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What Is Tinnitus?

Tinnitus simply means the sensation of noises coming from within the ear. Although the word has a simple definition, the symptom itself is regrettably more complicated and poorly understood.

We have all experienced that feeling of unusual ringing after being in a noisy nightclub or concert. This ‘ringing’ type of sound – the defining feature of which is that comes from within the head and not outside- is what is commonly referred to as tinnitus, though people also describe ‘buzzing’ and ‘humming’ sounds too. Fortunately, this uncomfortable sensation is temporary and resolves completely.

Some may also have also experienced longer periods of ringing in the ears. This is usually when the inner ear canal is congested from mucus during a common cold. Other common causes for short-term tinnitus include earwax or another foreign body in the ear but when the ear is unblocked the symptoms again disappear.

In some cases for 1/100 people, the ringing can go on continuously over the long-term. In these cases, it is vital to see a doctor to have this assessed the cause and undergo hearing tests to exclude potential serious underlying diseases- particularly if the ringing is in one ear, which can be suggestive of an auditory nerve tumour, or if accompanied by dizziness which is a sign of Meniere’s Disease.

However, in most cases, the tinnitus occurs alone and originates from both ears. The common cause of this is some degree of hearing loss- either because of the natural ageing process or because of repeated exposure to loud sounds at work or play such as drills or music in earphones. Often the sufferer will notice the tinnitus rather than the underlying hearing loss – but hearing tests would soon confirm the hearing defect.

Other rare causes are medications- in particular, water pills (e.g. Furosemide), antibiotics (e.g. erythromycin), NSAIDs in large doses (e.g. aspirin, ibuprofen) and quinine products (e.g. antimalarials) – and repeated deep sea diving, which causes barotrauma.

Tinnitus symptoms can vary from mild and tolerable to severe and disturbing enough to affect the quality of life. Typically tinnitus sufferers report decreased concentration, difficulty sleeping and anxiety. This can spill over into depression too over time given the lack of relief.

Currently, there is no definitive cure for tinnitus. Management of tinnitus is instead focused on advice and distraction therapy to minimise noticing the sounds- from relaxation to background noise to a sound generating heading aid. For the last decade there has been ongoing research with transcranial direct current stimulation but this disappointingly still remains under evaluation.

If you do suffer from tinnitus and are seeking advice, there are many support groups and organisations such as the British Tinnitus Association that can help.

© Syed Z Arfeen
Medical Advisor
December 2015

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