Tinnitus is the perception of sound when no actual external noise or sound is present. It is often referred to as “ringing” in the ears. I have even heard some people call it “head noises.” While ringing sounds are very common, many people will describe the sound they hear as buzzing, hissing, whistling, swooshing, and clicking. In some rare cases, tinnitus patients report hearing music. I hear about 2,000 crickets all going at once!
No matter what the cause, the condition interrupts the transmission of sound from the ear to the brain. Some of the neural circuits no longer receive signals. Strangely, this does not cause hearing loss. Instead, when neural circuits don’t receive stimulation, they react by chattering together, alone at first and then synchronous with each other. Once the nerve cells become hyperactive and occur at the same time, they simulate a tone the brain “hears” as tinnitus. Analogous to a piano, the broken “keys” create a permanent tone without a pianist playing the keys.
Another example of somatic tinnitus is that caused by temperomandibular joint disorder. The temporomandibular joint (TMJ) is where the lower jaw connects to the skull, and is located in front of the ears. Damage to the muscles, ligaments, or cartilage in the TMJ can lead to tinnitus symptoms. The TMJ is adjacent to the auditory system and shares some ligaments and nerve connections with structures in the middle ear.
We occasionally recommend neuropsychological testing using a simple screening questionnaire -- depression, anxiety, and OCD (obsessive compulsive disorder) are common in persons with tinnitus. This is not surprising considering how disturbing tinnitus may be to ones life (Holmes and Padgham, 2009). Persons with OCD tend to "obsess" about tinnitus. Treatment of these psychological conditions may be extremely helpful.
Tinnitus also could be the result of neural circuits thrown out of balance when damage in the inner ear changes signaling activity in the auditory cortex, the part of the brain that processes sound. Or it could be the result of abnormal interactions between neural circuits. The neural circuits involved in hearing aren’t solely dedicated to processing sound. They also communicate with other parts of the brain, such as the limbic region, which regulates mood and emotion.
Inspection of the eardrum may sometimes demonstrate subtle movements due to contraction of the tensor tympani (Cohen and Perez, 2003). Tensor tympani myoclonus causes a thumping. Another muscle, the stapedius, can also make higher pitched sounds. See this page for more. Opening or closing of the eustachian tube causes a clicking. The best way to hear "objective tinnitus" from the middle ear is simply to have an examiner with normal hearing put their ear up next to the patient. Stethoscopes favor low frequency sounds and may not be very helpful.
Take medication for a thyroid disorder, if necessary. Tinnitus can be related to both hyperthyroidism, or an overactive thyroid, and hypothyroidism, or an underactive thyroid. Your doctor can check for swelling or lumps in your thyroid gland, which is in your throat, and order blood screens to test its function. If they find an issue, they’ll prescribe medication to regulate your thyroid hormone levels.
Addressing Any TMJ Disorders. A small percentage of people will experience tinnitus if they are having problems with their temporomandibular joint. This joint is located in front of the ears, on each side of the head, where the lower jawbone meets the skull. In these rare cases, a dental treatment or bite realignment may relieve you of the ringing you hear in your ears.
While there are many different FDA-approved treatments for tinnitus available, the most important component is finding the right partner (i.e. a Doctor of Audiology), who will work closely with you to help explain your tinnitus and treatment progress over time. In order for the options below to be as successful as possible, the proper support and guidance from an experienced tinnitus specialist is mandatory.
In the advance online edition of Nature on January 12, 2011, the researchers reported that the number of neurons tuned to the high frequency had jumped by 79% compared to control rats. The scientist then tested 2 different tones in a second group of rats but stimulated the vagus nerve only for the higher one. The neurons tuned to the higher tone increased by 70%, while those tuned to the lower one decreased in number. This showed that the tone alone wasn’t enough to initiate the change; it had to be accompanied by VNS.
Think about your breathing. Notice that it has a natural rhythm. Try to breathe in a steady, even rhythm. It helps to breathe in through your nose, hold your breath for a moment and then breathe out through your mouth. Wait a moment before breathing in again. Every time you breathe out, try to release a little bit of your tension. Do this for a few minutes, until you feel ready to move on to the next step.
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).