The word tinnitus originates from Latin word 'Tinnituae' which means ringing. Tinnitus, commonly known as ringing in the ear, is basically a disorder characterized by sensation of noise in the human ear, without any existence of external sound. Though it is defined as ringing noise, it varies greatly from person to person. In some cases, it can also be heard as buzzing, humming, hissing, or beeping, whistling sound, or as ticking, roaring, and clicking noise.
It is not a disease but a causality originating from array of underlying causes like infection in ear, deposition of wax in ear or injury to tympanic membrane. Anatomically, human ear is classified further into four sections - the outer ear, the middle ear, the inner ear, and the brain. Tinnitus can happen in any of these sections. Moreover, it can arise in single or in both ears.
Some cases are considered as normal. For example, if we enter a soundproof cabin then most of us will experience buzzing or whistling and become aware of normal body sounds as masking effects of external sound is nonexistent in such cases. These conditions are defined as non tinnitus conditions. Thus Tinnitus is that medical term which describes severely affected cases of ear ringing in normal conditions.
As tinnitus is a subjective phenomenon, objective tests like an audiometric test fail to measure its severity. On the contrary, it is classified into different categories ranging from slight to cataclysmic, subject to practical complexity like disturbances to sleep, normal activities it imposes. The more descriptive THI (Tinnitus Handicap Inventory) is commonly used to do the research in this field. However, certain series of diagnostic tests like audiogram, ABR (Auditory Brain stem Response) are preferred to find the origin of Tinnitus or to find out whether it is due to vertigo or loss of hearing. Sometimes these patterns help doctors to diagnose the condition.
The inner ear houses minute hair like structures that vibrate with the introduction of sound waves. The receptor cells located at the base of these hair then transmit neural signals to brain. These cells are connected via neural loop and controlled by the brain. This neural feedback loop makes selectivity to certain frequencies possible.
Damage to receptor cells results in changing the parameters of loop by continuous exposure to excessive decibel levels than the normal one and Tinnitus occurs. Thus in Tinnitus, false information is transmitted to brain causing ringing or humming noises when there is no such external sound. Recent research has classified this disorder into two:
- Otic Tinnitus, which happens in the inner ear due to damage to nerves.
- Somatic Tinnitus, which happens outside the inner ear.
The causes are many and can be further classified as:
- Ontological causes and hearing loss - Deposition of earwax, infection in external ear, middle ear effusion, prolonged exposure to excessive loud noise, hearing loss associated with age, certain diseases of inner ear like Meniere's syndrome can cause Tinnitus. Certain ototoxic medications like aspirin, amino glycosides, tetracycline, bleomycin, cisplatin, furosemide etc. also have side effects which can lead to tinnitus.
- Neurological Disorders - Head injuries, multiple sclerosis can cause tinnitus.
- Metabolic disorders like deficiency of Vitamin B-12, thyroid disorder can result in tinnitus.
- Studies have shown that Psychological Problems like over anxiety, depression can end up in Tinnitus.
Precautionary measures are most advisable as the people suffering from these disorders continue to suffer throughout their life. Since, the most common cause is prolonged exposure to excessive noise; it is advisable to avoid such incidences where the possibility of loud noise is more. Earplugs can be the best means available. Again, certain medications should be closely monitored for side effects.
Once a careful diagnosis is done, Tinnitus can be treated effectively with varied treatments available, depending on the source or cause of the disorder. However a single treatment is not useful in treating different types of Tinnitus.
Objective Tinnitus can be treated with surgery using Gamma rays of radiation in case of glomus jugulare tumor. In case of palatal tremor treatment is done by Botulinum toxin. In arterial anatomic variation Propranolol is used effectively.
In Subjective Tinnitus intensity of external sound is reduced by Tinnitus masking, by completely avoiding the noise, by using music therapy or using hearing aids to facilitate the lost frequencies. Electrical treatment is also used to great effect to cure certain cases of Tinnitus. In chemical therapy, stress is laid on cutting off the consumption of alcohol, caffeine, nicotine. It is further supported by Zinc supplementation, sodium fluoride, Melatonin, Chinese herbal therapy. Cognitive behavior therapy is also very useful in Psychological treatments.
Tinnitus has been perceived as classified chronic pain. Hence, while treating this, identification of the cause is of utmost importance!
Disclaimer: This article is for informative purposes only and does not in any way attempt to replace the advice offered by an expert on the subject.