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Tinnitus

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Tinnitus

Millions of American suffer from tinnitus.

Tinnitus is a ringing, hissing buzzing or chirping sound that can be constant or permanent. It has many associations, but no one knows the actual cause or source of the sound. Tinnitus is often most apparent when background noise is limited (in quiet settings) because background noise drowns it out.

Temporary Tinnitus

Most tinnitus is temporary and intermittent and resolves on its own. It often happens from eustachian tube dysfunction (ETD), which results in a pressure differential in the middle ear when compared to the environment. ETD can occur with flying, elevators, scuba diving, allergies, and TMJ or teeth grinding. Medication or physical therapy is sometimes needed, and even though the symptom is annoying it usually resolves on its own.

Other possible causes of temporary tinnitus include:

  • Blockage of the ear due to earwax
  • Ear or sinus infections
  • Certain medications, such as aspirin, sleeping pills, heart medication

Permanent Tinnitus

Permanent tinnitus results from high frequency hearing loss. This hearing loss can be genetic, traumatic or due to loud noise exposure or a tumor. At first the hearing loss may be undetectable but the tinnitus presents itself and does not go away.

Those who have a family history of hearing loss or work in loud settings (construction, gun shooting ranges, subways, rock musicians, etc) are at risk for developing permanent tinnitus.

Because we have to yet to understand the mechanism that causes permanent tinnitus, no curative treatments are available. It is possible that when the cochlea (hearing organ) is functioning normally, the hearing nerve also depresses a feedback sound from the brain. As the hair cells become more sparse in the cochlea (which is what causes hearing loss) perhaps that feedback sound is no longer suppressed. Therefore, the key to relieving tinnitus is resolving hair cell damage in the cochlea. Unfortunately, these mechanisms are still being worked out.

The majority of tinnitus cases are annoying but manageable by using a noise machine to sleep or maintaining a low level of background noise. Acupuncture and craniosacral therapy is also quite helpful. Severe cases can impact sleep, concentration and strain relationships. If your tinnitus becomes serious and you have hearing loss, hearing aids can also be helpful.

Factors That May Worsen Permanent Tinnitus:

  • Stress
  • Alcohol
  • Smoking
  • Caffeine
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Linda D. Dahl, MD