What Is Tinnitus? - Causes, Symptoms & Treatment

Instructor: Marisela Duque

Marisela teaches nursing courses at the college level. She also works as a unit educator, teaching experienced nurses about changes in nursing practice.

After completing this lesson, you will be able to describe tinnitus, including it's symptoms and treatment. A short quiz follows the lesson so that you can test your new knowledge.

Do You Hear That?

Sally is just beginning her studies as a freshman in college. She finds the first few weeks overwhelming as she tries to sort out where things are, make new friends, and study for upcoming exams. She notices that she keeps hearing a ringing sound throughout the day and sometimes at night, but does not think anything of it at first. The next week, with very little sleep due to the ringing sound, she sets out to find the source. She asks classmates and teachers, but no one else seems to hear it. Sally starts to wonder if the sound is all in her head. Is she going crazy?

After consulting a healthcare provider on campus, Sally discovers that the sound that only she can hear does not mean she is crazy. Sally is diagnosed with tinnitus.

Defining Tinnitus

Tinnitus is a medical term that describes hearing a sound in your ears that has no external source. For example, hearing a bell when there is no bell ringing. It is also known as 'ringing in the ears,' but not all people hear a ringing sound (some hear hissing, roaring, or clicking). According to the Mayo Clinic (2015), tinnitus is pretty common, affecting about every one in five people. This condition can be constant or stop-and-go, with the volume of the sound ranging from minimal to uncomfortably loud. Smokers are more likely to suffer from this condition than non-smokers.

What Causes Tinnitus?

Tinnitus is not a disease within itself but a symptom. Think of it as an alarm that something has gone wrong somewhere in your body. Some conditions that cause tinnitus include:

Exposure to loud noises: Many people experience transient tinnitus after being exposed to a really loud sound, like sitting front row at a rock concert. The loud noise can disturb the fine hairs that live in your inner ear, called cilia. The cilia are responsible for detecting sound waves and alerting your auditory nerve to tell your brain what you are hearing. Once destroyed, these cilia cannot be restored. This is why people who constantly experience loud noise, such as construction workers, are at risk for developing hearing loss. This is the most common cause of tinnitus.

Age-related hearing loss: Many people experience hearing loss after age 60, oftentimes this can also cause tinnitus.

Earwax blockage: We need our earwax to protect our inner ear by trapping dirt, dust, and insects. Sometimes the earwax accumulates, causing blockage (like a road block after a multi-car accident) that is difficult to wash away. This, in turn, causes hearing loss, which may cause tinnitus.

Meniere's disease: An inner ear condition that causes changes in inner ear fluid pressure. Tinnitus is an early sign of this condition.

TMJ disorders: The temporomandibular joint (TMJ) is located on both sides of your head, in front of your ears. This joint is what allows you to move your lower jaw for talking and eating. Problems in this joint can also cause tinnitus.

Tumors: Acoustic neuroma is a benign (non-cancerous) tumor that is usually seen on one of the cranial nerves. This condition is also called vestibular schwannoma, and it often leads to tinnitus in only one ear.

Head and neck injuries: An injury of the head and/or neck (common in car accidents) can cause tinnitus along with vertigo (dizziness), headaches, and memory loss.

Medications: Some medications, such as high-dose aspirin, cancer medications, and some antibiotics (such as vancomycin), can also cause tinnitus.

Treatment Options

Treatment for tinnitus involves treating the underlying cause. For example, if your tinnitus is caused by earwax blockage, then removing that blockage will help relieve your symptoms. There are a variety of treatment options available to help relieve tinnitus, including:

Medications: Tricyclic antidepressants (such as amitriptyline and notrptyline) are sometimes used to relieve severe cases of tinnitus, but they also have nasty side effects (blurred vision, dry mouth, and heart problems). Alprazolam (Xanax) is another medication that reduces tinnitus, but it is used with caution due to its habit-forming tendency.

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