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.
The important thing to remember about tinnitus is that the brain’s response to these random electrical signals determines whether or not a person is annoyed by their tinnitus or not. Magnetoencephalography (MEG, for short) studies have been used to study tinnitus and the brain. MEG takes advantage of the fact that every time neurons send each other signals, their electric current creates a tiny magnetic field. MEG allows scientists to detect such changing patterns of activity in the brain 100 times per second. These studies indicated tinnitus affects the entire brain and helps with understanding why certain therapies are more effective than others.
When there does not seem to be a connection with a disorder of the inner ear or auditory nerve, the tinnitus is called nonotic (i.e. not otic). In some 30% of tinnitus cases, the tinnitus is influenced by the somatosensory system, for instance people can increase or decrease their tinnitus by moving their face, head, or neck. This type is called somatic or craniocervical tinnitus, since it is only head or neck movements that have an effect.
This study has several strengths. It included a relatively large number of patients, reducing the possibility of bias by “masking” which treatment patients received, classifying participants according to the severity of their tinnitus and using highly standardised interventions. Also, the researchers used established scales to measure the severity of tinnitus and its impact on quality of life.
^ Jump up to: a b Schecklmann, Martin; Vielsmeier, Veronika; Steffens, Thomas; Landgrebe, Michael; Langguth, Berthold; Kleinjung, Tobias; Andersson, Gerhard (18 April 2012). "Relationship between Audiometric Slope and Tinnitus Pitch in Tinnitus Patients: Insights into the Mechanisms of Tinnitus Generation". PLOS One. 7 (4): e34878. Bibcode:2012PLoSO...734878S. doi:10.1371/journal.pone.0034878. PMC 3329543. PMID 22529949.
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.
Tinnitus is not a disease in and of itself, but rather a symptom of some other underlying health condition. In most cases, tinnitus is a sensorineural reaction in the brain to damage in the ear and auditory system. While tinnitus is often associated with hearing loss, there are roughly 200 different health disorders that can generate tinnitus as a symptom. Below is a list of some of the most commonly reported catalysts for tinnitus.
Some persons with severe TMJ (temporomandibular joint) arthritis have severe tinnitus. Generally these persons say that there is a "screeching" sound. This is another somatic tinnitus. TMJ is extremely common -- about 25% of the population. The exact prevalence of TMJ associated tinnitus is not established, but presumably it is rather high too. Having TMJ increases the odds that you have tinnitus too, by about a factor of 1.6-3.22 (Park and Moon, 2014; Lee et al, 2016). This is the a large risk factor for tinnitus, similar to the risk from hearing loss (see table above).
Widex employs fractal tone technology, so that the sounds you hear are predictable but not repeating. Your audiologist can choose between an assortment of “musical tones” known as “Zen styles,” which are random and chime-like. Your audiologist can adjust the tones’ pitch, tempo, and volume. If employed correctly, Widex Zen Therapy can help re-wire your brain and make your tinnitus less noticeable.
Repetitive transcranial magnetic stimulation (rTMS). This technique, which uses a small device placed on the scalp to generate short magnetic pulses, is already being used to normalize electrical activity in the brains of people with epilepsy. Preliminary trials of rTMS in humans, funded by the NIDCD, are helping researchers pinpoint the best places in the brain to stimulate in order to suppress tinnitus. Researchers are also looking for ways to identify which people are most likely to respond well to stimulation devices.
None of these treatment options are supported by science. Many people are convinced that the herb gingko biloba is helpful, however large-scale studies have been unable to prove this. There are many nutritional supplements claiming to be tinnitus remedies. These are usually a combination of herbs and vitamins, often including zinc, ginkgo, and vitamin B-12.
Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
Exposure to Loud Noise: Exposure to loud or excessive noise can damage or destroy hair cells (cilia) in the inner ear. Because the hair cells cannot be renewed or replaced, this can lead to permanent hearing loss and/or tinnitus. Continued exposure can worsen these conditions, so people who work in loud environments should always wear ear protection. This includes musicians, air traffic controllers, construction workers, military personnel, and first responders. In addition, consider lowering the volume on your iPod and wearing earplugs at loud concerts.
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