughts. Breathing well stimulates the activity of our vagus nerve resulting in a calmer you and being more mindful can help you to change the relationship you currently have with tinnitus.
Meet your Audiologist
At PinnaClear, I want to provide personalised care by taking the time to understand your unique needs and tailoring our services to ensure the best possible outcomes. I want to listen to your concerns, answer your questions, and involve you in decision-making, ensuring you have an active role in your hearing health journey.
Hafiza Choonara
Senior Audiologist
Choosing an independent audiologist over a high street chain offers several distinct advantages that can greatly enhance your hearing health journey.
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