What is wrong with my ear??? Why can’t anybody else hear the sound? Or am I becoming crazy?? TINNITUS is taken from a Latin word tinnire means to ring. Tinnitus is not itself a disease but a symptom resulting from a range of underlying causes. The problem is the distress created by tinnitus, not the sound itself.  It can be very disappointing for the sufferers especially when none of the treatment work.

     Tinnitus is ringing or buzzing in the ears and most probably have been experienced by almost all of us. Tinnitus may come and go, or it may present as a continuous sound. It can vary in pitch from a low roar to a high squeal or whine, and it may be heard in one or both ears (unilateral or bilateral ears).  However, only 0.5-2% of people is severely affected by this problem. Peak age for onset of tinnitus is at 50-60 years old.

WHAT ACTUALLY HAPPEN DURING TINNITUS?

     The mechanism is obscure. It may represent spontaneous otoacoustic emission or emphatic transmission (cross-talk) between adjacent nerve fibres.

Most tinnitus comes from damage to the microscopic endings of the hearing nerve in the inner ear. The health of these nerve endings is critical for acute hearing. Injury to the nerve endings will lead to hearing loss and often tinnitus. Advancing age is generally accompanied by a certain amount of hearing nerve impairment and tinnitus. In younger people, exposure to loud noise is probably the leading cause of tinnitus. The extreme noise often damages the hearing as well. CAN OTHER PEOPLE HEAR THE SOUND?
     The answer is… not usually, but sometimes they are able to hear certain type of tinnitus. There are 2 types of tinnitus, “objective tinnitus” and “subjective tinnitus”.In subjective tinnitus, you are the only one that can hear the noise. Some causes of subjective tinnitus are not serious (a small plug of wax in the ear canal might cause temporary tinnitus).In objective tinnitus, other people can also hear the sound. It caused either by abnormalities in blood vessels around the outside of the ear or by muscle spasms, which may sound like clicks or crackling inside the middle ear. SOME IDENTIFIED CAUSES OF TINNITUS

• Most of the time the cause is unknown
• Hearing loss consist of only 20% of the cause
• Ear wax
• Viral infections of the ear
• Foreign body
• Presbyacusis
• Loud noise
• Head injury
• Suppurotive otitis media
• Post stapedectomy
• Meniere’s disease (this is a disease characterize by dilatation of the endolymphatic spaces of the membranous labyrinths – usually causes vertigo, unilateral or bilateral tinnitus)
• Anemia
• Hypertension
• Impacted wisdom teeth
• Acoustic neuroma – usually presented with unilateral tinnitus
• Drugs – aspirin, loop diuretics, aminoglycosides
• Abnormally low level of serotonin activity.
• Psychological – redundancy, divorce and retirement

  HISTORY – WHAT USUALLY BEEN ASK BY YOUR DOCTORS

• Site of tinnitus (Is it in the ear or is it central)
• Character of the tinnitus
• Alleviating and exacerbating factors
• Otalgia (pain in the ear)
• Otorrhoea (discharge from the ear)
• Vertigo (you might feel like “the room is spinning”)
• Head injury (do you fall or involve in an accident and knock the head)
• Family history of deafness or tinnitus
• Your sleeping pattern
• Social surrounding  (tinnitus is worse if isolated or depressed)
• Drugs

  TESTS AND EXAMINATIONS  

• Otoscopy – to detect middle ear disease
• Hearing tests ( tuning fork and audiometry ) – to check for severity of hearing loss
• Tympanogram – to examine for any middle ear function and stapedial reflex thresholds
• X-rays
• Balance tests
• Laboratory investigations

TREATMENT

The mainstay of treatment is to treat the patient as a whole and not just the malfunctioning ear.

• Psychological support – this is important aspect to relieve tinnitus. Patient support group can help a lot. Hearing therapist can employ tinnitus retaining therapy to make tinnitus less intrusive.
• Exclude serious cause – If a specific cause of your tinnitus can be found, the doctor may be able to eliminate the noise. However, most causes cannot be identified. Tinnitus is not a serious disease and does not mean madness. Most of the time, it will improves.
• Drugs are disappointing. Nortryptiline might be the drug of choice if you are suffering for depression. Hypnotics at night might help. Betahistine might help patient with Meniere’s disease.
• Masking may give a great relieve. Tinnitus is usually more bothersome in quiet surroundings. A prosthetic component like hearing aid is use to provide a low level of background sound to help you masking the tinnitus. Hearing aid also may help those with hearing loss by amplifying the desirable sound.

DOs and Don’ts

• It is crucial to avoid exposure to loud sounds and noises.
• Get your blood pressure checked. If you have a high blood pressure, it will impair the circulation, so get your doctor’s help to control it.
• Decrease salt intake. Salt is known to impair blood circulation.
• Avoid stimulants such as coffee, tea, cola, and tobacco.
• Exercise daily. This will help to improve the circulation.
• Adequate rest is important. Avoid fatigue.
• Learn how to stop worrying about the noise. Ignore it as much as possible.

Notable sufferers of tinnitus include:

• Charlie Haden
• Ayumi Hamasaki
• Kevin Hogan
• Garrison Keillor
• Steve Kilbey
• Martin Luther
• Steve Martin
• Moby
• Ted Nugent
• Tim Powles
• William Shatner
• Sting
• Lars Ulrich
• Neil Young

So… having tinnitus doesn’t mean that you are handicapped. You can still be famous and have a good life…  Reference:

1. Oxford handbook of clinical specialties, 5^th edition.
2. http://www.entnet.org/healthinfo/hearing/tinnitus.cfm
3. http://en.wikipedia.org/wiki/Tinnitus

Related posts

• Adult and childrens health - Scabies
• Women’s health - Sore Nipple
• Fungal skin infection - Tinea Corporis or ringworm
• Acne Rosacea
• TINEA PEDIS
• IMPETIGO
• WARTS: common warts, genital warts
• WHY YOUR BABY REGURGITATES?
• food for thought : breast feeding
• COGNITIVE THERAPY