What is tinnitus?
The term ‘tinnitus’ describes any sound that is heard by a person, but not by others around them, and is not created by an external source. It can affect one or both ears and can take any form; it might be a hiss, a buzz, a ringing sound or even musical sounds. For some patients the sound is constant and for others it may come and go, or sound like a pulse.
What causes tinnitus?
Tinnitus is a symptom and not a diagnosis. There is a wide range of possible causes, but on most occasions an exact cause cannot be found. This is known as ‘idiopathic’ tinnitus.
Tinnitus does not necessarily mean that there is a problem with the ears. You can have perfectly normal ears but still experience tinnitus. In fact, most people with normal ears can hear extra sounds if the room they are in is very quiet. Sometimes tinnitus may be related to problems with ears, but diseases that affect the nerve supply to the ears or the brain itself can also cause a sensation of tinnitus.
Tinnitus may be related to hearing loss which may occur suddenly or gradually over many years. Sometimes emotional stresses or illness can make the normal sounds of the ear seem louder – and these sounds can start to become a problem the more you think about them.
Tinnitus that is only heard by the patient is called subjective tinnitus. There are other causes of tinnitus, such as loud pulsations or muscular twitches, that may be heard by your doctor too. This is called objective tinnitus.
What should I do if I think I have tinnitus?
If you think you have tinnitus and are worried about it, then the best thing to do is to visit your doctor for advice and help. Your doctor will assess you and take a detailed history to gain clues regarding a possible diagnosis. You may be referred to an Ear, Nose and Throat (ENT) specialist for further tests. The doctor will examine you and arrange suitable tests. The most common test is a pure tone audiogram (hearing test), but your doctor may also recommend a scan. Commonly an MRI scan is performed, but sometimes a CT scan or ultrasound may be required.
Is tinnitus dangerous?
It is very rare for tinnitus to be related to significant underlying problems. Tinnitus symptoms are very common, are usually mild and don’t interfere with normal life. Often the tinnitus gets better on its own.
What are the recommended treatments?
Treatment will depend on the cause of the problem, but often it is difficult to find an exact diagnosis. For a small number of patients in whom a definite diagnosis is found, some medications or even surgery may help.
For mild tinnitus, simple reassurance can help. After you have been seen and examined by your doctor and you know that there is no worrying cause for the symptom then sometimes it resolves on its own.
If the tinnitus is more intrusive, then you may be referred for tinnitus therapy, a kind of counselling to help provide strategies for managing the symptom. This treatment is usually provided by specialist audiologists or hearing therapists. They can correct hearing loss at the same time, which can also help to control the symptom in some cases. Sometimes a form of sound therapy is offered. This can involve wearing a small noise generator which looks like a hearing aid. The noise produced blocks out the tinnitus sounds. There are other types of noise generators that can go next to your bed at night to help you sleep.
More complex therapies involve psychological treatments such as cognitive behavioural therapy (CBT), mindfulness, meditation and certain relaxation therapies.
Is there anything I can do to help myself?
There are a few simple things to help to manage tinnitus. Often, patients find that the tinnitus seems louder when they are in a quiet place or trying to go to sleep at night. It is a good idea therefore to have background noise like a quiet radio or television on in the background to distract you from the tinnitus sound. Also, avoiding stressful situations may be helpful as tinnitus may be worse when you are anxious. Alternative therapies and diet have no proven benefit for managing tinnitus symptoms.
What is the best thing to do to manage my symptoms?
Managing tinnitus is very individualised and there is no ‘one size fits all’ solution. Your doctor will work with you to ensure you are receiving the best care and treatment so the tinnitus can be managed effectively.
