TinnitusWhat is tinnitus?Tinnitus is the name given to noises in the head and ears that do not come from an outside source. The sounds vary from person to person and have been described as sounding like:
Most people experience tinnitus at some stage in their life, if only briefly.
Is tinnitus a disease?Tinnitus is not a disease or an illness, nor is it a psychiatric condition. It is a symptom generated within a person′s own auditory pathways and usually indicates a problem somewhere in the hearing system. While tinnitus used to be associated with some form of hearing loss, we now know it is sometimes experienced by some children and adults with good hearing. Also, many people with a hearing loss do not experience tinnitus. Tinnitus does not mean you are going deaf or your hearing loss is going to get worse. Many people have suffered with tinnitus most of their lives while others have had it develop in later years. The condition can be extremely unpleasant. While for most it is merely a nuisance, for some it can be a chronic condition resulting in loss of concentration, sleep problems, irritability, anxiety and even depression. Like any hearing disability, because tinnitus is an invisible problem, it is difficult for other people to understand and sympathise with the sufferer. Causes of tinnitusTinnitus usually indicates a problem in the auditory system which could have been caused by many different things. Damage to the inner ear through ageing or loud noise can bring on tinnitus. It may also develop after neck or head injuries including whiplash, illness or infection of the ear, following stress, raised blood pressure, as a side effect of a drug or from damage to the ears from scuba diving. It may also be the result of something as simple as excessive wax in the ears. The actual mechanism of tinnitus is still not fully understood and is being extensively studied at the moment. Forms of tinnitusTinnitus has two forms - subjective tinnitus, the most common form, and objective tinnitus which is rarer. Subjective tinnitusCan only be heard by the person who experiences it. The sounds may be perceived in one ear, both ears or inside the head. Some times there is a sensation of the sound just outside the head. There may be one sound that never changes, a different sound in each ear or six to eight sounds that are constantly changing. Objective tinnitusCan be heard not only by the person who experiences it but also a doctor or other interested person, using a stethoscope or other listening device. Most commonly it is a regular pulsing noise, sometimes corresponding to the pulsing of blood near the ear tissue. It can be heard as a lower pitched thumping or booming, as well as a rougher blowing sound which coincides with breathing, or as a clicking, higher pitched rhythmic sensation. The noises are usually caused by cardiovascular disorders, noises relating to blood flow in the arteries or the veins, the sounds of repetitive muscle contractions, or problems in the structure of the inner ear. Treatment optionsThose suffering from tinnitus should first discuss it with their doctor. Sometimes the cause of tinnitus can be treated medically either by the GP, an otolaryngologist (ear, nose and throat specialist) or cardiovascular specialist. If the problem doesn′t have an immediate medical solution, a hearing assessment and discussion with a hearing therapist or audiologist is recommended. While there is no "magic cure" for this sort of tinnitus, it is not true that nothing can be done. Today there are many treatments and therapies that can help and most people learn to live with their tinnitus and often forget it is there. However, for some this can be a long process and take help and plenty of patience. CounsellingCounselling from an audiologist, hearing therapist, otologist or other trained person can help lessen the impact of tinnitus. By reassuring the patient that the sounds are real, explaining the mechanisms of tinnitus, and discussing the different therapies and coping techniques available counsellors can reduce the anxiety often felt by tinnitus sufferers, which in turn can reduce the impact of the tinnitus itself. RelaxationStress is known to aggravate tinnitus so relaxation techniques, such as listening to soothing music, yoga, and meditation, can help. Support groupsThere are tinnitus support groups throughout the country, which provide information, allow people to share their experiences and offer self-help tips. Contact any of the following organisations to find out more
Auditory Habituation TherapyThe difference between a person who experiences tinnitus and one who ‘suffers’ from it may be the person’s ability to ignore, or habituate to the tinnitus. The environment is full of noises that the hearing system filters out as unimportant, while faint sounds that it considers significant are given more attention. For example, hearing your name against the background babble of a cocktail party, or an ambulance siren in the din of traffic. If noises associated with tinnitus are viewed as threatening or annoying, the auditory system will more readily pay attention to them, making them seem even noisier and harder to ignore, and a vicious circle is established. For this reason, it is important to try and find ways to tinnitus, and not to let it worry you. Auditory habituation therapy, available through some audiology clinics, attempts to get the brain so accustomed to a neutral sound that mixes with the tinnitus that it no longer pays attention to it. If the brain becomes accustomed to the sound generated externally, then it may learn to ignore the tinnitus itself. Habituation therapies usually combine sound therapy with counselling. Three options to help mask the tinnitus and help the habituation to it are:
Initially the devices help only when they are worn, as the sound they generate reduces the contrast between tinnitus-related and normal auditory activity. In six to 18 months, if a programme of use for over eight hours per day is followed, the tinnitus may be reduced sufficiently to discontinue the use of the devices. Other masking devicesTinnitus can often be particularly disturbing at night, and make it difficult to sleep. There are a number of ways to mask the tinnitus noise and reduce its effects. A radio tuned between stations on the FM produces static or white noise that can prove helpful. Special masking devices are available which can usually be programmed to play a number of different masking sounds (e.g. static, rainfall, ocean or surf). To prevent annoyance of others in the room headphones or pillow speakers can be fitted. Pillow speakers plug into a standard headphone socket and are slipped under the listener′s pillow. A special sound pillow is also available which plugs into a radio, walkman, or CD player. It can be used with special tapes, or with the radio tuned between stations on the FM frequency. Many different types of masking sounds such as "white", "blue" or "pink" noise, the sound of waves, rain, air conditioning, a fan turning and many more can be downloaded from the internet, often for free, and played on CD players or MP3 players. Diet and medicationMany different foods, drinks and medicines, have been found to make tinnitus worse for some people, while making no difference to others. Coffee, tea, chocolate and cola, alcohol, colourings, artificial colourings and preservatives, MSG, as well as tobacco and some drugs such as aspirin have all been linked to tinnitus. However, as effects of these foods differ widely, it is better to try and identify those which are causing a problem, rather than giving them up all at once. If you are worried that your diet might be affecting your tinnitus, try giving up one food for about a month at a time, reintroduce it, and repeat until you have worked out which ones (if any) seem to make it worse. Foods to start with are those high in caffeine, such as coffee, tea or chocolate, very salty foods, red wine, tonic water (quinine) and some cheeses. If you find that a certain food does aggravate your tinnitus, you then have to decide which is worse, the louder tinnitus, or giving up a food you enjoy. Overall it is important to maintain a healthy balanced diet, as anything which improves your state of health will likely reduce your levels of tiredness and general stress, which may well help your tinnitus. Similarly, giving up smoking will improve your health, and so is likely to help your tinnitus. More informationNZ Tinnitus Association The Hearing Association
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