What is tinnitus?
Tinnitus is the perception or sensation of a sound in either one or both ears. A clear identifiable cause is usually absent. The nature of the sound may vary: it could be perceived as a hissing, whistling, ringing, clicking, humming or buzzing sound. It may be pulsating and follow the heart beat (pulsating tinnitus). It is usually noticed by the patient only (subjective tinnitus) but in some instances bystanders, listening closely, may also hear it (objective tinnitus).
How common is tinnitus?
Tinnitus is so common that nearly every person experiences it from time to time. It is estimated that approximately 15%-20% of the population is bothered by it. Many of these patients seek medical advice. It is more common in elderly patients. and those patients suffering from hearing loss.
Which conditions may lead to tinnitus?
Tinnitus is not a specific disease but rather a symptom of an underlying condition, although in many cases, and underlying cause cannot be determined. Fortunately, it is usually not serious. In rare cases it may be caused by more serious conditions. The most common causes of tinnitus include hearing loss, loud noise exposure, ear wax, ear disease, high blood pressure, atherosclerosis, certain medication, and stress.
How is tinnitus generated.
It is currently believed that tinnitus is a consequence of modified neural activity in the central auditory system of the brain. This occurs in response to damage in the peripheral hearing structures such as the hair cells of the cochlea or the auditory nerve.
The vicious cycle.
The manner in which a person experiences tinnitus and the amount of attention paid to it, varies from individual to individual. Basically, in patients where the tinnitus is mostly ignored, it almost “blends” into the background. On the other hand, if it receives attention, it can become “strong” take control; if this continues for an extended period of time, the brain will learn to focus on it, even when other background sounds are present.
Continuous tinnitus can cause anxiety and stress in many individuals. Once the negative connection is established, a cycle can begin that affects other regions of the brain, including the limbic system (involved in processing emotions) and the autonomic nervous system (physical/bodily reactions).
This is commonly known as the vicious cycle. When tinnitus is perceived, it can prompt a number of emotional reactions such as fear, a feeling of danger, unhappiness, etc. These can in turn cause physical reactions such as anxiety, stress, fatigue thus reinforcing the tinnitus and making the cycle repeat itself.
Treatments for tinnitus.
Tinnitus treatment can be a dilemma for clinicians and patients. In the middle ear, hearing loss, abnormal blood vessels or inappropriate muscle twitching may be surgically corrected. Conventional hearing aids and implantable hearing solutions may also help to suppress tinnitus in addition to amplifying sound.
Sensorineural tinnitus involves the cochlea and/or neural pathways. Although there is currently no approved cure, it does not mean that nothing can be done. Sometimes treatment of underlying pathology can improve tinnitus. However, for the vast majority of tinnitus sufferers, there is no surgical option or magic drug.
It is important to distinguish the tinnitus from the reactions to the tinnitus. It is possible to treat a person’s reaction to tinnitus. There is a variety of counselling strategies available including cognitive behaviour modification involving relaxation exercises, acceptance and sensory meditation. Often patients report that they benefit from sound therapy or sound enrichment.
Tinnitus and implantable hearing solutions
Current research indicates tinnitus is caused by changes in the cochlea’s nerve activity caused by reduced auditory input. If that is the case, what will happen if you increase that auditory input and restart neural activity? This is exactly what a cochlear implant does: it sends sound information to the nerve cells of the cochlea. Several studies have shown that although cochlear implants might not be a 100 % cure for tinnitus, they can help to suppress tinnitus.
Cochlear implants are not designed to treat just tinnitus, but for someone with both hearing loss and tinnitus, receiving and using a cochlear implant can reduce or even eliminate perceived tinnitus.
It is important to note that tinnitus won’t necessarily disappear immediately after receiving a cochlear implant. It can take between three to six months to arrive at a point where tinnitus is effectively managed.
Always remain positive. Severe tinnitus is difficult to live with, but there are professionals out there who can help you. Together you can find a successful solution.