Tinnitus is a hearing impairment that affects millions of people around the world. It is a condition in which a person hears ringing in the years when no such sound is actually being made. swa In other words, it is a phantom sound.
Hearing a sound that does not come from any source external to the body is not a disease in itself. Rather it is a symptom of an underlying medical condition, such as age-related hearing loss, ear injury or a circulatory system disorder.
Tinnitus is typically the hearing of phantom sounds which result in annoying sensations. These sounds include ringing/buzzing/roaring/clicking/ hissing, etc. The sound may vary in pitch and volume from being low and almost unnoticeable to being so loud that it affects the hearing of actual sounds, the ability to concentrate and the quality of life. The sensation of these phantom sounds may be in one to both the ears. Tinnitus may come and go, or it may be present all the time.
In some cases, tinnitus can be caused by damage to the hair cells in the ear and/or to the nerve fiber. However, in most cases, the real culprit is the brain. When it detects the reduction of auditory input from the ears, it tries to compensate by increasing the power of the sound signals it is receiving. This is akin to turning up the volume of the TV to make it easier to hear faint sounds. This results in stressing out the sound cells and the perception of the phantom sounds that do not really exist.
Treatment begins with a detailed assessment of the patient including developing a detailed case history, evaluating the hearing function, establishing the severity of the tinnitus, identification of causal factors, associated symptoms and determining if there are other medical conditions that contribute to the problem.
There are, at present, no medically proven cures for tinnitus, even though studies have shown positive results from medications, surgery and the use of neural and external sound simulators. Many widely used treatments involve counseling and there is evidence that cognitive behavioral therapy can be helpful. In many cases ignoring the problem rather than focusing on it can be helpful. People become accustomed to the phantom sounds are and able to tune it out.
However, some patients may develop insomnia, anxiety, hearing difficulties, social isolation and depression due to the effects of tinnitus. These patients will benefit from sound therapy, tinnitus retraining therapy (TRT) and cognitive behavioral therapy (CBT). Dealing with these issues, instead of ignoring them, can significantly improve a person's quality of life.
Sound therapy uses external noise to mask the effect of tinnitus. This can be achieved through the use of background music, white noise or the use of special ear maskers. The choice of sound should be that which is pleasant to the patient. Masking devices are only effective as long as they are turned on and the tinnitus reappears when they are turned off. Hearing aids which amplify environmental sounds and redirect attention to those instead of allowing the patient to focus on the phantom sound can be helpful.
Tinnitus retraining therapy involves retraining the auditory system to accept the abnormal sounds of tinnitus as natural rather than disruptive. Ongoing counseling sessions can help patients to cope with the condition. The success of this treatment depends on the severity of the condition and the patient's overall mental health. Studies have shown that this form of treatment provides relief to about 80% of those who receive it.
Cognitive behavioral therapy (CBT) can help relieve depression in people with tinnitus, although it does not appear to reduce the perceived sound.
If you have or suspect you have tinnitus or other hearing issues, consult with an ENT specialist to determine if there is a problem and if so, begin treatment without delay.
Article by Dr. Sundhari V,
Senior ENT Consultant
Kauvery Hospital