Tinnitus can be defined as ringing or buzzing sound in ears without any external source. 1 out of every 5 individual suffers from tinnitus. A patient of tinnitus may also experience whistling, blowing or roaring sound in ears. These anonymous sounds can be continuous or intermittent or may be high pitch or low pitch. Tinnitus is not a disease in itself, but it is a symptom of an underlying complication. According to the studies done, nearly 50 million people of USA are suffering from tinnitus right now. Tinnitus affects adults more than children. As for as gender is considered, males are found affected by tinnitus more than the women.

Two types of tinnitus are generally found in patients. First one is subjective tinnitus and the other one is objective tinnitus. In subjective tinnitus, only sufferer can hear sounds in his ears. No other person can experience whistling, blowing or any such other sound nearby. Most of the people suffering from tinnitus have subjective tinnitus. This type of tinnitus is generally caused by any problem in structure of outer, middle or inner ear. Any complication in auditory nerve of patient may also lead to subjective tinnitus. Objective tinnitus, on the other hand, may be caused by some problem in blood vessels of ear or due to abnormal muscles contractions. In objective tinnitus a Doctor can also experience such sounds as defined by patients. Suitable devices are used to experience the source and root cause of objective tinnitus. This type o tinnitus is rare as compared to subjective tinnitus.

Before going through the treatment of tinnitus, it is important to understand different cause and factors which lead to tinnitus. This disease is associated with ears. Our ears consist of three parts-outer ear, middle ear and inner ear. Outer ear is funnel shaped which receives sound signals and conveys them towards ear drum. Middle ear has bones in it. Middle ear primarily helps in balancing and transfer of sound waves to the inner ear. Inner ear has tiny hairs which move in relation to the sound waves. In response to this movement, an electric signal is released which is conveyed to the brain with the help of auditory nerve. Brain interprets these signals as sound. Any damage to the hairs inside inner ear may cause leakage of electrical impulses inside inner ear. This disturbance in electric impulses by sound waves lead to tinnitus.

Continuous exposure to loud sound is the most common cause of tinnitus. That is why, people working as road side workers, carpenters, traffic controller, musicians and street workers become victim of tinnitus often. There are some other causes of tinnitus too like-

Presbycusis :It is the tinnitus caused by old age. As an individual grows, some parts of ear like cochlea (sound sensitive cells of ear) may get deterioration. Due to this condition, inner ear becomes unable to function properly, causing tinnitus.

Accumulation of ear wax: Ear wax is produced by wax glands present in outer part of ear canal. Ear wax traps dirt and foreign materials preventing their entrance towards ear drum. Accumulation of ear wax more than a normal limit cause blockage of ear drum leading to tinnitus.

Otosclerosis: Third common cause of tinnitus is a disease known as otosclerosis.It is the stiffening of bones of middle ears. When bones of middle ear grow abnormally or become stiff,patient may be subjected to tinnitus.

Meniere’s disease: This is a disorder of inner ear. Our inner ear consists of a fluid known as endolymph.Endolymph helps both in hearing and in balancing. In Meneiere,s disease an abnormal increase in pressure of inner ear fluid occurs ,which leads to tinnitus.

Temperomandibular Joint Syndrome: It is also known as TMJ syndrome.Temperomandibular joints are present in each side of our head in front of both ears where our skull and jaws meet. Any problem in these joint can cause tinnitus.

Presence of benign tumors: Sometimes some non cancerous tumors develop in our cranial nerves. Cranial nerve runs from our inner ear to brain. This nerves control hearing process. Development of tumor affects the structure of cranial nerves. This type of tinnitus occurs in the one ear in which the tumor gets developed.

Atheroscleosis: This is the condition where the level of cholesterol and other deposits exceeds their normal limit. Due to increased cholesterol, blood vessels of middle and inner ear lose their elasticity to some extent. Circulation of blood become forceful in these blood vessels leading to a detection of heart beat sound in ear of patient .This type of tinnitus affects both the ears.

Apart from these causes there are some other reasons of tinnitus like –injury to head and neck parts, high blood pressure, consumption of alcohol and some medicines like aspirin, antidepressants, quinine and diuretics are also known to cause tinnitus.

Diagnosis and treatment

Suitable diagnosis must be done before treating tinnitus. There are many techniques used for diagnosing root cause of tinnitus. Imaging tests; CT and MRI may be done to get the cause behind tinnitus. An audio logical examination is another common diagnostic technique where patient is allowed to sit in a sound proof room. Patient has to wear an ear phone from which specific sounds are played in each ear one by one. Patient indicates which type of sound he is getting and then the results are compared with the reaction of a normal individual. This helps in ruling possible cause behind tinnitus. When tinnitus is caused by problem in blood vessels or due to problem in Eustachian tubes, sound of heart beat comes in ear. This is known as pulsating tinnitus.Meniere’s disease causes low pitch ringing sound in ears where as conditions like ageing and acoustic neuroma may cause tinnitus in one or both ears. After diagnosing real cause of tinnitus, Doctor starts suitable treatment.

Treatment

Treatment of tinnitus is based on the factor causing it.Basicaly; the cause of tinnitus is cured to treat tinnitus. Some of the treatments available are:

Ear wax removal: When tinnitus is caused by accumulation of ear wax .it should be removed as soon as possible. Manual removal of ear wax can be done by experienced medical practitioner. Apart from it many chemicals like hydrogen peroxide, carbamide peroxide are available in market for removing ear wax. Ear wax removal opens the blockage of ear drum which cures tinnitus.

White noise machine: White noise machine is a device used by patients of tinnitus. These devices produce soothing sounds like rain falling or oceans sound. This machine is an effective treatment of tinnitus. The sound produced by white noise machine is usually patient friendly and can easily cover the internal sounds from inner ear.

Use of masking devices: These devices are similar to white noise machine. These are worn by patients when they are at work or are indulged in their other activities. These devices also produce low level noises which suppresses tinnitus voice.

Medicines for tinnitus: Unfortunately, no absolute medicine is there for treating tinnitus. Medicines are given to suppress the symptoms of tinnitus. Some anti depressant medicines may be given to treat these symptoms like Amitriptyline and Nortriptyline.These medicines relax the patients for some time.Benzodiazepines like alprazolam can also be given.Alprazolam acts on brain and central nervous system to produce a calming effect. These medicines are habit forming and can be given only in severe condition of tinnitus.

Treatment of blood vessels condition: When tinnitus is caused by problem in blood vessels, blocking, and presence of tumors, head and neck injury or due to any other complexity in inner ear than suitable medicines are given to the patients based on their symptoms. In rare cases surgery can also be done to avoid the symptoms. Success rate of these surgeries is very high. Patient can get rid of his tinnitus after a successful surgery of the part causing it.

Avoidance of factors causing tinnitus: Factors which cause tinnitus must be avoided to prevent the disease. The most common cause is loud noise. Mask and cover ups should be worn by the workers who continuously work in an environment where loud noise is produced. Stress should be managed if it is causing tinnitus. Patients of tinnitus are advised to keep themselves away from alcohol consumption. Alcohol has an ability to dilate blood vessels. This causes increase of blood circulation near inner ear area which may be a cause of tinnitus.

Tinnitus is a troublesome symptom. Continuous ringing sounds affects patient mentally as well as psychologically. A victim of tinnitus may also be subjected to anxiety and depression if proper treatment is not provided to him. In this case counseling of patient should be done. Sleeping pattern of victim is negatively affected by this complication. Roaring and buzzing in ear do not allow patient to sleep calmly which affects his body clock and work performance. Memory problems may also arise due to long term exposure of tinnitus.

Tinnitus affects physical and mental health of a person. A suitable treatment and counseling may help the person to fight this complication.Hence,if we have any symptom of tinnitus in us we should take an appointment with doctor as early as possible. Proper treatment may help the patient to lead a normal life again!