Demystifying Tinnitus: A Complete Overview of Causes and Treatments

Have you ever heard an unfamiliar sound and then realized there was no external sound source present? Then there is a likely chance you have experienced a form of tinnitus!

Most individuals will experience a temporary version of tinnitus throughout their lives, whether it be after a loud rock concert, working near loud machinery, the results of severe cold and/or ear infection, or even after a big night of drinking too much alcohol.

Unfortunately, these sounds become permanent for many people, with an estimated 17% of the Australian population suffering from tinnitus. Although tinnitus is often not harmful to the individual, there are times when it can become a concern, particularly when other symptoms accompany tinnitus.

Read on as we discuss everything about tinnitus, its common causes, symptoms, and how we can help you with treatment options available in our clinic.

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What Is Tinnitus?

Tinnitus is commonly defined as the perception of a sound in the absence of an external sound source. Our patients frequently describe it as a ringing, buzzing, whooshing, clicking, hissing, or pulsating sound heard in one or both ears.

The type and intensity of the noises vary from person to person. The noise might be faint or loud, and it can occur in either one or both ears. Tinnitus can be temporary or permanent, depending on the cause. It may be accompanied by other symptoms such as hearing loss, dizziness, pain, a feeling of fullness, or increased pressure.

For many, the symptoms are mild, and most patients accept that the noise is present and learn to self-manage the symptoms. In contrast, the symptoms can be much more severe for some, and the condition can significantly impact their quality of life.

Types of Tinnitus:

Tinnitus is typically categorized into three categories; subjective tinnitus, objective tinnitus, and somatic tinnitus.

Subjective tinnitus

The most common type of tinnitus is subjective. It is characterized by sounds that the affected person can only hear. It is generally linked to sensorineural and conductive hearing loss and can be caused by an abnormality within the auditory system. Subjective tinnitus can be either temporary or permanent in nature.

Somatic tinnitus

Somatic tinnitus, also known as sensorimotor tinnitus, occurs due to specific body movements such as exerting pressure on the head and neck, clenching the jaw, and turning the eyes, affecting the intensity regularity of the noise.

Objective tinnitus

Objective tinnitus is a rare type of tinnitus and is also commonly referred to as pulsatile tinnitus. This type of tinnitus presents as a rhythmic pulsing in the ear, usually in time with your heartbeat. Your hearing specialist may be able to hear it by pressing a stethoscope on your neck or inserting a small microphone into your ear canal.

Pulsatile tinnitus is most frequently caused by blood flow issues or pressure within the head or neck. Although not always concerning, if you are experiencing this type of tinnitus, further investigation into the cause is recommended as it can be a symptom associated with more severe medical conditions such as brain tumours or structural abnormalities in the head, neck, or brain.

Common Symptoms of Tinnitus:

Tinnitus is most commonly described as a ringing in the ears. But it can present itself in a wide range of different sounds. Some common terms used are:

  • Buzzing
  • Roaring
  • Clicking
  • Humming
  • Ringing
  • Whooshing
  • Hissing
  • Music

Tinnitus is not a medical condition but rather a “symptom” of an underlying condition. Most commonly it is caused by issues related to the auditory pathway (hearing system), which includes the outer, middle and inner ear, including the retro-cochlear pathway.

Causes of Tinnitus:

Given that it is a symptom, it is possible that it can be corrected if the condition that is causing it is treated. Below we will outline some of the more common conditions that are associated with tinnitus.

Noise-Induced Hearing Loss

Noise-induced hearing loss, as the name suggests, occurs as a result of exposure to loud noises. This type of hearing loss commonly occurs over time, generally due to exposure to loud machinery or tools through work-related activities. On occasion, noise-induced hearing loss has been known to occur even after exposure to a single sound source, such as a bomb blast or firearm use.

As noise-induced hearing loss commonly affects the higher frequencies of the hearing range, a common symptom accompanied by the loss is tinnitus.

Cerumen Occlusion (Earwax)

Earwax, also known as cerumen, is your ears’ natural protective tool that cleans and clears the ear canal, removing dirt and preventing bacterial growth. For most people, this process works as intended, but for some, it is compromised, which in turn results in a build-up of wax in the canal, often leading to a blockage.

When the wax builds up in the ear canal, the increased pressure can cause tinnitus symptoms. This will typically be temporary and disappear once the obstruction has been removed by either a doctor or hearing care professional.

Head Trauma

An injury or trauma to the head or ears may cause damage to the auditory pathway. Damage can occur to the little bones in the middle ear, impacting the delicate hair cells in the inner ear or damaging the auditory nerve leading to the brain.

Side Effect of Medication

Various medications can also cause or aggravate tinnitus symptoms. The tinnitus generally worsens as the dose of these drugs increases and will typically subside when the medication is reduced or discontinued.

Some common medications that can cause tinnitus include anti-inflammatory drugs, antibiotics, cancer medications, water pills (diuretics), antimalarial treatments, and antidepressants.

Ear Infection

Ear infections such as otitis media and otitis externa may result in the occurrence of tinnitus symptoms. This is typically due to an infected blockage in the outer or middle ear, causing a change in the pressure in the ear.

Otosclerosis

Otosclerosis is a condition that occurs due to abnormal bone growth within the middle ear that results in the fixation of the stapes bone, causing a conductive hearing loss. Along with hearing loss, another common symptom of this condition is tinnitus.

Meniere’s Disease

Meniere’s disease is a condition that affects the inner ear and is caused by abnormal fluid pressure within the inner ear system. This condition typically causes severe dizziness (vertigo), increased hearing loss and aggravated tinnitus symptoms.

Acoustic Neuroma

An acoustic neuroma is a non-malignant (benign) tumour that grows around the auditory nerve that connects your inner ear to the auditory cortex in the brain. As the tumour grows, it constricts the auditory nerve, affecting the transfer of sound from the inner ear to the brain. Tinnitus symptoms are common in people with acoustic neuromas and will typically be noticeable in the affected ear only.

Aging Process (Presbycusis)

Hearing loss is commonly associated with the ageing process. As we age, the delicate hair cells in the inner ear collapse, causing what we commonly refer to as age-related hearing loss. Approximately one in six people who experience hearing loss will also experience tinnitus. Commonly, once the hearing loss is treated, whether through a medical procedure or hearing aids, the tinnitus symptoms disappear.

Stress 

An increase in stress levels can bring on tinnitus symptoms or increase the intensity of the current symptom you may already be experiencing. This will usually be a temporary type of tinnitus and subside or disappear once the stress levels are reduced.

Sex 

Men are more prone than women to experience tinnitus symptoms.

Treatment for Tinnitus:

Treatment starts with determining what is causing the tinnitus symptom. The first step is to have a full comprehensive hearing test with a hearing professional who will conduct a thorough case history and perform a hearing assessment to determine the likely source of the tinnitus symptoms.

Unfortunately, there is no magic pill that can be taken to cure tinnitus directly. If the underlying medical issue causing the tinnitus can be discovered and treated, the overall effect of the tinnitus can usually be reduced or corrected with treatment. For example, if the tinnitus is caused as a result of excessive ear wax, then once it is removed, the tinnitus should disappear. For some, tinnitus may be permanent, and there are a number of treatment options available to assist with managing the symptoms.

Independent Hearing specializes in tinnitus management programs and treatment for all types of hearing loss. Call us at 08 8004 0077 today for a FREE Hearing Assessment with one of our hearing specialists!

Below we have listed some common treatments for tinnitus:

Hearing aids

Tinnitus can often be a direct symptom of hearing loss. When the hearing loss is treated through the use of hearing aids, the tinnitus symptoms are often reduced or removed. Typically, in the early stages, the tinnitus is not noticeable while the user is wearing the hearing aids, and over longer periods of time with regular hearing aid use, it can disappear completely.

Cerumen Removal (Earwax)

If the tinnitus symptoms are a direct result of wax occlusion, then the tinnitus symptoms can be removed by reducing or removing the wax. If considering wax removal, it is recommended that you seek treatment from your doctor or hearing care professional first to determine the best option for removal. If the procedure is not done correctly, it could further damage the auditory pathway.

Sound Therapy

Sound therapies can be used in order to divert the patient’s attention away from their tinnitus symptoms. They are designed to replace the sounds of tinnitus with another sound that may be more tolerable to the individual. This treatment is commonly used to assist patients in falling asleep, often by playing soft natural sounds in order to divert the individual’s attention away from the tinnitus, allowing them to fall asleep.

Many hearing aids have built-in tinnitus management programmes and sound generators that can be used as part of the tinnitus management program.

Behavioural Therapy 

This type of therapy primarily focuses on your responses to tinnitus. Behavioural therapy may be beneficial in minimizing stress and anxiety associated with tinnitus and improving your general quality of life. Behavioural treatment includes a variety of techniques, such as:

  • Cognitive behavioural therapy
  • Acceptance and commitment therapy
  • Mindfulness-based stress reduction
  • Tinnitus management:
  • Tinnitus treatment

Tinnitus retraining therapy (TRT) is another type of behavioural therapy that can reprogram the way your brain responds to tinnitus. This can assist you in tuning out and being less aware of the sounds. Tinnitus retraining therapy combines counselling, sound therapy, and the use of a noise-generating device such as a hearing aid. However, this therapy will only be effective if you invest sufficient time and effort.

Frequently Asked Questions About Tinnitus:

Below we will answer some of the most common questions asked about tinnitus.

Does tinnitus go away?

Tinnitus will typically subside on its own in the majority of cases. Within 16 to 48 hours, your hearing should return to normal. However, if your tinnitus persists, you will need to seek treatment. The first step is to have a hearing test to determine whether underlying auditory factors may contribute to the symptoms.

When should I see a doctor or a hearing specialist?

Generally, if the tinnitus symptoms last more than 48 hours, then you should consider seeking advice from a doctor or hearing care professional. If your tinnitus is accompanied by other symptoms such as the ones below, then immediate medical attention is recommended:

  • You are experiencing anxiety and depression due to tinnitus symptoms.
  • Tinnitus is accompanied by dizziness/vertigo and reduced hearing.
  • Facial Paralysis
  • Pulsatile tinnitus
  • Any pain or discomfort is experienced along with tinnitus.

What can I do to prevent tinnitus?

Noise-induced hearing loss is one of the most common causes of tinnitus. Anything you can do to minimize that exposure will assist in minimizing your risk of developing tinnitus. Some common ways to reduce noise exposure are the use of hearing protection such as earplugs or ear muffs or by simply removing the noise source altogether.

Dietary factors also play a part in tinnitus and aggravation of the symptom. If you experience tinnitus, try to reduce your nicotine, caffeine, and alcohol consumption, as they are all common contributors to tinnitus.

If your tinnitus results from your hearing loss, the best thing you can do is treat the loss to reduce the symptoms. The extra auditory stimulation from the hearing aids will assist with reducing and often removing the symptom altogether.

How is tinnitus diagnosed?

Typically, tinnitus is diagnosed only based on your reported symptoms. The severity of tinnitus can be determined by using specifically designed tinnitus questionnaires that ask a number of questions in relation to the effect of tinnitus on your lifestyle.

Does tinnitus go away on its own?

Tinnitus frequently disappears on its own, depending on the cause. As a general rule, if the tinnitus has occurred for more than 48 hours or is significantly affecting your lifestyle, then you should seek advice from a hearing care professional.

What does tinnitus sound like?

Tinnitus can be described in various ways; patients often describe the sound as ringing, buzzing, hissing, whooshing or whizzing. It can range in intensity from mild to moderate to severe, and come in a range of different pitches, from deep low-pitched tones to higher high-pitched tones.

Can earwax cause tinnitus?

When the wax builds up in the ear canal, the increased pressure can cause tinnitus symptoms for the individual. This will typically be temporary and disappear once the obstruction has been removed by a doctor or hearing care professional.

Can a hearing aid stop tinnitus?

According to a 2007 survey of healthcare providers published in The Hearing Review, over 60% of people with tinnitus reported relief from their symptoms by use of a hearing aid. Around 22% had significant improvement.

Can tinnitus be cured naturally?

Currently, there is no known natural cure for tinnitus. Depending on the cause of your tinnitus, it may be possible to reduce the symptoms by improving your diet and/or removing stimulants such as caffeine, alcohol, or nicotine. If your tinnitus is caused by stress, then mediation and stress reduction activities may improve the symptoms.

Final Thoughts:

As you can see from today’s article, there are a number of different causes and treatment options available to assist you with your tinnitus.

Like always, the first step is to seek advice. If you or someone you know is experiencing tinnitus symptoms, then we recommend you come to speak with one of our hearing care professionals for some further advice on your specific situation.

Remember, you don’t necessarily have to live with it. There is likely a treatment option available for you.

Independent Hearing specializes in all forms of hearing rehabilitation, including tinnitus management programs. Our expert team of specialists works with our patients and designs individually tailored programmes to assist their specific hearing needs and goals.

If you would like any more information on what has been discussed in today’s article or for any other hearing-related assistance, then feel free to contact our specialists. We provide FREE consultations for all patients and are fully accredited by the government’s office of hearing services programme to provide fully subsidized services to pension and DVA cardholders. Give us a call today at 08 8004 0077!

Luke Argent
Luke Argent
Luke is a Co-founder/Director and Senior Audiometrist at Independent Hearing and graduated with a Diploma of Audiometry in 2018. He holds a Qualified Practitioner (QP) number with the Federal Government’s Hearing Services Program. Luke has been involved with the hearing industry since 2015 when he co-founded the business ‘Eyre Hearing’. Due to an expansion of the business in 2020 it was rebranded to its current name ‘Independent Hearing’.

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