Tinnitus
is the hearing of noises in the ears or
head which are not generated outside the
body. Nearly all tinnitus is only
heard by the the person concerned although,
in a few rare cases, it can also be heard
by other people.
In some cases,
tinnitus may be a side effect of the common
cold, in which case it is usually temporary.
However, around 2% of people have serious
problems with long-term tinnitus which can
be very distressing.
Tinnitus
can be low or high-pitched, and can mimic
many different noises.
Causes
In many cases
of tinnitus, no cause can be found.
The traditional
view of tinnitus was that it happens due
to damage to the hearing nerves in the ear
(cochlea or inner ear). Much tinnitus
in older people is caused by natural hearing
loss (presbyacusis) which lessens the sensitivity
of hearing nerves. However, tinnitus
is not an inevitable side effect of hearing
loss.
Other possible
causes include:·
- Obstruction
caused by wax or foreign object·
- Middle
ear infection (otitis media) or glue ear
(serous otitis media)
- Otosclerosis
(stiffening of the tiny bones which transmit
sound from the eardrum to the sound-detecting
organ, the cochlea)·
- Ménière's
disease·
- Pierced
eardrum
- Long term
exposure to high noise levels (eg at work
or for entertainment)
Less common
causes are:·
- After
a sudden loud noise (eg gunfire, explosion)·
- After
a head injury or blow to the head·
- Impacted
wisdom teeth·
- Adverse
reactions to certain drugs such as antibiotics,
diuretics, aminoglycosides, quinine, aspirin;
more likely when the dosage is exceeded;
also allergic reactions·
- Solvent
abuse, alcohol abuse; other drug abuse·
- High blood
pressure, narrowing of the arteries (atherosclerosis)·
- Overactive
thyroid gland·
- Deficiency
of the blood pigment that carries oxygen
(anaemia)
Tinnitus
is rarely a symptom of a more serious problem
but there can be other causes such as growths
(tumours), spasm, and abnormal blood flow.
There is
also a view that tinnitus results from over-sensitivity
to noises which are normally filtered out.
Treatment
Treatment
may be quite different in each case of tinnitus.
If an underlying cause can be found, then
this will be treated accordingly.
Where an
obvious cause cannot be found, a number
of options are possible.
Treatment
using Tinnitus Retraining Therapy (TRT)
is widely used (1) as are some psychological
and behavioural therapies. Within this
framework sound-based therapies, counselling
and relaxation therapy may also be used
to some effect.
A variety
of drug treatments have been tried, although
as yet, there is no firm evidence to support
their widespread use.
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Tinnitus
