This article is written in collaboration with the Week of Sound.
Most of people
have experienced a high pitched noise after being exposed to loud sounds such
as a music concert, heavy traffic or a stadium atmosphere. It usually subsides
after a while, and is a naturally occurring phenomenon. Yet, some people hear
such sounds even unprovoked, and they can range from barely audible to
distracting. If this rings any bells, it might be high time to see a doctor!
10-15% of people around the world, and becomes more prevalent with increased
age. One in every three people over the age of 55 is affected by it, with their
conditions ranging from mild to severe.
It is most often perceived as a ringing sound without any external source. It
can be perceived in one or both ears, or more central in the head. Other than
ringing, it can take the form of buzzing, whining, hissing, tinging, clicking,
roaring, ticking, beeping or a myriad of other sounds, including a pure steady
Rather than a
disease, it is a symptom that results from various underlying causes, including
hearing damage, noise-induced or age-related hearing loss, ear infections,
tumors of the auditory nerves of the inner ear, migraines, head injuries,
accumulated earwax and other.
prevalent form of tinnitus is the acute version, which starts as a reaction to
an outside event. Most commonly experienced example is the ringing in ears
after attending a loud music concert, being exposed to loud traffic or
fireworks. This happens because sound waves travel through the ear canal to the
middle and inner ear, where hair cells in part of the cochlea help transform those
sound waves into electrical signals that then travel to the brain's auditory
cortex via the auditory nerve. When hair cells are damaged, the circuits in the
brain don't receive the signals they're expecting. This stimulates abnormal
activity in the neurons, which results in the illusion of sound. Other examples
of acute tinnitus include accumulation of earwax which interferes with sound
pathways, infections and certain ototoxic medications, where tinnitus subsides
upon removal of the underlying problem, or shortly thereafter. One definition
of tinnitus, as compared to normal ear noise experience, is noise lasting five
minutes at least twice a week. It can be present constantly or intermittently,
with some people not being aware of it all the time, but only for example
during the night when there is less environmental noise to mask it.
illustration of ear and auditory pathways to the brain. Hair cells in the
cochlea help transform the audio waves into electric signals which travels via
the auditory nerve to the brain. Disruption of this pathway may lead to acute
tinnitus, whereas damaging the pathway may lead to a chronic version.
If the sounds
persist for six months or more, we are talking about chronic tinnitus. The
causes are similar to acute tinnitus, but more severe. It usually involves
damage to the inner ear, or more directly to the hair cells of the cochlea.
Untreated tinnitus often worsens with age and damage accumulation, and can become
so prominent that it affects everyday activities, levels of concentration,
sleep, and others. While there is no cure for tinnitus, it can be lessened by
understanding and treating the underlying problem.
subjective in vast majority of cases, meaning, it is a sound only the affected
person can perceive. But a minority of cases experience objective tinnitus,
where it can be detected by other people and is sometimes caused by muscle
twitches, jaw clicking, dislocation of small bones around the ear area, or even
altered blood flow, called pulsatile tinnitus. This type of tinnitus results
from increased blood turbulence near the inner ear such as from atherosclerosis
or venous hum. Rarely, pulsatile tinnitus may be a symptom of potentially
life-threatening conditions such as carotid artery aneurysm or carotid artery
dissection. Pulsatile tinnitus may also indicate vasculitis, or more
specifically, giant cell arteritis and should be accounted for when diagnosing.
currently no cure for tinnitus, although patient aren't left to their own
devices. No single approach works for everyone, and some combining of
treatments might be necessary to find the best approach.
behavioral therapy focuses on making the sound less bothersome and noticeable,
if not more silent. This can significantly improve the quality of life in
patients with severe conditions.
Retraining Therapy aims to habituate the auditory system to the tinnitus
signals, making them less noticeable or bothersome. Their assumption is that
tinnitus results from abnormal neuron activity caused by a disruption or damage
in the auditory pathway. It uses sound therapy to generate low-level noise and
environmental sounds that match the pitch, volume and quality of patient's
tinnitus, shadowing it.
tinnitus signal is another way to lessen the persistent pestering of tinnitus
sounds, especially during sleeping hours. Wearable or tabletop sound generators
are used for this purpose. They can produce sounds ranging from soft hush, to
random tones, soft music, sounds of rain, waterfalls or waves, leaves rustling
persistent sound bothering every minute of your life can become annoying,
agitating or even distracting in a dangerous sense. Tinnitus might not be
life-threatening per se, but neglection and misinformation can lead to
unnecessary complications and decreased quality of life, stress, and in the
worst cases depression and sleep disorders. While no medication have been
approved for its treatment yet, there are promising alternatives currently
being investigated, such as Repetitive Transcranial Magnetic Stimulations, Deep
Brain Stimulations, and stimulation of the inner ear, with emphasis on the
Han BI, Lee HW, Kim TY, Lim JS, Shin KS (March 2009). "Tinnitus: characteristics, causes, mechanisms, and treatments". Journal of Clinical Neurology. 5 (1): 11–19. doi:10.3988/jcn.2009.5.1.11. PMC 2686891.
B; Kreuzer, PM; Kleinjung, T; De Ridder, D (September 2013). "Tinnitus: causes
and clinical management". The Lancet Neurology. 12 (9): 920–30.
doi:10.1016/S1474-4422(13)70160-1. PMID 23948178. S2CID 13402806.
RA; Oron, Y (2015). "Tinnitus". The Human Auditory System –
Fundamental Organization and Clinical Disorders. Handbook of Clinical
Neurology. 129. pp. 409–31. doi:10.1016/B978-0-444-62630-1.00023-8. ISBN
9780444626301. PMID 25726282.