Pulsatile tinnitus: This problem usually is related to blood flow, either through normal or abnormal blood vessels near the ear. Causes of pulsatile tinnitus include pregnancy, anemia (lack of blood cells), overactive thyroid, or tumors involving blood vessels near the ear. Pulsatile tinnitus also can be caused by a condition known as benign intracranial hypertension (an increase in the pressure of the fluid surrounding the brain).
The most common noise is the sound of rapid or turbulent blood flow in major vessels of the neck. This abnormal blood flow may occur because of a reduced red blood cell count (anemia) or a blockage of the arteries (atherosclerosis) and may be worsened in people with poorly controlled high blood pressure (hypertension). Some small tumors of the middle ear called glomus tumors are rich in blood vessels. Although the tumors are small, they are very near the sound-receiving structures of the ear, and blood flow through them can sometimes be heard (only in one ear). Sometimes, blood vessel malformations that involve abnormal connections between arteries and veins (arteriovenous malformations) develop in the membrane covering the brain (the dura). If these malformations are near the ear, the person sometimes can hear blood flowing through them.
Almost every ENT, audiology practice, and hearing aid dispenser who claims to offer tinnitus treatment only offers one solution: hearing aids. While amplification may help some, only 50% of people living with tinnitus experience hearing loss that affects their understanding of speech, which means hearing aids are ineffective. At Sound Relief, we offer only evidence-based options like sound therapy and have seen countless patients experience life-changing results.
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.
Noise exposure. Exposure to loud noises can damage the outer hair cells, which are part of the inner ear. These hair cells do not grow back once they are damaged. Even short exposure to very loud sounds, such as gunfire, can be damaging to the ears and cause permanent hearing loss. Long periods of exposure to moderately loud sounds, such as factory noise or music played through earphones, can result in just as much damage to the inner ear, with permanent hearing loss and tinnitus. Listening to moderately loud sounds for hours at a young age carries a high risk of developing hearing loss and tinnitus later in life.
Tinnitus is a symptom, not a disease. Most cases are due to damage to the microscopic endings of the sensory nerve in the inner ear, commonly from exposure to loud noise (as from amplified music or gunfire). Other causes include allergy, high or low blood pressure, a tumor, diabetes, thyroid dysfunction, and head or neck injury. In addition, some drugs, including aspirin and other anti-inflammatories, antibiotics, sedatives, and antidepressants can also cause tinnitus. If so, changing drugs or lowering the dosage usually helps.
Her most recent study, published in January 2018 in the journal Science Translational Medicine, showed success rates similar to Kilgard’s on 20 adult tinnitus patients. (5) People who underwent the therapy 30 minutes a day for one month reported about a 50 percent drop in the loudness of their tinnitus. More than half of the study participants also reported that their tinnitus bothered them less after the therapy, she says.
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.
Tinnitus Control contains both a spray that is administered under the tongue three times a day and a gelatin capsule that is to be taken twice a day. Each package comes with a one month’s supply of the spray (1 fluid ounce) and capsules (60 capsules). Tinnitus Control is not currently available in local stores such as CVS, Walgreens and Rite Aid, but it is available directly from the manufacturer’s website at http://www.tinnituscontrol.com
The exact biological process by which hearing loss is associated with tinnitus is still being investigated by researchers. However, we do know that the loss of certain sound frequencies leads to specific changes in how the brain processes sound. In short, as the brain receives less external stimuli around a specific frequency, it begins to adapt and change. Tinnitus may be the brain’s way of filling in the missing sound frequencies it no longer receives from the auditory system.
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.
The treatment group (245 patients) received some elements of standard care (such as a masking device and hearing aid if needed), but also received CBT. The CBT included an extensive educational session, sessions with a clinical psychologist and group treatments involving “psychological education” explaining their condition, cognitive restructuring, exposure techniques, stress relief, applied relaxation and movement therapy.
Cochlear implants are sometimes used in people who have tinnitus along with severe hearing loss. A cochlear implant bypasses the damaged portion of the inner ear and sends electrical signals that directly stimulate the auditory nerve. The device brings in outside sounds that help mask tinnitus and stimulate change in the neural circuits. Read the NIDCD fact sheet Cochlear Implants for more information.
White Noise Machines. These devices do a great job of simulating the sound of everything from ocean waves, to rain, to a thunder storm, to a crackling fire to an oscillating fan to just plain old static. The result is that your brain focuses on the sounds around you instead of the ringing in your head. You can even download apps on your iPhone that do the same thing so that you can always have a noise machine with you wherever you go. The constant background noise can not only bring back nostalgic feelings of joy, if you used to site around a crackling fire on holidays with your family, but also allow you to forget about your tinnitus.
To answer your question about NAC (N-acetyl-L-cysteine), I’ve seen little evidence suggesting that is effective for tinnitus. Instead – though the research is very limited – multiple anecdotal reports describe success with the herb ginkgo biloba. Try taking two tablets of standardized extract of ginkgo three times a day with meals (no more than a total dose of 240 mg a day). Ginkgo may work by increasing blood circulation to the head and neck. Give it at least a two-month trial. You might also explore cranial therapy, a gentle manipulative technique performed by osteopathic physicians. This approach seems to take the pressure or irritation off the auditory nerves. If high blood pressure is responsible for your tinnitus, try to get that under control through diet, exercise, and weight loss or medication if necessary.
It is also very common for jaw opening to change the loudness or frequency of tinnitus. This is likely a variant of somatic modulation of tinnitus (see above). The sensory input from the jaw evidently interacts with hearing pathways. The muscles that open the jaw are innervated by the same nerve, the motor branch of 5, that controls the tensor tympani in the ear. In other words, changing tension in the jaw may also change muscle tension in the ear.
Oticon Tinnitus SoundSupport works by adding sound to the buzzing, hissing, or roaring you already hear. This may seem peculiar, but in fact, the relief sounds (which are dynamic and soothing) can mix with and distract you from those bothersome noises, giving you control over your condition. The flexible program includes a variety of relief sounds that can ease the effects of tinnitus. Your audiologist can personalize the sounds to your needs and preferences, and they can be used alongside Tinnitus Retraining Therapy for instruction and support.
If the source of the problem remains unclear, you may be sent to an otologist or an otolaryngologist (both ear specialists) or an audiologist (a hearing specialist) for hearing and nerve tests. As part of your examination, you may be given a hearing test called an audiogram. An imaging technique, such as an MRI or a CT scan, may also be recommended to reveal any structural problem.