Tinnitus - Bruce E. Maniet, DO, FACOFP

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Tinnitus
Most people have never heard of the term Tinnitus, but many are often affected and
their lives change greatly by this condition. Tinnitus is the medical term for ringing in
the ears. Ringing is often described as a ring, buzz, hiss, hum, roar, or pulse. Tinnitus
can occur for a brief period or can last for the rest of a person’s life. No matter how long
it lasts, it is often very aggravating and can affect ones quality of life. We live in a noisy
world and loud noise exposure, which can affect your hearing, is the most common cause
of Tinnitus. Tinnitus may be the first sign of inner ear damage affecting the fine hair
cells of the cochlea in your ears.
Tinnitus can be transient which means that the ringing lasts about 20 seconds and then
goes away. This is usually of no significance and not of great concern. Most Tinnitus
lasts longer and usually has some reason for its presence. There are many other causes of
Tinnitus that can be found and treated.
The symptoms of Tinnitus can change. Things that can cause these fluctuations
include stress, noise, fatigue, lack of sleep, migraines, hearing fluctuations, tobacco,
caffeine, salt, head injury, muscle tension in the jaw and neck, dental problems, sinus
problems, wax impaction in the ear canal, and certain medications. There are over 500
medications that list Tinnitus as a possible side effect but the more common ones are
aspirin, anti-inflammatory agents, loop diuretics like furosemide, aminoglycoside
antibiotics, quinine, risedronate for osteoporosis, and chemotherapy drugs. Some can
even tell an increase in the noise following a short nap.
Even though the most common cause for Tinnitus is a hearing loss, there are
numerous other causes. There are a number of tests that are performed by your physician
when trying to find out your cause. These tests can include a comprehensive hearing test,
acoustic reflex tests, auditory brainstem responses, vestibular evoked myogenic
potentials, and MRI scanning.
Treatment of Tinnitus of course would start with treatment of any underlying cause
found on testing. Avoidance of loud noise, limiting stress, getting enough sleep, stopping
tobacco use, limiting caffeine and salt use, treating dental and sinus problems are simple
things that can be tried first. Hearing aids have been helpful in people fighting the
frustrating symptoms. Hearing aids enable the brain not to have to work as hard to hear
so the internal volume control in the brain is turned down. They also allow more
background sound from the environment to reach the brain so you do not perceive the
sounds of your Tinnitus. Medications have been shown to be helpful as well. A
medication such as benzodiazepines, which is a type of a tranquilizer, is helpful to reduce
the loudness of the noise. Others might need to use a medication to control their mood
like an antidepressant, or an agent to help them sleep. Non-medicine treatments include
counseling and sound therapy. Sound therapy is the use of a wide-spectrum sound played
through earphones. This has the potential to have relaxing sound therapy mix with the
annoying sound of the Tinnitus to try to calm down and neutralize the noise. The brain
can actually be retrained to interpret a new sound as neutral.
The best treatment for any medical problem of course is never having the problem to
begin with. Please start early reducing your loud noise exposure by wearing the proper
ear protection. Do not start smoking or stop if you already do. If you begin to perceive
any new noises, please get to your doctor early for help. With the proper treatment, even
someone with chronic Tinnitus can get relief. I wish everyone good health.
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