Tinnitus, which is usually pronounced “TIN-a-tus,” is perception of sound in the head or ears when there is no noise present. The most common description of Tinnitus is ringing in the ears, though tinnitus may involve other sounds, such as clicking, whistling, pulsing, or roaring. It may occur in one or both ears.
Tinnitus is extremely common to some degree. Most everyone has experienced the occasional ringing in the ears that goes away as mysteriously as it shows up. However, some people have chronic tinnitus. Over 30% of adults report having experienced tinnitus at some point in life. Ten to 15% of adults have persistent tinnitus that requires medical intervention to cope with. Estimates of hard numbers of people in the U.S. with tinnitus range from 8 million to 37 million.
Tinnitus is a symptom
Tinnitus, however, is not a disease, but rather a symptom. It is common to many problems, and that’s why it can be difficult to pin down to one cause. Estimates are that around 90% of people who have chronic tinnitus have hearing loss. Therefore, anyone with tinnitus should have their hearing evaluated as a first step to understanding what is causing their tinnitus. If hearing loss is diagnosed, tinnitus hearing aids will be fitted before devices for masking tinnitus are fitted. Sometimes hearing aids alone can stop tinnitus, but not always.
There are hearing appliances known as tinnitus instruments that combine a tinnitus hearing aid with broadband (white) noise to reduce or eliminate tinnitus. There are five main parts of the human hearing system, and problems with an y one of them may cause tinnitus. Such problems include:
- Hearing trauma from a blast or explosion
- Temporomandibular joint disorders
- Damage from drugs such as aspirin and antibiotics
- Inner ear disorders such as Meniere’s Disease
- Otosclerosis, or hardening of the bones in the middle ear
- Middle ear infection
- Blocked eustachian tube
- Blocked ear canal
Sometimes tinnitus is a symptom of a systemic condition such as anemia, high blood pressure, coronary artery disease, hypothyroidism, or head injury. Many people with tinnitus are frustrated to find that identifying the underlying cause of tinnitus – particularly if no hearing loss is involved, is not easy. Some people find the noise more bothersome than others. Some of the ways tinnitus is treated, in addition to tinnitus hearing aids, include white noise generators, tinnitus maskers (worn like a hearing aid, they produce pleasant sounds), and for those with profound hearing loss, cochlear implant surgery may stop tinnitus.
Masking
Since it is so hard to pin down the causes of tinnitus, the only solution is often masking the sound with other sounds. Masking works for some individuals, but not for others. One way to determine if masking will stop tinnitus is called the “faucet test.” The person with tinnitus stands near a sink and turns on the water full blast. Many people with tinnitus will discover that they do not hear the sounds when they hear running water. If the faucet noise cancels out the tinnitus, then masking is more likely to work.
If a person still hears the noises when a faucet is turned on, it doesn’t necessarily mean that masking is futile. It could mean that they have hearing loss that doesn’t allow the masking noise to be heard enough to drown out the tinnitus. It may be that the person has high frequency hearing loss, or hearing loss at sound frequencies over 2,000 Hz. Even “normal” hearing is a matter of some debate. Some people believe that a person must be able to hear up through 8,000 Hz in both ears in order to hear speech well in noisy environments such as at social gatherings.
Hearing aids
Sometimes tinnitus hearing aids are prescribed to people who have high frequency hearing loss. Often people fitted with these are able to pass the “faucet test” if they are wearing hearing aids. But there are others whose tinnitus may be impossible to mask. Sometimes tinnitus is complex, meaning it’s composed of more than one kind of sound, and only some of that sound can be successfully masked.
A tinnitus hearing aid will succeed in making tinnitus maskable because the masking sound will differ significantly from the tinnitus sound. While tinnitus is usually perceived as a high-pitched, shrill, unpleasant sound, masking sounds and running water are usually perceived as soothing. The tinnitus hearing aid may allow some people to learn to ignore certain sounds, particularly if they are not too harsh and are relatively monotonous.
If tinnitus is a symptom of associated hearing loss, then a tinnitus hearing aid may be quite helpful. However, it is also important to rule out other systemic medical problems that can cause tinnitus, problems like impaired kidney function, high blood pressure, allergies, and drug reactions. Hearing exams should be performed by an audiologist who is certified by the American Speech Language Hearing Association.
Tinnitus maskers
There are tinnitus hearing aids called tinnitus maskers. They look like hearing aids but make sounds that mask the tinnitus. While some people find the sounds generated by tinnitus maskers to be preferable than the tinnitus itself, some do not. Pitch and volume will determine what kind of noise brings relief from tinnitus. In cases with hearing loss, combination tinnitus hearing aids that aid hearing as well as masking tinnitus can help greatly. An evaluation by a qualified audiologist is the best firs t step to properly diagnosing and treating tinnitus.
Anecdotal evidence suggests that tinnitus hearing aids stop tinnitus in over half of tinnitus sufferers, allowing them to manage the tinnitus effectively. With amplification comes relief to many people with tinnitus. At night when patients take out their hearing aids, bedside masking noise machines are helpful. Some hearing aid manufacturers are studying the use of tinnitus hearing aids to help people with unrelenting tinnitus. When the hearing aids are fitted similarly to hearing aids for those with high frequency hearing loss, relief from tinnitus is often found to be masked or eliminated.
Negative impact
Untreated tinnitus and associated hearing loss has a negative impact on the quality of daily life. People with difficulty hearing and / or tinnitus can experience skewed and inadequate communication that can have a serious effect on their personal and professional lives, and can lead to withdrawal and isolation. Untreated, hearing l oss and / or tinnitus can lead to the following:
- Diminished psychological functioning
- Fatigue, depression, and tension
- Anger and irritability
- Social rejection and avoidance
- Impaired ability to learn new tasks
- Poorer job performance
- Reduced levels of personal safety
Tinnitus hearing aids give over half of tinnitus patients relief from tinnitus while wearing the hearing aids. Of those fitted with hearing aids, more than 20% experience major relief. Clearly, the person with untreated hearing loss and untreated tinnitus suffer a double blow to their quality of life compared with those who have only hearing loss or only tinnitus.
Hearing specialists who are able to successfully treat tinnitus are often also successful in helping tinnitus sufferers treat associated hearing loss as well, which results in improved quality of life. Tinnitus hearing aids certainly aren’t an across-the-board cure, but they stop tinnitus in enough people that they are definitely worth exploring by those who live with tinnitus, with or without associated hearing loss.