Tinnitus

What Is Tinnitus?

Tinnitus is noise that originates within the ear rather than from the outside environment. This may affect one or both ears.

The sounds have been described variously as a “ringing” sound, a “buzzing” sound, a “humming noise, “like running water”, a “whistling” sound or like the “sound from a seashell held close to the ear.”

There are several types of tinnitus:

• Tonal tinnitus is often called “ringing in the ears.” This type of tinnitus produces a continuous sound, like a single note playing over and over.
• Pulsatile tinnitus, in which the tinnitus sounds are intermittent, continuous, or pulsating in time with the heartbeat.
• Tinnitus in which the sound is a ringing, buzzing, roaring, whistling, or hissing noise.
• Less common tinnitus, in which the sounds are described as beeping, Morse code type of signals, or even a musical notes.
• Less common still is tinnitus experienced as several different types of noises at the same time.

In a rare, unusual type of tinnitus, known as “objective tinnitus,” the noise is heard not only by the affected individual but also by others.

Other Symptoms Associated With Tinnitus

In addition to the noises associated with tinnitus, certain other symptoms may accompany this condition. These include:

• Dizziness
• Pain in the ear
• A sense of fullness in the ears
• Headache

Who Gets Tinnitus?

Tinnitus may affect anyone. However, it is more common with increasing age. People who are prone to hardening of the arteries are at greater risk for tinnitus than the general population. In addition, individuals who work in noisy surroundings are also at greater risk for developing tinnitus. But in fact there are many causes for tinnitus.

Is Tinnitus Serious?

Tinnitus is typically not a serious condition; however, it is frequently accompanied by hearing loss. Many people with tinnitus are concerned that they may become completely deaf; however, tinnitus does not cause deafness.

Others fear that they have a brain tumor or that they have some form of mental illness. While possible, such underlying conditions are most unlikely and rarely found in people with tinnitus.

Is Depression Associated With Tinnitus?

Some people believe that depression produces tinnitus and if the depression is treated, their tinnitus will be relieved. Most experts believe that the opposite is more likely the case; namely, that tinnitus may cause a depression. Therefore, treatment is required for the depression.

There are effective treatments for depression, including antidepressant drugs and “talk” therapy. Some research studies suggest that certain antidepressant medications actually worsen the symptoms of tinnitus.

With objective tinnitus, an examiner can hear the sound heard by the patient by using a stethoscope. Benign problems, such as the noise from a problem with the jaw joint, openings of the eustachian tubes (the passage that connects the ear and the back of the nose), or repetitive muscle contractions may be the cause of the objective tinnitus. Other causes are the pulsing flow of blood through the carotid artery in the neck, or the continuous hum of normal blood outflow through the jugular vein.

There are two relatively tiny muscles in the middle ear attached to the tiny bones in the ear. These muscles contract briefly in response to loud or sudden noises in order to protect the inner ear from over-stimulation. On occasion, one or both of these muscles may begin to contract and relax rhythmically for no apparent reason. Because these muscles are attached to the tiny ear bones, contractions may result in repetitious clicking sounds.

In rare cases, rhythmic muscle contractions or spasms may affect one of the throat muscles attached to the eustachian tube. This is called palatal myoclonus and often produces an annoying clicking noise.

In some very severe cases, objective tinnitus may be an early sign of increased pressure in the fluid that surrounds that brain and spinal cord (cerebrospinal fluid). A pulsating sound may result from a blocked artery, an aneurysm, a tumor in a blood vessel, or other blood vessel disorders.

Understanding How We Hear

Hearing is a complex process involving the coordination of many different parts of the ear and nervous system.

The ear consists of five main parts:

1. The outer ear
2. The middle ear
3. The inner ear
4. Nerve pathways
5. The brain

The Outer Ear

• The outer ear consists of the auricle, the part of the ear that we can see, and includes the ear lobe and the external ear canal. These structures collect sound waves and carry them toward the eardrum.

The Middle Ear

• The middle ear lies between the eardrum and the inner ear. It contains three tiny bones, commonly called the hammer, anvil, and stirrup or stapes. These bones are named for their distinctive shapes.
• Sound, which is carried through the air like a continuously moving wave, makes the eardrum vibrate. These vibrations are then transmitted across the middle ear space by the tiny ear bones. Movement of the stapes bone produces waves in the liquid-filled inner ear.
• The middle ear chamber is connected to the back of the nose by a small canal called the eustachian tube. This tube maintains equal pressure between the middle ear and outside environment.

A good example of how this mechanism works is to think of the popping sensation experienced during altitude changes such as while landing in an airplane or traveling at high altitudes. The popping sound is a result of pressure adjustments in the middle ear through the eustachian tube.

The Inner Ear

• The inner ear is enclosed in dense bone and is composed of two specific parts:
  1. The organ of hearing (the cochlea)
  2. The organ of balance (the vestibular labyrinth)
• The interior of the organ of hearing or cochlea is divided into three compartments by strands of tissue, as in a shell. The middle compartment contains the hearing hair cells that are bathed in special fluid. These special cells respond to the fluid waves produced by the movements of the tiny ear bones, the stapes.

The Nerve Pathways

• Fluid waves in the cochlea are changed into electrical impulses, which travel rapidly along the auditory or hearing nerve to the brain.
• The nerve pathways leading to the brain are enclosed in a small bony canal along the nerve responsible for balance, and the nerve that stimulates the movement of the facial muscles.

The Brain

• The nerve hearing pathways divide as they reach the brain into an extremely complex intercommunication system.
• Ultimately, nerve impulses are transmitted to a certain part of the brain behind the temple. There, these impulses are processed and interpreted as recognizable sounds.

What Causes Tinnitus?

Tinnitus may be a symptom of a variety of ear disorders or other medical conditions. Usually it is difficult for doctors to determine the exact cause of tinnitus.

Many disorders of the ear, including a problem with one or more of the five parts of the hearing mechanism, may cause tinnitus. Tinnitus may also be a symptom associated with:

• Blocked ear canal
• Blocked eustachian tube
• Ear infection

  For further information about ear infection, go to Middle Ear Infection.

• Otosclerosis: a common ear disorder characterized by unusual stiffness or lack of flexibility of the tine bones of the middle ear. This condition frequently causes tinnitus.
• Meniere’s disease: a disorder of the inner ear characterized by recurrent dizziness, deafness, and tinnitus. In 80 to 85 percent of cases, only one ear is affected.
• Damage caused by certain drugs, including aspirin and certain antibiotics
• Hearing loss

  For further information about hearing loss, go to.Hearing Loss

• Trauma or injury resulting from a blast or explosion
• Temporomandibular joint syndrome or TMJ: pain and other symptoms affecting the head, jaw, and face. TMJ is believed to be caused when the jaw joints and muscles and ligaments that support them are not working properly.

Tinnitus may also occur along with certain other medical conditions, such as:

• Anemia, or a condition in which blood levels of hemoglobin, the part of red blood cells that carries oxygen to nourish the tissues of the body, are below normal

  For further information about anemia, go to Anemia.

• Hypertension, or high blood pressure

  For further information about high blood pressure, go to High Blood Pressure (Hypertension).

• Arteriosclerosis, or hardening of the arteries
• Hypothyroidism, or low levels of thyroid hormone production

  For further information about hypothyroidism, go to Hypothyroidism.

• Presbycusis: hearing loss and other hearing problems related to advanced age.
• Head injury

Is Tinnitus Hereditary?

There are a few rare inherited inner ear disorders, such as neurofibromatosis in which tinnitus may be a feature. However, in the vast majority of cases, this condition does not seem to run in families or be inherited as a genetic trait.

How Is Tinnitus Diagnosed?

Because, in most cases, the exact cause of tinnitus is not known, diagnosis typically begins with a visit to an ear specialist known as an otologist or otolaryngologist. A thorough clinical evaluation, including a complete patient history and medication regimen, helps the doctor to determine if tinnitus is present and what may be the cause of the condition. Specialized tests are performed to diagnose tinnitus. Some of these tests measure the specific features of the tinnitus itself. These tests may include:

• X-rays
• Audiogram
• Evoked response audiometry
• Tinnitus pitch match
• Tinnitus loudness match
• Maskability of tinnitus
• Residual inhibition

X-rays

X-rays films of the head are sometimes ordered to determine if any structural problems are present in the ear that may cause tinnitus. More high tech tests like an MRI or a CT scan may be ordered.

Audiogram

An audiogram, also known as a hearing acuity test, is a test that produces a chart measuring a person’s ability to hear sound and recognize various speech sounds. Because some hearing loss is usually associated with tinnitus, an audiogram is helpful with the diagnosis.

Evoked Response Audiometry

Evoked response audiometry is usually done for people who have tinnitus in one ear only. This test consists of painless computerized inner ear recordings that are similar in principle to the computer “fault-finding” checks that car garages use on computerized car engines.

Tinnitus Pitch Match

This test is based on the fact that ordinary physical tones have a pitch that corresponds to the frequency of each tone. Frequency refers to the number of cycles a sound wave completes in one second. Some sound waves have very high frequencies, while others are very low. For example, household electricity is at 60 cycles per second (60 Hertz or 60 Hz).

• To identify the “pitch” of tinnitus, the person selects from a group of external tones or noises. The selected tones are those that most closely match their tinnitus.
• A good way to imagine the value of this test is to consider that the highest tone produced on a grand piano cycles at slightly over 4,000 Hz. According to recent data, 74 percent of people with tinnitus have a “pitch match” for their tinnitus at 3,500 Hz or higher. Tones in this range typically have an unpleasant, screeching quality.

Tinnitus Loudness Match

The loudness of tinnitus is evaluated by adjusting the loudness of an external tone that most closely matches the sounds of the tinnitus. The test proceeds until the external tones are as loud as the tinnitus.

• Using this technique, the actual loudness of the tinnitus is measured. Typically, it is more of a whisper than a shout, between 4 and 7 decibels (or dB) above the threshold of hearing. This finding presents somewhat of a puzzle. Frequently, people describe their tinnitus as being “very loud,” when in fact the measurable “loudness” is in the very low range of 4 to 7 dB.
• Because of the difference between actual loudness and perceived loudness, another test known as the Visual Analog Scale is administered.
• This scale is a horizontal line marked off in equal units (like a ruler), from zero to 10. A rating of zero means “no tinnitus” while a 10 means the “loudest tinnitus one can imagine.”
• The person selects the number on the scale that best represents the loudness of their tinnitus. Using this scale, 70 percent of people tested chose a value of six or above. This seems to confirm that tinnitus is perceived as a loud noise.

Maskability Of Tinnitus

The maskability of tinnitus measures the degree to which tinnitus may be covered up or “masked” by other external sounds.

• This test uses a band of noise for the external or masking sound. In scientific terms, this noise band extends from 2,000 Hz through 12,000 Hz and is painlessly applied by using earphones on the affected ear.
• During this test, the masking sound is increased gradually until its presence is detected. Then the pitch of the sound is further increased until the person can no longer hear the tinnitus in that ear. The minimum masking level (MML) is expressed in dBsensation level (SL). In most people, the MML is 8 dB SL or less. It is rare for the MML to go above 22 dB SL.

Residual Inhibition

This test records the amount of time that the noise in the ear is reduced or eliminated following a period of masking. The test is conducted by masking the tinnitus at a minimum masking level plus 10 dB for 60 seconds. After this period of masking, the length of time the tinnitus has improved, if at all, is determined.

• In this test, 85 percent of those tested displayed either complete or partial residual inhibition (that is,improvement in the noise heard in the ear). The average duration was 65 seconds.
• A test period of 60 seconds, producing a residual inhibition that lasts 65 seconds, does not mean that a one-hour test would produce one hour of residual inhibition.
• Making the masking sound louder does not increase the length of time or the level of the residual inhibition. However, some people who use masking extensively over long periods of time find that residual inhibition may be extensive, lasting hours or even longer.

How Is Tinnitus Treated?

Unfortunately, attempts to identify and treat the underlying disorder causing tinnitus are often unsuccessful. The ability to tolerate tinnitus varies widely from person to person. Some or all of the following techniques may help make tinnitus tolerable.

1. Using a hearing aid may help to suppress tinnitus.
2. Relief by playing background music to mask the tinnitus-so-called “white noise.”
3. Using a “tinnitus masker”. This is a device worn like a hearing aid that produces pleasant sounds.
4. For the profoundly deaf, a procedure called a cochlear implant may reduce tinnitus.

Below we consider the following:

What is masking?

Are there medications for tinnitus?

Is surgery effective for tinnitus?

When tinnitus is present in both ears, how is it treated?

Are there effective alternative therapies for tinnitus?

What is masking?

Masking is the use of other sounds to “drown out” or “mask” the annoying noises associated with tinnitus. Unfortunately, some people reject this type of treatment without a trial, assuming that one sound is as bad as another. Fortunately, a simple test is available to obtain a preliminary idea of the value of masking for a particular individual.

The faucet test

In the faucet test, people with tinnitus stand near a sink and turn the water faucet on full force. The reason for this test is that many people with tinnitus notice that they do not hear their tinnitus while standing near running water or while taking a shower.

• If water sounds mask their tinnitus, it is possible that masking may relieve it.
• A person can record the water sound that is effective for them and then play it back when they want relief. Another approach, of course, is to invest in a commercial tinnitus masker.

What if the faucet test fails?

If a person can still hear their tinnitus in the presence of water sounds, like the running shower or kitchen faucet, it does not necessarily mean that masking is unsuitable for them. It may mean that their hearing loss is such that masking itself cannot be heard and, therefore, does not drown out the tinnitus.

• Approximately 90 percent of people with tinnitus have a hearing loss, which most frequently involves high-pitched tones. Most noises associated with tinnitus are within this high-pitched region of tones. In order to mask the tinnitus, it is necessary to use a high-pitched masking noise.
• When water sounds fail to mask tinnitus, it may be that the person is simply unable to hear that portion of the water sound needed to mask their tinnitus.
• People who have had their hearing tested and have only a high frequency hearing loss are often told they have normal hearing. Their hearing is, in fact, normal-but only for the low frequencies or up to 2,000 Hz.
• Hearing experts disagree about the definition of normal hearing. Some experts think that a person needs to hear up through 8,000 Hz or higher in both ears in order to understand speech in the presence of background noise, such as that found in restaurants, social gatherings, offices, etc.
• If a person has high-frequency hearing loss but otherwise normal hearing, electronic assistance in the form of hearing aids may be required if masking relieves their tinnitus. Clinical studies show that some people can only pass the faucet test while wearing hearing aids.
• Others who fail the faucet test include individuals whose tinnitus cannot be masked, regardless of the type or intensity of masking. Additionally, in those with complex tinnitus, which is composed of more than one kind of sound, only part of the tinnitus may be masked.

Why does masking work?

Masking is generally successful because the masking sound and the tinnitus sound are vastly different in quality. Tinnitus usually produces a shrill, high-pitched, unpleasant tone. In contrast, water and masking sounds are typically soothing.

• Most individuals can and usually do “automatically” ignore certain external sounds.
• These sounds are ignored if they are not too loud or harsh and if they are relatively constant and monotonous.
• Ignoring the masking sound, which covers up the tinnitus, means that the tinnitus is automatically ignored as well.

A healthcare specialist typically fits a variety of tinnitus maskers. Then people with tinnitus decide if masking is effective for them. If masking is beneficial, the affected individual and healthcare specialist work together to determine the most effective masker. Ultimately, the person with tinnitus makes the final decision.

When should masking be used?

When masking relieves tinnitus, there is no set schedule to follow for its use. People determine when they need relief and use masking accordingly. For example, some people find that their tinnitus does not bother them except at night. Others require masking during the entire day. A few people wear their maskers 24 hours a day.

• Some people find that they require masking less as they continue to use it. In these cases, residual inhibition probably plays some role in providing a reduced level of tinnitus.
• In rare cases, tinnitus becomes permanently suppressed after extensive masking.

Can masking be used during sleep?

Some people with severe tinnitus experience sleep disturbances. In such cases, wearable masking units can be fitted as an in-the-ear unit. This type of unit is more comfortable while sleeping.

• For those people who do not have wearable tinnitus maskers, FM static may be helpful. “Detuning” a FM radio to pick up only static sound, not a clear station, obtains so-called FM static. This noise is constant in volume and contains all frequencies. The volume may be increased until it just covers the tinnitus, or, if that is too loud, to the maximum comfort level.

• If hearing loss is significant, FM static masking may not be effective. In such cases, the noise of a fan or air conditioner may mask tinnitus and help to bring on sleep.
• If all else fails, but the sound of running water or a running faucet does mask the tinnitus, these sounds may be recorded on a high-quality tape recorder and played at any time that relief is desired, such as at bedtime.

Are there medications for tinnitus?

There are varieties of medications that may help to relieve the symptoms of tinnitus. Unfortunately, these drugs rarely provide long-term relief of the condition.

• Intravenous lidocaine was studied for its effectiveness in tinnitus relief. In one well-controlled study, 85 percent of people obtained partial or total relief of their tinnitus. Unfortunately, the relief was short-lived, lasting about 30 minutes or less. However, the study does suggest that tinnitus may be relieved by certain medications. Research is ongoing to find the appropriate drugs that may provide effective and long-term relief.
• Another drug that shows promise is alprazolam (Xanax®), which is an anti-anxiety medication. In one study, 76 percent of people treated with this medication found their tinnitus symptoms reduced by at least 40 percent. Moreover, those who found relief with alprazolam also demonstrated a reduction in tinnitus loudness.
• Some people may be helped by anticonvulsant medication (medications normally used to prevent seizures),or antihistamines (medications used in allergy treatment), or certain medications used for cardiovascular problems.
• Such studies indicate that, with continued research, better relief and more effective procedures-even cures-may be found.

Is surgery effective for tinnitus?

On rare occasions, surgery may be considered to help relieve severe symptoms of tinnitus. The intensity of tinnitus may be unbearably loud and comparable to the sound intensity of standing near a pneumatic drill. Such cases typically result from inner ear injuries and are frequently associated with profound or even total deafness.

• If no other forms of treatment are effective, an operation, during which the hearing (auditory) nerve is divided, may be beneficial in about 50 percent of severe cases.
• Surgical failures occur because the tinnitus may set up a “secondary central focus” within the brain itself. In such cases, the alternate source of the tinnitus, located deep within the brain, cannot be treated with surgery.
• Surgery for tinnitus requires a high degree of technical skill and is usually only undertaken in major teaching hospitals or university centers with specialized departments.

When Tinnitus Is Present In Both Ears, How Is It Treated?

When tinnitus occurs in both ears, it is usually necessary to mask both ears. Only rarely does masking on one side relieve tinnitus on the opposite side.

Are There Effective Alternative Therapies For Tinnitus?

In addition to the treatments outlined above, other options are available and worth considering when tinnitus is severe and interferes with daily activities, quality of life, and sleep.

• Relaxation training therapy teaches the person to learn to relax while experiencing tinnitus symptoms, thereby reducing the effect of that stress.
• Meditation or yoga may help some people with tinnitus.
• Biofeedback training may also be helpful. This consists of a series of exercise sessions, in which one learns to control circulation in various parts of the body and relax muscles that control the movement of the head. When a person is able to achieve a good state of relaxation, the tinnitus often subsides.
• Hypnosis or acupuncture may be tried, although benefit depends on the hypnotist or acupuncturist as well as the confidence the patient has in these methods.

Tinnitus And Hearing Loss

It is estimated that approximately 90 percent of people with tinnitus have some degree of hearing loss. Therefore, hearing tests are essential before a proper diagnosis of tinnitus may be determined.

• When a hearing loss is diagnosed, hearing aids are generally fitted before trying the various masking devices for tinnitus.
• Since hearing aids alone generally are insufficient to solve the problem, tinnitus maskers are usually tried next.
• Because so many people with tinnitus also have some hearing loss, it suggests that correction of the hearing loss with hearing aids may also relieve the tinnitus. Unfortunately, this has become conventional wisdom among some practitioners, who may inform people with tinnitus that hearing aids alone may relieve their symptoms. Clinical studies show that this is not usually the case.
• Additional research has demonstrated the value of a combination unit, called the tinnitus instrument, which generates a broadband noise that prevents users from experiencing tinnitus.

Can Tinnitus Be Cured?

As with most conditions, the exact cause must first be determined before the condition can be cured. Unfortunately, in most cases, it is not possible to diagnose the cause of tinnitus with any degree of certainty. However, when careful assessment by specialists points to a specific underlying disorder, appropriate treatment may lead to improvement or even the elimination of tinnitus symptoms.

The following medical conditions, if found to be associated with tinnitus, and cured or treated with medication or surgery, may lessen, reduce, or even eliminate the noise associated with tinnitus:

• High blood pressure

    For further information about high blood pressure, go to High Blood Pressure (Hypertension).

• Anemia

  For further information about anemia, go to Anemia.

• Early Meniere’s disease
• Surgery for otosclerosis or inner ear fluid leaks
• Treatment with antibiotics for a middle ear infections

  For further information about ear infection, go to Middle Ear Infection.

• Surgical correction of conductive hearing loss

  For further information about hearing loss, go to Hearing Loss.

Living With Tinnitus

Although tinnitus often can not be “cured,” the following general measures may be helpful in alleviating or improving symptoms:

• Avoid nervous anxiety or stress, as these stimulate an already “sensitive” hearing system.
• Obtain adequate rest and avoid fatigue.
• Avoid the use of stimulants to the nervous system, including coffee (caffeine), alcohol, and smoking (nicotine).
• Sleep with the head propped up in an elevated position. This may usually be accomplished with the use of one or two extra pillows. This also lessens head congestion and tinnitus may become less noticeable.
• Be aware that tinnitus is usually more noticeable after retiring for the night and the surroundings are more quiet. Any noise in the room, such as a ticking clock or softly playing radio, helps to mask tinnitus and make it less irritating.
• Use a tinnitus masker if you’ve found one helpful
• Some people benefit by using a hearing aid since it amplifies outside noise (like masking)
• Avoid situations that can further damage hearing (excessive noise), and protect your ears from injury and occupational hazards. Use protective ear wear when appropriate.
• Some people are considerably helped by alternative therapies
• Counseling may be beneficial, especially if people are afraid that they have a serious or progressive disease, such as a brain tumor. Some people worry they may have a mental illness, since the noise is “in their head.” Reassurance by a specialist helps to calm such fears and anxieties.

What Is The Outlook For People With Tinnitus?

At the present time, there are many ongoing research studies. These investigations will inevitably lead to a better understanding of this condition as well as provide new treatment possibilities and relief.

• Electrical suppression techniques hold substantial promise for the relief of tinnitus. During this procedure, electrical current is delivered to the middle ear via special electrodes. More study is needed to determine the long-term safety and effectiveness of this procedure for the treatment of tinnitus.
• Future surgical procedures may also provide options for treatment or even a cure for tinnitus.

Tinnitus: Frequently Asked Questions

Here are some frequently asked questions related to Tinnitus:

Is there a belief that, because tinnitus is “all in the head,” it is not a real problem?

Unfortunately, some physicians may mistakenly believe this to be the case.

• When tests measuring loudness indicate tinnitus in the decibel range of “only” 4 to 7 dB, some healthcare professionals dismiss the complaints in the mistaken belief that these people really do not have a problem, that they are overreacting, or that the problem is most likely due to some psychological weakness.
• Despite the fact that an objective measurement of tinnitus is not currently available, people do experience this condition and should be treated.

What does a tinnitus instrument look like?

The tinnitus instrument is a small electronic device built into a standard hearing aid that fits behind the external flap of the ear. This instrument generates a broadband noise that prevents users from experiencing tinnitus.

• The masker is based on the principle that most individuals with tinnitus tolerate outside noise better than inner head noise. If possible, the frequency or pitch of the tinnitus is identified. Then, a masker is chosen that produces a noise matching this particular frequency as closely as possible.

Why do some middle ear infections cause tinnitus?

Middle ear infections, particularly when they are chronic, may cause tinnitus because of scarring around the tiny bones of the middle ear. In some cases, scarring occurs near the membrane that covers openings between the middle and inner ears.

What about the newspaper and magazine ads that claim there are cures for tinnitus?

Unfortunately, any medical problem for which there is no standard cure or reliable treatment is fair game for those who wish to take advantage of people who are seeking help for their problem. Newspapers and magazines routinely publish advertisements about “tinnitus relief.” These ads are usually accompanied by what appears to be convincing testimonials.

• Those seeking treatment should be aware that, no matter how compelling, testimony is not evidence.
• Testimonials never indicate how many failed to find relief.
• These so-called “miracle cures” have not been scientifically tested for safety or effectiveness. There is no approval from the Food and Drug Administration (FDA), the US federal agency that regulates drugs and medical devices.

Tinnitus: Putting It All Together

Here is a summary of the important facts and information related to Tinnitus:

• Tinnitus is noise that originates within the ear rather than from the outside environment. This may affect one or both ears.
• Tinnitus is a relatively common condition.
• Tinnitus is not likely to worsen, even if associated hearing loss increases.
• Tinnitus usually decreases in severity with time.
• Tinnitus does not cause deafness, though a high percentage of people with tinnitus do have some degree of deafness.
• The sounds of tinnitus are not in fact usually loud when compared with many everyday sounds; they may only seem to be very loud.
• Coping with the symptoms of tinnitus may be a matter of learning to control reactions to the irritations caused by the symptoms
• Many people attempt to ignore tinnitus and not allow the symptoms to “take control.”
• It is not true that “nothing can be done” for people with tinnitus. There are various means adapting to tinnitus. In fact, most people learn to cope with the condition and try not to let it affect their quality their day-to-day life.
• There are several treatment options for people with tinnitus, including masking, medications, lifestyle changes, or, in severe cases, cochlear implant surgery.
• Masking is the camouflage of the annoying sound associated with tinnitus by more pleasant, soothing sound.

Tinnitus: Glossary

Here are definitions of medical terms related to Tinnitus:

Aneurysm: Widening of an artery

Auricle: The part of thr ear that we see

Cochlea: An organ in the inner ear that transforms sound vibrations in the inner ear into nerve impulses for transmission to the brain.

Cochlear implant: A device used for treating severe deafness that consists of one or more electrodes surgically implanted inside or outside the cochlea, an organ in the inner ear that transforms sound vibrations in the inner ear into nerve impulses for transmission to the brain. Unlike a hearing aid, which amplifies sounds, the implant receives and passes on electrical signals.

Decibel (dB): A unit of measure used to determine the relative loudness of a sound.

Eustachian tube: The passage that connects the middle ear and the back of the nose. It acts as a drainage way for the middle ear and regulates the pressure between the middle ear and the outside environment.

Hardening of the arteries: Called atherosclerosis,this refers to a buildup of cholesterol and other fatty deposits in the arteries, that increases the risk of heart and other diseases

Hearing aid: An instrument designed for amplifying sound.

Lidocaine: A local anesthetic used to relieve pain and irritation, to numb tissues before minor surgical procedures, and as a nerve block.

Masking: The use of other sounds to “drown out” the annoying noises associated with tinnitus. A simple test is available to obtain a preliminary idea of the value of masking for a particular individual.

Meniere’s disease: A disorder of the inner ear characterized by recurrent dizziness, deafness, and tinnitus. In 80 to 85 percent of cases, only one ear is affected.

Otosclerosis: A common ear disorder characterized by unusual stiffness or lack of flexibility of the tiny bones of the middle ear. This condition frequently causes tinnitus.

Presbycusis: hearing loss and other hearing problems related to advanced age.

TMJ syndrome: Referring to temporomandibular (i.e., jaw) joint syndrome, TMJ syndrome is thought to be a malfunction of jaw joints of the upper and lower jaw bones and the muscles and ligaments that control and support them.

Tinnitus Additional Sources Of Information

Here are some reliable sources that can provide more information on Tinnitus:

American Tinnitus Association 
http://www.ata.org/

The Marsona Corporation 
P.O. Box 3098
Wilmington, Nicole 28406-0098

markets a sound generator called the TSC-300, which produces a rain sound capable of making high-pitched tinnitus for some people. The same unit produces a waterfall sound, which may be sufficiently low-pitched to mask pulsatile tinnitus.

Additional products are clocks, or clock/radio combinations that can be programmed to produce sounds like ocean waves, babbling brooks, rainstorms, and similar, soothing-type sounds.

American Academy of Audiology 
www.audiology.org

American Academy of Otolaryngology, Head & Neck Surgery, Inc. 
www.entnet.org

American Speech-Language-Hearing Association (ASHA) 
www.asha.org

American Society on Aging (ASA) 
www.asaging.org

Association of Research in Otolaryngology (ARO) 
www.aro.org

Better Hearing Institute 
www.betterhearing.org

EAR Foundation 
– www.theearfound.com

Hearing Alliance of America 
www.hearingalliance.com/~hearnow/

National Institute on Deafness and Other Communication Disorders 
http://www.nidcd.nih.gov/

National Institute of Health 
www.nih.gov/

SHHH (Self Help for Hard of Hearing people) 
www.shhh.org