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tinnitus

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Medical Encyclopedia: Tinnitus
 
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Definition

Tinnitus is hearing ringing, buzzing, or other sounds without an external cause. Patients may experience tinnitus in one or both ears or in the head.

Description

Tinnitus affects as many as 40 million adults in the United States. It is defined as either objective or subjective. In objective tinnitus, the doctor can hear the sounds, as well as the patient. Objective tinnitus is typically caused by tumors, turbulent blood flow through malformed vessels, or by rhythmic muscular spasms. Most cases of tinnitus are subjective, which means that only the patient can hear the sounds.

— Rebecca J. Frey, PhD


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Dictionary: tin·ni·tus   (tĭ-nī'təs, tĭn'ĭ-) pronunciation
 
Home > Library > Literature & Language > Dictionary
n., pl. -tus·es.

A sound in one ear or both ears, such as buzzing, ringing, or whistling, occurring without an external stimulus and usually caused by a specific condition, such as an ear infection, the use of certain drugs, a blocked auditory tube or canal, or a head injury.

[Latin tinnītus, from past participle of tinnīre, to ring, of imitative origin.]


 
World of the Body: tinnitus
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Tinnitus refers to the sensation of sound, most often a high-pitched, noisy whistle, in one or both ears in the absence of external stimulation. Like pain, tinnitus is a very subjective phenomenon, and descriptions by sufferers tend to be in terms of a familiar sound such as the roar of the ocean or the ringing of bells. Nearly everyone experiences a mild and transient form of tinnitus. Estimates of the incidence of more severe forms vary, but around 10-14% of adults complain of tinnitus that is either prolonged or present for much of the time, and 0.5% are so affected as to have difficulty in leading a normal life.

The first written record of tinnitus appears to date back to ancient Egyptian medical documents. There are several references in Babylonian medicine to the ‘singing ear’ or the ‘whispering ear’, for which incantation of charms was advocated. Descriptions of noises in the ear and their possible causes were placed on a more scientific footing through the works of the Greek scholar Hippocrates in the fourth and fifth centuries bc and the term tinnitus originates from ancient Rome. Over the subsequent centuries, different types of tinnitus were recognized and described more completely. However, tinnitus remains one of the least understood hearing conditions, for which there is still, in many cases, no specific cure.

Many sounds are generated within the head as a result of muscular activity and by blood rushing through the cranial vessels. However, we are rarely aware of these sounds because the cochlea is shielded by the hard temporal bone. Although people with apparently normal hearing do experience tinnitus, it usually accompanies some form of hearing loss. Indeed, most people who complain to their general practitioners of deafness will also have tinnitus. Although it is often associated with disorders of the ear itself, including blockage of the ear canal by wax, otosclerosis, and Menière's disease, it is now apparent that neural activity within the brain may be a more important factor. The discovery in the late 1970s that the ear produces sounds that can be detected in the ear canal suggested a possible link between tinnitus and the activity of outer hair cells in the cochlea. However, because drugs such as aspirin both eliminate these emissions and induce tinnitus, this seems to provide an explanation in only a few cases. Moreover, tinnitus is often found in people with severe sensorineural hearing loss or following physical damage to the inner ear, which would argue against a cochlear origin for the condition.

Because of its subjective nature and the paucity of external signs associated with tinnitus, the development of animal models has been problematic. Nevertheless, studies in animals have shown that high doses of aspirin give rise to increased spontaneous activity both in the auditory nerve fibres that leave the inner ear and in the auditory midbrain. We do not yet know the mechanisms underlying central tinnitus or even which areas of the auditory pathway are responsible, but it is possible that a change in the level of inhibitory activity may be involved.

Early remedies for tinnitus usually involved the administration, either orally or into the ear canal, of a variety of substances ranging from oils to ox urine. It was observed in ancient Greece that external noise could mask buzzing in the ears and this was used therapeutically in the nineteenth century. Unless the patient is completely deaf, noise generators are still useful today as a means of providing temporary relief. By amplifying speech or environmental noise, hearing aids can also be effective in many cases. It was claimed at the beginning of the nineteenth century that electrical stimulation of the ear could be used to treat tinnitus. In a similar vein, tinnitus is often reduced after profoundly deaf patients are fitted with a cochlear implant in which sounds are transduced into electrical signals that are delivered to electrodes inserted into the cochlea of the inner ear.

In a small minority of cases tinnitus may be alleviated if the cause of the hearing loss can be treated by surgical or medical means. Because tinnitus is aggravated by stress or fatigue, the most successful treatment involves psychological counselling or some form of relaxation therapy, often in conjunction with devices that use external noise to mask the sounds that are generated within the head.

— Andrew J. King

Bibliography

  • Shulman, A., Aran, J.-M., Feldmann, H., Tonndorf, J., and Vernon, J. A. (1991). Tinnitus: diagnosis/treatment. Lea and Febiger, Philadelphia.
  • Vesterager, V. (1997). Tinnitus — investigation and management. British Medical Journal, 314, 728-31

See also deafness; hearing; hearing aid.

 
Dental Dictionary: tinnitus
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(tinī′tus)
n

Noises or unpleasant sounds in the ears, such as ringing, buzzing, roaring, or clicking; usually high pitched. Heard by many persons with auditory impairment. Clicking tinnitus may be heard by others.

 
Alternative Medicine Encyclopedia: Tinnitus
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Definition

Tinnitus is a condition where the patient hears ringing, buzzing, or other sounds without an external cause. Patients may experience tinnitus in one or both ears or in the head.

Description

Tinnitus affects as many as 40 million adults in the United States. It is defined as either objective or subjective. In objective tinnitus, the doctor can hear the sounds as well as the patient. Objective tinnitus is typically caused by tumors, turbulent blood flow through malformed vessels, or by rhythmic muscular spasms. Most cases of tinnitus are subjective, which means that only the patient can hear the sounds.

Causes & Symptoms

Subjective tinnitus is frequently associated with hearing loss and damage to the cochlea, or the inner ear. About 90% of patients have sensorineural hearing loss; 5% suffer from conductive hearing loss; and 5% have normal hearing.

The causes of subjective tinnitus include:

  • impacted ear wax
  • ear infections
  • hardening of the structures of the inner ear
  • hearing loss related to age
  • prolonged exposure to excessive noise
  • ototoxic medications, including aspirin, quinine, some diuretics, heavy metals, alcohol, and certain antibiotics
  • Ménière's syndrome
  • head trauma
  • systemic diseases, including syphilis, hypertension, anemia, or hypothyroidism
  • tumors of the ear

Diagnosis

Diagnosis of tinnitus includes a physical examination of the patient's head and neck. The doctor will use an instrument called an otoscope to examine the ears for wax, infection, or structural changes. He or she will also use a stethoscope to listen to the blood vessels in the neck.

The patient's doctor may also refer him or her to an audiologist, who is a health care professional trained to perform diagnostic testing of hearing problems.

In some cases, tinnitus is a symptom of temporomandibular joint disorder, or TMJ, which is caused by dysfunction of the temporomandibular joint in the jaw. The muscles and nerves in the jaw are located very close to the nerves that control hearing, which is why TMJ can cause tinnitus. Patients with tinnitus may be referred to a dentist or orthodontist for assessment of their jaw muscles or a misaligned bite.

Additional tests may include the following:

Tuning Fork Tests

The Rinne and Weber tests are commonly used to evaluate the type and severity of hearing loss. In the Weber test, the doctor holds a tuning fork against the patient's forehead or front teeth. If the hearing loss is sensorineural, the sound radiates to the ear with better hearing; if the hearing loss is conductive, the sound will be louder in the damaged ear. In the Rinne test, the tuning fork is placed alternately on the mastoid bone, which is behind the ear, and then in front of the ear. In conductive hearing loss, bone conduction (BC) is greater than air conduction (AC). In sensorineural hearing loss, AC is greater than BC.

Diagnostic Imaging

Magnetic resonance angiography or venography (MRA and MRV) can be used to evaluate malformations of the blood vessels. Computed tomography scans (CT scans) or magnetic resonance imaging scans (MRIs) can be used to locate tumors or abnormalities of the brain stem.

Blood Tests

The doctor may order a complete blood count (CBC) with specific antibody tests to rule out syphilis or immune system disorders.

Treatment

Dietary adjustments, including the elimination of coffee and other stimulants, may be useful in treating tinnitus. In addition, reducing the amount of fat and cholesterol in the diet can help improve blood circulation to the ears. Nutritional supplementation with vitamin C, vitamin E, B vitamins, calcium, magnesium, potassium, and essential fatty acids is also recommended.

In particular, zinc supplements have been recommended for patients diagnosed with tinnitus. A recent Turkish study has confirmed that older people whose diets have been deficient in zinc may benefit from supplements of this mineral as a treatment for tinnitus, but that younger patients eating well-balanced diets do not find that their symptoms improve when they take zinc supplements. The American Tinnitus Association comments that zinc supplements "… generally carry little risk to health and some people find them helpful."

Gingko biloba, an herbal extract, has been shown to decrease tinnitus symptoms in controlled animal studies and may be helpful in treating humans, since it is believed to enhance circulation to the brain in situations where reduced circulation is the cause. Individuals taking such blood thinners as coumadin or heparin should not take Ginkgo biloba, as the herb can interfere with platelet activating factor, the chemical that enables blood to clot.

Acupuncture treatments may help decrease the level of tinnitus sounds the patient hears, and constitutional homeopathic treatment may also be effective. Some Chinese herbal treatments can be effective, as well.

Tinnitus Retraining Therapy, or TRT, has been successful in treating some subjective tinnitus patients. This therapy is based on the assumption that the severity of tinnitus is determined not by the patient's auditory system, but by the parts of the brain that control emotion (the limbic system) and body functions (autonomic nervous system). TRT focuses on habituating the patient to his or her tinnitus, retraining the brain to, in effect, "become used to" the tinnitus so that it does not perceive it as an annoyance.

Allopathic Treatment

Some cases of tinnitus can be treated by removal of the underlying cause. These include surgical treatment of impacted ear wax, tumors, head injuries, or malformed blood vessels; discontinuance of ototoxic medications; and antibiotic treatment of infections.

Patients whose tinnitus is related to TMJ usually experience improvement in or complete disappearance of the tinnitus when the dental problem is corrected.

Subjective tinnitus, especially that associated with age-related hearing loss, can be treated with hearing aids, noise generators or other masking devices, biofeedback, antidepressant medications, or lifestyle modifications.

One mainstream form of psychotherapy that is recommended to patients with tinnitus is cognitive-behavioral therapy, or CBT. CBT works by changing the patient's emotional reaction to the tinnitus. The patient keeps a symptom diary and works on an individual basis with a counselor to identify negative thought patterns and behaviors related to the tinnitus and then changes them. The latest innovation in CBT for tinnitus is therapy via the Internet. According to a 2002 study by a group of Swedish researchers, 31% of patients who participated in a CBT program via the Internet reported significant relief from tinnitus at 1-year follow-up.

Expected Results

The prognosis depends on the cause of the tinnitus and the patient's emotional response. Most patients with subjective tinnitus do not find it seriously disturbing, but about 5% have strong negative feelings. These patients are frequently helped by instruction in relaxation techniques.

Studies indicate that CBT is most effective as a treatment for tinnitus when it is combined with masking techniques or medication.

Prevention

One preventive measure is to wear earplugs when operating loud machinery or spending extended periods in such noisy environments as rock concerts. Prolonged exposure to noises of 90 decibels (about as loud as a running blender) or higher can cause permanent hearing loss and tinnitus. In some cases a change of occupation may be advisable; a recent British study found that as many as 266,000 men and 84,000 women in the United Kingdom between the ages of 35 and 64 suffer from tinnitus resulting from work-related noise.

More detailed information and advice on dealing with tinnitus associated with noise-induced hearing loss is available from the National Institute on Deafness and Communication Disorders (NIDCD), listed under Resources below.

Resources

Books

House, John W. "Tinnitus." In Conn's Current Therapy, edited by Robert E. Rakel. Philadelphia: W. B. Saunders, 1998.

Jackler, Robert K., and Michael J. Kaplan. "Ear, Nose, & Throat." In Current Medical Diagnosis & Treatment 1998, edited by Lawrence M. Tierney, Stephen J. McPhee, and Maxine Papadakis. Stamford, CT: Appleton & Lange, 1997.

Pelletier, Kenneth R., MD. The Best Alternative Medicine, Part II, "CAM Therapies for Specific Conditions: Tinnitus." New York: Simon & Schuster, 2002.

"Tinnitus." Section 7, Chapter 82 in The Merck Manual of Diagnosis and Therapy, edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 2001.

Periodicals

Andersson, G., T. Stromgren, L. Strom, and L. Lyttkens. "Randomized Controlled Trial of Internet-Based Cognitive Behavior Therapy for Distress Associated with Tinnitus." Psychosomatic Medicine 64 (September-October 2002): 810–816.

Delb, W., R. D'Amelio, C. J. Boisten, and P. K. Plinkert. "Evaluation of the Tinnitus Retraining Therapy as Combined with a Cognitive Behavioral Group Therapy" [in German] HNO 50 (November 2002): 997–1004.

Henry, J. A., M. M. Jastreboff, P. J. Jastreboff, et al. "Assessment of Patients for Treatment with Tinnitus Retraining Therapy." Journal of the American Academy of Audiology 13 (November-December 2002): 523–544.

Jastreboff, P.J., W.C. Gray, and S.L. Gold. "Neurophysiological Approach to Tinnitus Patients." American Journal of Otology 17 (1996): 236–240.

Palmer, K. T., M. J. Griffin, H. E. Syddall, et al. "Occupational Exposure to Noise and the Attributable Burden of Hearing Difficulties in Great Britain." Occupational and Environmental Medicine 59 (September 2002): 634–639.

Schechter, M. A., and J. A. Henry. "Assessment and Treatment of Tinnitus Patients using a 'Masking Approach.'" Journal of the American Academy of Audiology 13 (November-December 2002): 545–558.

Yetiser, S., F. Tosun, B. Satar, et al. "The Role of Zinc in Management of Tinnitus." Auris Nasus Larynx 29 (October 2002): 329–333.

Organizations

American Academy of Audiology. 11730 Plaza America Drive, Suite 300, Reston, VA 20190. (703) 790-8466. .

American Tinnitus Association. P.O. Box 5, Portland, Oregon 97207-0005. (800) 634-8978 or (503) 248-9985. .

Better Hearing Institute. 515 King Street, Suite 420, Alexandria, VA 22314. (703) 684-3391.

National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health. 31 Center Drive, MSC 2320. Bethesda, MD 20892-2320. .

Vestibular Disorders Association (VEDA). PO Box 4467, Portland, OR 97208-4467. (800) 837-8428. .

Other

National Institute on Deafness and Other Communication Disorders (NIDCD). Noise-Induced Hearing Loss. Bethesda, MD: NIDCD, 2002. NIH Publication No. 97-4233. .

[Article by: Paula Ford-Martin; Rebecca J. Frey, PhD]

 
Veterinary Dictionary: tinnitus
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A noise in the ears, as ringing, buzzing or roaring.

  • objective t. — one heard by others than the patient; reported in dogs and horses.
  • subjective t. — one heard only by the patient; difficult to determine in animals.
 
Obscure Words: tinnitus
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a sensation of noise (as a ringing or roaring) that is purely subjective
 
Wikipedia: Tinnitus
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Tinnitus
Classification and external resources
ICD-10 H93.1
ICD-9 388.3
DiseasesDB 27662
MedlinePlus 003043
eMedicine ent/235 
MeSH D014012

Tinnitus (pronounced /tɪˈnaɪtəs/ or /ˈtɪnɪtəs/,[1] from the Latin word tinnītus meaning "ringing"[2]) is the perception of sound within the human ear in the absence of corresponding external sound.

Tinnitus is not a disease but a symptom resulting from a range of underlying causes that can include ear infections, foreign objects or wax in the ear, nose allergies that prevent (or induce) fluid drain and cause wax build-up, and injury from loud noises. Tinnitus is also a side-effect of some medications.

As tinnitus is often defined as a subjective phenomenon, it is difficult to measure using objective tests, such as by comparison with noise of known frequency and intensity, as in an audiometric test. The condition is often rated clinically on a simple scale from "slight" to "catastrophic" according to the practical difficulties it imposes, such as interference with sleep, quiet activities, and normal daily activities.[3]

Tinnitus is common. About one in five people between 55 and 65 years old report tinnitus symptoms on a general health questionnaire and 11.8% on more detailed tinnitus-specific questionnaires.[4]

Contents

Characteristics

Tinnitus can be perceived in one or both ears or in the head. It is usually described as a ringing noise, but in some patients it takes the form of a high pitched whining, buzzing, hissing, screaming, humming, tinging or whistling sound, or as ticking, clicking, roaring, "crickets" or "tree frogs" or "locusts", tunes, songs, or beeping.[5] It has also been described as a "wooshing" sound, as of wind or waves.[6] Tinnitus can be intermittent or it can be continuous in which case it can be the cause of great distress. In some individuals, the intensity of tinnitus can be changed by shoulder, head, tongue, jaw, or eye movements.[7]

Most people with tinnitus have hearing loss,[8] in that they are often unable to properly hear external sounds which occur within the same range of frequencies as their "phantom sounds." [9] This has led to the suggestion that one cause of tinnitus might be a homeostatic response of central dorsal cochlear nucleus auditory neurons that makes them hyperactive in compensation to auditory input loss.[10]

The sound perceived may range from a quiet background noise to one that can be heard even over loud external sounds. The term "tinnitus" usually refers to more severe cases. Heller and Bergman (1953) conducted a study of 100 tinnitus-free university students placed in an anechoic chamber and found that 93% reported hearing a buzzing, pulsing or whistling sound. Cohort studies have demonstrated that damage to hearing (among other health effects) from unnatural levels of noise exposure is very widespread in industrialized countries.[11]

For research purposes, the more elaborate Tinnitus Handicap Inventory is often used.[12] Persistent tinnitus may cause irritability, fatigue, and on occasions clinical depression [13] [14] and musical hallucinations. [15]

Objective tinnitus

In some cases, a clinician can perceive an actual sound (e.g., a bruit) emanating from the patient's ears. This is called objective tinnitus. Objective tinnitus can arise from muscle spasms that cause clicks or crackling around the middle ear.[16] Some people experience a sound that beats in time with the pulse (pulsatile tinnitus or vascular tinnitus).[17] Pulsatile tinnitus is usually objective in nature, resulting from altered blood flow or increased blood turbulence near the ear (such as from atherosclerosis or venous hum[18]), but it can also arise as a subjective phenomenon from an increased awareness of blood flow in the ear.[17] Rarely, pulsatile tinnitus may be a symptom of potentially life-threatening conditions such as carotid artery aneurysm[19] or carotid artery dissection.[20]

Measuring tinnitus

The basis of quantitative measurement of tinnitus relies on the brain’s tendency to select out only the loudest sounds heard. Based on this tendency, the amplitude of a patient's tinnitus can be measured by playing sample sounds of known amplitude and asking the patient which he or she hears. The tinnitus will always be equal to or less than sample noises heard by the patient. This method works very well to gauge objective tinnitus (see above.) For example: if a patient has a pulsatile paraganglioma in his ear, he will not be able to hear the blood flow through the tumor when the sample noise is 5 decibels louder than the noise produced by the blood. As sound amplitude is gradually decreased, the tinnitus will become audible, and the level at which it does so provides an estimate of the amplitude of the objective tinnitus.

Objective tinnitus, however, is quite uncommon. Often patients with pulsatile tumors will report other coexistent sounds, distinct from the pulsatile noise, that will persist even after their tumor has been removed. This is generally subjective tinnitus, which, unlike the objective form, cannot be tested by comparative methods.

If a subject is focused on a sample noise, they can often detect it to levels below 5 decibels, which would indicate that their tinnitus would be almost impossible to hear. Conversely, if the same test subject is told to focus only on their tinnitus, they will report hearing the sound even when test noises exceed 70 decibels, making the tinnitus louder than a ringing phone. This quantification method suggests that subjective tinnitus relates only to what the patient is attempting to hear. Whilst it is tempting to assume that patients actively complaining about tinnitus have simply become obsessed with the noise, this is only partially true. The noise is often present in both quiet and noisy environments, and can become quite intrusive to their daily lives. The problem is involuntary; generally complaining patients simply cannot override or ignore their tinnitus.

Subjective tinnitus may not always be correlated with ear malfunction or hearing loss. Even people with near-perfect hearing may still complain of it. Tinnitus may also have a connection to memory problems, anxiety, fatigue or a general state of poor health.[citation needed]

Mechanisms of subjective tinnitus

One of the possible mechanisms relies in the otoacoustic emissions. The inner ear contains thousands of minute hairs, called stereocilia, which vibrate in response to sound waves and cells which convert neural signals back into acoustical vibrations. The sensing cells are connected with the vibratory cells through a neural feedback loop, whose gain is regulated by the brain. This loop is normally adjusted just below onset of self-oscillation, which gives the ear spectacular sensitivity and selectivity. If something changes, it's easy for the delicate adjustment to cross the barrier of oscillation and tinnitus results. Listening to loud music kills our hair cells, and studies have that as we lose hair cells, afferent neurons are activated, activating auditory parts of the brain and giving the perception of sound.[citation needed]

Other possible mechanisms of how things can change in the ear is damage to the receptor cells. Although receptor cells can be regenerated from the adjacent supporting Deiters cells after injury in birds, reptiles, and amphibians, in mammals it is believed that they can be produced only during embryogenesis. Although mammalian Deiters cells reproduce and position themselves appropriately for regeneration, they have not been observed to transdifferentiate into receptor cells except in tissue culture experiments.[21][22] Therefore, if these hairs become damaged, through prolonged exposure to excessive decibel levels, for instance, then deafness to certain frequencies occurs. In tinnitus, they may falsely relay information at a certain frequency that an externally audible sound is present, when it is not.

The mechanisms of subjective tinnitus are often obscure. While it is not surprising that direct trauma to the inner ear can cause tinnitus, other apparent causes (e.g., temporomandibular joint disorder (TMJ) and dental disorders) are difficult to explain. Research has proposed that there are two distinct categories of subjective tinnitus: otic tinnitus, caused by disorders of the inner ear or the acoustic nerve, and somatic tinnitus, caused by disorders outside the ear and nerve but still within the head or neck. It is further hypothesized that somatic tinnitus may be due to "central crosstalk" within the brain, as certain head and neck nerves enter the brain near regions known to be involved in hearing. [23]

Studies by researchers at the University of Western Australia suggest that tinnitus is caused by increased neural activity in the auditory brainstem where the brain processes sounds, causing some auditory nerve cells to become overexcited. The basis of this theory is that most people with tinnitus also have hearing loss[8] and the frequencies they cannot hear linking to the subjective frequencies of their tinnitus.[9] Models of hearing loss and the brain support the idea that a homeostatic response of central dorsal cochlear nucleus neurons could result in them being hyperactive in a compensation process to the loss of hearing input.[10] This in turn is related to changes in the genes involved in regulating the activity of those nerve cells. This proposed mechanism suggests possible treatments for the condition, involving the normalization or suppression of overactive neural activity through electrical or chemical means.[24]

While most discussions of tinnitus tend to stress physical mechanisms, there is strong evidence that the level of an individual's awareness of their tinnitus can be stress-related, and so should be addressed by improving the state of the nervous system generally, using gradual, unobtrusive, long-term treatments.[citation needed][25]

Prevention

Tinnitus and hearing loss can be permanent conditions, and therefore precautionary measures are advisable. If a ringing in the ears is audible following lengthy exposure to a source of loud noise, such as a music concert or an industrial workplace, it means that lasting damage may already have occurred.[26] Prolonged exposure to noise levels as low as 70 dB can result in damage to hearing (see noise health effects). For musicians and DJs, special musicians' earplugs play a huge role in preventing tinnitus and can lower the volume of the music without distorting the sound and can prevent tinnitus from developing in later years. For anyone operating loud electrical appliances, such as vacuum cleaners, hair dryers, and lawn mowers, earplugs are also helpful in reducing noise exposure.

It is also important to check medications for potential ototoxicity. Ototoxicity can be cumulative between medications, or can greatly increase the damage done by noise. If ototoxic medications must be administered, close attention by the physician to prescription details, such as dose and dosage interval, can reduce the damage done.[27]

Causes of subjective tinnitus

Tinnitus can have many different causes, but most commonly results from otologic disorders – the same conditions that cause hearing loss. The most common cause is noise-induced hearing loss, resulting from exposure to excessive or loud noises. But tinnitus, along with sudden onset hearing loss, may have no obvious external cause. Ototoxic drugs can cause tinnitus either secondary to hearing loss or without hearing loss, and may increase the damage done by exposure to loud noise, even at doses that are not in themselves ototoxic.[28]

Tinnitus is also a side-effect of some oral medications, such as aspirin, and may also result from an abnormally low level of serotonin activity. It is also a classical side effect of Quinidine, a Class IA anti-arrhythmic. In many cases, however, no underlying physical cause can be identified.

Causes of tinnitus include:[29]

Treatment

There are many treatments for tinnitus that have been claimed, with varying degrees of statistical reliability:

Objective tinnitus:

  • Gamma knife radiosurgery (glomus jugulare)[33]
  • Shielding of cochlea by teflon implant[34]
  • Botulinum toxin (palatal tremor)[35]
  • Propranolol and clonazepam (arterial anatomic variation)[36]
  • Clearing ear canal (in the case of earwax plug)[37]

Subjective tinnitus:

  • Drugs and nutrients
    • Ginkgo biloba[38]
    • Lidocaine, injection into the inner ear found to suppress the tinnitus for 20 minutes, according to a Swedish study.[39]
    • Benzodiazepines (lorazepam, clonazepam) in small doses
    • Tricyclics (amitriptyline, nortriptyline) in small doses [40]
    • Avoidance of caffeine, nicotine, salt[41][42][43]
    • The consumption of alcohol has been found to both increase and decrease the severity of tinnitus. Therefore, alcohol's effect on the severity of tinnitus is dependent on the causes of the individual's affliction and cannot be considered a treatment.[43][44]
    • Zinc supplementation (where serum zinc deficiency is present)[45][46][47]
    • Acamprosate[48]
    • Etidronate or sodium fluoride (otosclerosis)[49]
    • Lignocaine or anticonvulsants (usually in patients responsive to white noise masking)[50]
    • Carbamazepine[51]
    • Melatonin (especially for those with sleep disturbance)[52]
    • Sertraline[53]
    • Vitamin combinations (Lipoflavonoid)[54]
  • Electrical stimulation
    • Transcranial magnetic stimulation or transcranial direct current stimulation[55][56]
    • Transcutaneous electrical nerve stimulation[57]
    • Direct stimulation of auditory cortex by implanted electrodes[58]
    • Berthold Langguth, German neurologist would apply an electric or magnetic current for stimulation over the head of the patient to reduce ringing sound. Dirk De Ridder, Belgian neurosurgeon implanted electrodes to the brain of sufferers to normalise overactive neurons. Cambridge scientists also found that lidocaine, an anaesthetic reduces the sound in 2/3 of patients for 5 minutes, but it needs another drug to suppress its dangerous effects.[59]
  • Surgery
    • Repair of perilymph fistula[60]
  • External sound
  • Psychological

Notable individuals with tinnitus

Notable sufferers of tinnitus include:

See also

References

  1. ^ American Tinnitus Association | Home | Help For Ringing In The Ears
  2. ^ Dictionary of tinnitus - Merriam-Webster Online Dictionary
  3. ^ Guidelines for the Grading of Tinnitus Severity
  4. ^ Demeester K, van Wieringen A, Hendrickx JJ, Topsakal V, Fransen E, Van Laer L, De Ridder D, Van Camp G, Van de Heyning P. (2007).Prevalence of tinnitus and audiometric shape. B-ENT. 3 Suppl 7:37-49. PMID 18225607
  5. ^ RNID.org.uk: Information and resources: Tinnitus: About tinnitus: What is tinnitus
  6. ^ MedlinePlus Encyclopedia Ear noises or buzzing
  7. ^ Simmons R, Dambra C, Lobarinas E, Stocking C, Salvi R. (2008). Head, Neck, and Eye Movements That Modulate Tinnitus. Semin Hear. 29(4):361-370. PMID 19183705
  8. ^ a b Nicolas-Puel C, Faulconbridge RL, Guitton M, Puel JL, Mondain M, Uziel A. (2002). Characteristics of tinnitus and etiology of associated hearing loss: a study of 123 patients.Int Tinnitus J. 8(1):37-44. PMID 14763234
  9. ^ a b König O, Schaette R, Kempter R, Gross M. (2006). Course of hearing loss and occurrence of tinnitus. Hear Res. 221(1-2):59-64. PMID 16962270
  10. ^ a b Schaette R, Kempter R. (2006). Development of tinnitus-related neuronal hyperactivity through homeostatic plasticity after hearing loss: a computational model. Eur J Neurosci. 23(11):3124-38. PMID 16820003
  11. ^ Holgers KM, Pettersson B (2005). "Noise exposure and subjective hearing symptoms among school children in Sweden". Noise & Health 7 (27): 27–37. PMID 16105247. http://openurl.ingenta.com/content/nlm?genre=article&issn=1463-1741&volume=7&issue=27&spage=27&aulast=Holgers. 
  12. ^ Newman CW, Jacobson GP, Spitzer JB (Feb 1996). "Development of the Tinnitus Handicap Inventory". Arch Otolaryngol Head Neck Surg. 122 (2): 143–8. PMID 8630207. 
  13. ^ Berrios G E & Rose G S (1992) Psychiatry of subjective tinnitus: conceptual, historical and clinical aspects. Neurology, Psychiatry and Brain Research 1: 76-82
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Books

  • Laurence McKenna; Gerhard Andersson; Baguley, David (2005). Tinnitus: A Multidisciplinary Approach. Whurr Publishers, Ltd. ISBN 1-86156-403-1. 

External links

v • d • e
Diseases of the ear and mastoid process (H60-H99, 380-389)
External ear
Middle ear and mastoid
Inner ear
Hearing impairment
Other
Deafblindness
see also congenital

This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)

 
Translations: Tinnitus
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Home > Library > Literature & Language > Translations

Dansk (Danish)
n. - tinnitus (øresygdom)

Nederlands (Dutch)
oorsuizing

Français (French)
n. - bourdonnement d'oreilles, acouphène

Deutsch (German)
n. - Ohrensausen

Ελληνική (Greek)
n. - (παθολ.) βόμβος (βούισμα των αφτιών)

Italiano (Italian)
ronzio

Português (Portuguese)
n. - zunido (m), zumbido (m)

Русский (Russian)
(мед.) шум в ушах

Español (Spanish)
n. - zumbido en los oídos

Svenska (Swedish)
n. - tinnitus (med.)

中文（简体）(Chinese (Simplified))
耳鸣

中文（繁體）(Chinese (Traditional))
n. - 耳鳴

한국어 (Korean)
n. - 이명, 귀울음

日本語 (Japanese)
n. - 耳鳴り

العربيه (Arabic)
‏(الاسم) طنين ألأذن‏

עברית (Hebrew)
n. - ‮צלצול באוזן‬

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