Tinnitus is the perception of sound in the absence of an external sound source and it is a SYMPTOM of an underlying condition. TINNITUS IS NOT A DISEASE ITSELF. Tinnitus is one of the common symptoms among children and adults with hearing loss. Although many things can lead to tinnitus, the most common causes are from otologic disorders (ear infections or impacted ear wax), sensorineural hearing loss and noise-induced hearing loss (working in factories or construction sites). In rare cases, it can be a symptom of a serious disease such as vascular tumour or vestibular schwannoma. Tinnitus can occur from medical conditions not directly associated with the ear such as Temporomandibular Joint (TMJ) Disorders. Tinnitus can be idiopathic too, where the cause is unknown! The sound perceived by tinnitus patients can range from a quiet background noise to a noise that is audible over loud external sounds. The sound of tinnitus can vary, with ringing, buzzing, clicking, whooshing, pulsations, and other noises had been reported by tinnitus patients. Most tinnitus is subjective, perceived only by the patient. In contrast, objective tinnitus can be perceived by others, but is rare.
The functions impaired by tinnitus are classified into 4 broad groups:
(1) thoughts and emotions
When these primary functions are affected by tinnitus, numerous secondary activities can be affected too, and this can broadly impair their quality of life (QOL). Untreated tinnitus can be bothersome and often affects their quality of life. The effects of tinnitus on health-related quality of life (HQOL) could be different, with most patients less severely affected, while others might experience anxiety, depression, and extreme life changes. Some of the most common complaints were insomnia, impaired concentration, and problems with both work and family life. Sleep deprivation, which may be reported in more than half of tinnitus patients, can reduce the ability to concentrate and can lead to anger, frustration, and other emotional disturbances. General health-related and tinnitus related QOL is worsened further in tinnitus patients with comorbidities such as hypertension, diabetes mellitus, and arteriosclerosis.
An ENT specialist would perform a targeted & detailed case history and physical examination (of the ear and nose) during the initial evaluation of a patient with presumed primary tinnitus to identify conditions that if promptly identified and managed may relieve tinnitus.
Audiologist would do a hearing test for patients with tinnitus that may or may not be associated with hearing losses.
If the patient may or may not have hearing loss but a unilateral (only in one ear) tinnitus, asymmetrical hearing losses, and many other symptoms such as double vision, then an MRI scan might be done.
If sensorineural hearing loss is identified, then the patient will be recommended to proceed with hearing aid evaluation. Hearing amplification such as hearing aids can improve a patient’s quality of life by both treating hearing loss and making the tinnitus less noticeable.
Over 50 years, the use of masking noises, , sound therapy and counselling have been recommended for managing tinnitus. Since a portion of tinnitus patients have hearing loss, the use of hearing aids will amplify ambient sounds which will completely or partially mask tinnitus. By doing this, we can reduce the attention drawn to the tinnitus and the loudness of tinnitus.
Written by: Mohana, Audiologist of 20dB Digisound