Individuals were recruited from within and around Hamilton, Ontario via online announcements and audiology clinics. Applicants were initially interviewed via telephone to screen for all inclusion and exclusion criteria for the study in order to determine whether they qualified for on-site screening. The on-site screening, and characterization of participants’ hearing thresholds and tinnitus profiles were conducted in a lab at McMaster University using a computer-based tinnitus assessment tool. Participants were randomly allocated to the treatment or placebo-control group. The assignment of the treatment or placebo music package was completed by a distributor site independent of the research study site. Participants and research personnel were blinded to which music package the participants received.
Tinnitus (pronounced ti-ni-tis), or ringing in the ears, is the sensation of hearing ringing, buzzing, hissing, chirping, whistling, or other sounds. The noise can be intermittent or continuous, and can vary in loudness. It is often worse when background noise is low, so you may be most aware of it at night when you're trying to fall asleep in a quiet room. In rare cases, the sound beats in sync with your heart (pulsatile tinnitus).
If the cause of your tinnitus is excessive earwax, your doctor will clean out your ears by suction with a small curved instrument called a curette, or gently flush it out with warm water. If you have an ear infection, you may be given prescription ear drops containing hydrocortisone to help relieve the itching and an antibiotic to fight the infection.
Tinnitus can arise anywhere along the auditory pathway, from the outer ear through the middle and inner ear to the brain's auditory cortex, where it's thought to be encoded (in a sense, imprinted). One of the most common causes of tinnitus is damage to the hair cells in the cochlea (see "Auditory pathways and tinnitus"). These cells help transform sound waves into nerve signals. If the auditory pathways or circuits in the brain don't receive the signals they're expecting from the cochlea, the brain in effect "turns up the gain" on those pathways in an effort to detect the signal — in much the same way that you turn up the volume on a car radio when you're trying to find a station's signal. The resulting electrical noise takes the form of tinnitus — a sound that is high-pitched if hearing loss is in the high-frequency range and low-pitched if it's in the low-frequency range. This kind of tinnitus resembles phantom limb pain in an amputee — the brain is producing abnormal nerve signals to compensate for missing input.
Although mitochondrial DNA variants are thought to predispose to hearing loss, a study of polish individuals by Lechowicz et al, reported that "there are no statistically significant differences in the prevalence of tinnitus and its characteristic features between HL patients with known HL mtDNA variants and the general Polish population." This would argue against mitochondrial DNA variants as a cause of tinnitus, but the situation might be different in other ethnic groups.
There seems to be a two-way-street relationship between tinnitus and sleep problems. The symptoms of tinnitus can interfere with sleeping well—and poor sleep can make tinnitus more aggravating and difficult to manage effectively. In the same study that found a majority of people with tinnitus had a sleep disorder, the scientists also found that the presence of sleep disorders made tinnitus more disruptive.
Most of the causes of tinnitus alter neurological activity within the auditory cortex, the portion of the brain responsible for hearing. The transmission of sound is interrupted, so some of the neural circuits fail to receive signals. Instead of causing hearing loss, as you might expect due to the lack of stimulation, the neural circuits begin chattering. First, they chatter alone. Then, they become hyperactive and synchronous. When we experience this deviation, our brains attempt to compensate for the change by interpreting the neurological activity as sound. This can resemble ringing, buzzing, hissing, whistling, or roaring, amongst a variety of other noises.
Ear canal obstructions, infections, injuries or surgeries. This can include ossicle dislocation within the ear that affects hearing or recurring ear infections (like swimmer’s ear) either in the outside or inside of the ear canal (otitis media or otitis externa). Other ear disorders tied to tinnitus include otosclerosis (causes changes to the bones inside the ears), tympanic membrane perforation or labrynthitis (chronic infections or viruses that attack tissue in the ears).
Tinnitus habituation therapies, such as tinnitus retraining therapy (TRT), involve using low level sounds in a graduated fashion to decrease the perception of tinnitus. This differs from use of masking devices such as described earlier. TRT involves a wearable device that an affected individual can adjust so that the level of sound emitting from the device is about equal to or matches the tinnitus sound. This may be called the “mixing point” because the sound from the device and the tinnitus sound begin to mix together. An affected individual must repeatedly adjust the device so that the sound is at or just below the mixing point. TRT is supported by counseling with a trained professional who can teach the individual the proper techniques to maximize the effectiveness of TRT. Eventually, by following this method, affected individuals no longer need the external sound generating device. Affected individuals will become accustomed to the tinnitus sound (habituation), except when they choose to focus on it. Even then the sound will not be bothersome or troubling. The theory is akin to a person’s ability to ignore sounds such as the hum of air conditioner, the refrigerator motor turning on, or raindrops falling on the roof when driving a car in the rain.
MRI (or magnetic resonance imaging) scan is a radiology technique which uses magnetism, radio waves, and a computer to produce images of body structures. MRI scanning is painless and does not involve X-ray radiation. Patients with heart pacemakers, metal implants, or metal chips or clips in or around the eyes cannot be scanned with MRI because of the effect of the magnet.
Tinnitus usually comes in the form of a high-pitched tone in one or both ears, but can also sound like a clicking, roaring or whooshing sound. While tinnitus isn't fully understood, it is known to be a sign that something is wrong in the auditory system: the ear, the auditory nerve that connects the inner ear to the brain, or the parts of the brain that process sound. Something as simple as a piece of earwax blocking the ear canal can cause tinnitus, but it can also arise from a number of health conditions. For example, when sensory cells in the inner ear are damaged from loud noise, the resulting hearing loss changes some of the signals in the brain to cause tinnitus.
From amongst the many treatments for tinnitus, you’re certain to find a solution that helps you live a more comfortable life, free of the frustration of tinnitus. Although a definitive cure is not currently available, these tools can help you manage your tinnitus and minimize its influence on your life. If you work closely with an experienced tinnitus specialist, they can help you determine which course of action is best for you.
Currently there is no cure for most cases of tinnitus. Depending on the type of tinnitus, symptoms will tend to come and go over time. Stress level, diet, and exposure to noise can worsen tinnitus. Many people find their tinnitus annoying but can learn to adapt without difficulty. It is likely that if you have had tinnitus, you will have it again in the future.
Loud noise is the leading cause of damage to the inner ear. Most patients with noise trauma describe a whistling tinnitus (Nicholas-Puel et al,. 2002). In a large study of tinnitus, avoidance of occupational noise was one of two factors most important in preventing tinnitus (Sindhusake et al. 2003). The other important factor was the rapidity of treating ear infections.
Cognitive Behavior Therapy (CBT) / Hypnotherapy. Another alternative treatment option worth considering is Cognitive Behavior Therapy (CBT), which is often simply referred to as hypnotherapy. The goal of CBT is to help lower any anxiety, anger or depression you are feeling toward your tinnitus, as well as to help retrain your brain to notice the ringing in your ears less. CBT is typically used in conjunction with sound stimulation therapies, like Neuromonics or Transcranial Magnetic Stimulation (TRT). When choosing your therapist, be sure they not only do they have previous experience working with patients with tinnitus, but also have Neural Linguistic Programming (NLP) training.
Tinnitus can be extremely frustrating and can leave you feeling overwhelmed and unsure about your next steps. Remember that you are not alone - tinnitus, while not well-understood, is common. Make an appointment with a hearing care professional near you, preferably one who specializes in tinnitus treatment. Be prepared to discuss your symptoms in detail so you can get relief and regain your quality of life.
The sound you hear is actually being generated by the part of your ear known as the cochlea. It’s a very complicated organ with sensory hairs, internal fluid and nerve receptors, that when damaged (or as it naturally degrades as you get older), can cause it to send incorrect input into your brain. In layman’s terms, because it’s no longer working as well as it used to, it thinks there’s a ringing sound in the area and tells your brain to generate that sound in your head. There are other symptoms of tinnitus, but this is the main one.
While it’s definitely not a cure by any stretch of the imagination, if your tinnitus does not respond to Tinnitus Control, nor is there any identifiable underlying medical condition, then an effective way to drown out the sounds in your head is via noise suppression devices. These sound generators, in essence, mask the sounds of tinnitus so that you notice them less and can go about your daily life without going crazy over the annoying buzzing, whistling or ringing in your ears.
At Sound Relief Hearing Center, we utilize a variety of evidence-based tinnitus treatment options. Most audiologists only offer one solution, hearing aids, which are ineffective in many cases. To treat each unique case of tinnitus, we utilize a variety of innovative technologies and therapies, including Tinnitus Retraining Therapy (TRT). For more information about your tinnitus treatment options, visit our page Tinnitus Treatment. If you’re worried that you won’t ever escape the ringing in your ears, check out our page Tinnitus Success Stories. Finally, follow our Tips from Tinnitus Experts to avoid exacerbating the problem.
Medications, Prescription Drugs and Food Additives. Other external irritants that can cause tinnitus are over the counter medications and prescriptions. Even something as simple as aspirin can generate tinnitus. I have experienced this throughout my lifetime. I take aspirin only when I absolutely need it. Certain antibiotics and other prescription drugs are also known to cause tinnitus. Two very common ones that have shown to cause tinnitus are quinine and chloroquine which are in malaria medications. Certain diuretics and cancer medications can also cause tinnitus. Although not a drug, NutraSweet has been linked to tinnitus and a whole host of side effects in clinical studies.
The use of sound therapy by either hearing aids or tinnitus maskers helps the brain ignore the specific tinnitus frequency. Although these methods are poorly supported by evidence, there are no negative effects. There is some tentative evidence supporting tinnitus retraining therapy. There is little evidence supporting the use of transcranial magnetic stimulation. It is thus not recommended. As of 2017 there was limited evidence as to whether neurofeedback is or is not helpful.
Tinnitus is commonly thought of as a symptom of adulthood, and is often overlooked in children. Children with hearing loss have a high incidence of tinnitus, even though they do not express the condition or its effect on their lives. Children do not generally report tinnitus spontaneously and their complaints may not be taken seriously. Among those children who do complain of tinnitus, there is an increased likelihood of associated otological or neurological pathology such as migraine, juvenile Meniere’s disease or chronic suppurative otitis media. Its reported prevalence varies from 12% to 36% in children with normal hearing thresholds and up to 66% in children with a hearing loss and approximately 3–10% of children have been reported to be troubled by tinnitus.
Acoustic neuroma: This is a rare subjective cause of tinnitus, and includes a certain type of brain tumor known as an acoustic neuroma. The tumors grow on the nerve that supplies hearing and can cause tinnitus. This type of the condition usually are only noticed in one ear, unlike the more common sort caused by hearing loss usually seen in both ears. Causes of objective tinnitus are usually easier to find.
Prolonged exposure to loud sounds is the most common cause of tinnitus. Up to 90% of people with tinnitus have some level of noise-induced hearing loss. The noise causes permanent damage to the sound-sensitive cells of the cochlea, a spiral-shaped organ in the inner ear. Carpenters, pilots, rock musicians, street-repair workers, and landscapers are among those whose jobs put them at risk, as are people who work with chain saws, guns, or other loud devices or who repeatedly listen to loud music. A single exposure to a sudden extremely loud noise can also cause tinnitus.