Tinnitus is the medical term used to describe ringing or buzzing in the ears. These noises originate in the head rather than outside the body. People with tinnitus complain of hissing, deep humming, rustling, crackling or pulsing noises, which are all either intermittent or constant. The volume of these sounds varies and can occur in one ear (left or right) or both. For those affected, the sounds can be quite unpleasant.

About 40% of the population will experience some of these unpleasant sounds at some point in their lifetime, and 10% to 20% will experience chronic tinnitus (a duration of over three months). People over the age of 40 are more likely to develop symptoms of tinnitus. However, tinnitus can also affect people of any age.

Do you think you are experiencing tinnitus? Carefully read the information below so that you can identify the symptoms, causes, and available treatments for tinnitus. You can always speak to one of our hearing aid experts and get free advice over the phone, without any obligations and completely risk free.


Symptoms

Tinnitus Symptoms

The main symptom of tinnitus is hearing different noises when none are actually present. These noises may sound like whistling, crackling, rustling, or ringing. This symptom may come and go or be present all the time, affecting one ear or both. Other symptoms include sleeping difficulties, poor concentration, headaches, and tension in the neck.


Ear noise sounds like:

Whistling

Crackling

Rustling

Ringing


Diagnosis

If tinnitus is present for more than three days, one should go to an ear, nose and throat (ENT) doctor. In diagnosing tinnitus the doctor will usually begin by asking key questions to assess the patient’s condition and discover possible causes. The doctor will then examine the ear canal and the eardrum by means of an otoscope (basically a magnifying glass, mirror and a light) to check for damage to the ear. In many cases an audiogram (hearing test) is carried out to evaluate factors relevant to tinnitus. The ENT doctor also has a series of other medical tests to provide a firm diagnosis.

Tinnitus Diagnosis

Common examinations

  • Examine the throat, nose and ears
  • Subjective hearing test 
  • Analyse the noise in the ear; test the noise emission of the inner ear (otoacoustic emissions) 
  • Test for any balance disorders 
  • Objective hearing test (auditory brainstem response)

There are different methods to diagnose tinnitus:

  • Blood analysis
  • MRT of the skull (magnetic resonance tomography)
  • CT of the skull (computer tomography) 
  • Examine the neck vertebrae and the jaw

BRIEFLY EXPLAINED

What is a subjective hearing test?

With the patient’s participation a subjective hearing test checks the perception of sound in the ears. Seated in a soundproofed room, various sounds in a variety of frequency domains fed into the patient’s ears via headphones. The patient indicates to the specialist the instant the sound becomes audible. This allows the ENT doctor to firstly establish any hearing loss and then concentrate on the tinnitus.

What are otoacoustic emissions?

Otoacoustic emissions (OAE) are active sound emissions, originating from the inner ear, which though often present are not perceived. OAE occur due to movements of the exterior hair sensory cells. There are two types of otoacoustic emissions to distinguish. Objective audiometry measures otoacoustic emissions, testing the functioning of the external hair sensory cells. Clinically relevant hearing disorders can be deduced from this. The OAE measurements are carried out using a small probe in the outer auditory canal.


Tinnitus and hearing aids


Tinnitus and hearing difficulties

People with tinnitus often have hearing difficulties which reduce quality of life and health significantly. A hearing test used in a research study of ear noise therapy revealed 95% of tinnitus patients had damaged hearing. 89% of the patients had hearing impairment in both ears. Only 5% had no hearing impairment. However, one cannot conclude that hearing loss or difficulties result in tinnitus. Nonetheless, damaged hearing is considered to be a direct cause for tinnitus symptoms. Around 80% suffering hearing damage for a long period have chronic tinnitus. Hearing aids can be an appropriate means for treating hearing difficulties and at the same time prevent tinnitus.

The Tinnitus-Noiser

The noise from the noiser is softer than the tinnitus noise to enable the brain to re-learn how to focus on noises in the external environment. This minimizes or completely eradicates the fixation on the ear noise. The therapy helps the brain become accustomed to sounds and after a certain time, fade them out. Leading companies in the hearing aid sector have specialized in these devices due to the high number of tinnitus sufferers. Renowned manufacturers such as Siemens and Phonak offer hearing aids with integrated tinnitus noisers.

Other forms of therapy

The treatment and therapy varies according to what has actually caused the tinnitus. They can be acoustic stimulation, behavioral therapy approaches, medication, magnetic and electrical brain stimulation and physiotherapy. In acute cases Vitamin E preparations, magnesium, glucocorticoids such as cortisone, local anesthetics administered intravenously such as procaine and active ingredients to improve blood circulation (e.g. pentoxifylline). According to the cause and severity of the tinnitus the treatment and therapy can be in tablet form or intravenous drip.


Forms of tinnitus

Acute and chronic tinnitus

Acute tinnitus occurs when an unpleasant ear noise suddenly appears and remains for up to three months. In the case of chronic tinnitus the ear noises remain longer than the three month and may remain perceptible in the long term. If life quality is not impaired the sound is not compensated. If it is pathologically impaired the tinnitus is compensated for. Acute tinnitus is usually healed spontaneously or the patient recovers from the symptoms. The longer the ear noise remains, however, the higher the possibility of chronic illness.

Tinnitus after 3 month

Subjective tinnitus

Subjective tinnitus refers to an ear noise that can only be heard by that person. Most tinnitus cases are subjective. Subjective tinnitus is caused by a mistake in processing at the points of sound transmission and sound perception. There can be a dysfunction in the area of the middle ear right down to the cortex. For instance, ear noises occur through insufficient absorption of high sound pressure by the muscle in the middle ear. There are a number of causes of subjective tinnitus. Often ear noises become audible when a foreign substance enters or during a middle ear infection. A number of illnesses stress can trigger subjective tinnitus.Sudden deafness or hearing loss is generally accepted as a cause of tinnitus.

In summary: subjective tinnitus at a glance

  • Foreign substances in the auditory canal (e.g. a build up of ear wax)
  • An ear infection (otitis media or externa)
  • Viral and bacterial infections (e.g. borreliosis)
  • Middle ear diseases disturbing sound transmission e.g. otosclerosis
  • Noise trauma (acute or chronic)
  • Sudden deafness
  • Diving accidents
  • Autoimmune disease of the inner ear
  • Ototoxic substances
  • A tumor on the hearing nerves (acoustic neurinoma)
  • Difficulty hearing (hypoacusis)
  • Stress
  • Problems with the neck vertebrae or in the teeth and jaw area trigger or increase the symptoms

Objective tinnitus

If an ear noise can be heard and measured by the person examining it is an objective tinnitus. By comparison with subjective tinnitus, objective tinnitus is rather rare.

In summary: objective tinnitus at a glance

  • Breathing noises
  • Current noises of arteries
  • Tension of the middle ear muscle
  • Movements in the opening of the ear trumpet or acute functional disorder of the Eustachian tube.

Reasons for its emergence

The reasons for the emergence of tinnitus have only been partially explained. One of the possible causes is the effect of noise or certain medicaments on the auditory nerve. In healthy ears the nerves spontaneously produce electrical impulses, so-called spontaneous activity. This changes when the noise meets the ear. Through this encrypted information is sent to the ear. If the auditory nerve is damaged it has the effect of spontaneous activity. This can reduce or change in time. It is assumed that a deviation of spontaneous activity results in subjective tinnitus. Tinnitus can also, however, take place in the brain.

In this case it is a so-called central tinnitus, a defective transmission of information, which occurs on the transmission path between the hair cells in the ear and the brain. One of the major causes of tinnitus continues to be diagnosed as stress. Stress induces a great number of physical reactions. The body excretes more of the hormone cortisol, which results in a constriction of the blood vessels reducing blood circulation. This reduction has a particular effect on the small blood vessels, the so-called capillaries and can lead to closure of the blood vessels in the inner ear. It is not yet known precisely how the reactions triggered by stress cause tinnitus.


Tinnitus in old age

Around 159 million people in India have hearing difficulties – brought about by various causes, such as specific diseases, strong medication or sudden deafness. Current figures, estimate over 12% of the population have tinnitus (for 2014). This illness cannot, however, be entirely placed into one age bracket. Children can also have ear noises. Nonetheless, the majority of people with tinnitus are 50 or older. Furthermore, occurrences are diagnosed more frequently in women than men. Recent years have also seen an increasing frequency of tinnitus in youths and young adults. This increase in young tinnitus patients is caused, above all, by increasing contact with loud noise levels through music venues and the use of headphones and MP3 players for example. hear.com is there to advise and help you on ear noise (tinnitus) and give you the means to become its master with the Tinnitus Noiser!

Tinnitus in old age

Preventing tinnitus

The causes of tinnitus are many. But there are good news as the risk of occurrence can be reduced and preventative measures to avoid this illness can be taken. Fundamentally one must avoid the danger of damaging the ear through loud noise, by having enough protection for your hearing against it. Furthermore, one should reduce stress as much as one can. To this end, optimized time management to allow for buffer periods and relaxation exercises is of great benefit. Alongside an active coping with stress, balanced and healthy nutrition has a great effect on health. This can lead to more energy and a more efficient everyday life. One should most certainly go to an ENT specialist with acute era noise for a short-term therapy – usually through the use of medicaments – to avoid long-term problems. 

Preventing tinnitus

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