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Tinnitus

Tinnitus is the perception of sound when no external source is present. It is a common condition that is estimated to affect up to 20% of the global population1 with as many as 4% reporting they are severely impacted by their tinnitus. In New Zealand, approximately 200,000 Kiwis have debilitating tinnitus2.

Technically speaking, tinnitus is not a condition itself, rather, it is a symptom of an underlying condition. It rarely indicates a serious problem, despite the annoyance. There are things that tend to worsen the perception and there are known risk factors, however, no cure exists.

If you have questions or concerns about tinnitus, it's always worth a visit with your local audiologist.

Symptoms

Tinnitus is defined as hearing sound when there is no known source and although everyone experiences tinnitus differently, there are some common descriptions/symptoms1

Causes

No one is exactly sure what causes tinnitus, but there are common correlations with certain things.

The most common cause for tinnitus is damage to the inner hair cells in the cochlea (the organ of hearing). These tiny little cells are situated deep in the inner ear and help send electrical signals to the auditory nerve. It's possible for these cells to bend or break, causing them to send improper signals to the nerve and brain - causing these phantom sounds we call tinnitus.

Hearing loss, other problems with your ears (ear infections or wax blockage), chronic health conditions, and/or other health conditions that affect sensory nerves are possible causes for tinnitus2.

Explore Common Causes of Tinnitus

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Hearing Loss

Hearing loss is commonly connected with tinnitus. Although not everyone with a hearing loss experiences tinnitus, many people with tinnitus have some degree and type of hearing loss.

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Hearing Loss

Age-related hearing loss, also known as presbycusis, is one of the most common types of hearing loss. As we age, our cochlea (inner ear of hearing) loses some of it's sensory cells, either from every day damage or changes in the biomechanics of our auditory system. These cells are very important for sending signals to the auditory nerve and brain, but once damaged, they can send incorrect information which is often translated by the brain as sound - what we call tinnitus. 

If you have tinnitus, it's important to find out what the underlying cause is. Schedule a visit with your local audiologist to learn more.

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Noise Exposure

Our world is getting more and more noisy. Constant exposure to loud level sound, or in some cases, one-time exposure to extreme sound, can damage the inner ear and cause tinnitus.

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Noise Exposure

Every person is different in how their auditory system is impacted by loud sound. There are general guidelines for safe exposure times and noise levels but if you're every worried about causing damage to your ears, put some earplugs in. 

If you are concerned about noise exposure in your past or your current daily endeavors, talk with your local audiologist to learn about protective measures.

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Ear Problems

There are several different conditions that can affect our ears and hearing such as wax build-up, Meniere's Disease, and Eustachian tube dysfunction.

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Ear Problems

Wax build-up is one of the more common problems people have with their ears. Wax, for the most part, is a healthy and normal part of our ear canal. However, sometimes it gets built up and causes temporary hearing loss. Some people are more prone to wax build up than others. There are no great over-the-counter treatments so if you're wondering if you have wax build up, have your local audiologist check your ears for you.

Tinnitus is one of the hallmark symptoms of Meniere's Disease (MD) - a disease that impacts the fluid pressure in the inner ear.

Eustachian tube dysfunction (ETD) can cause your ears to feel full all the time, sometimes resulting in tinnitus. The Eustachian tube is a small tube that connects the middle ear to the back of the throat (important for "popping" your ears when your in the mountains or on an airplane).

Some people might develop complications with the tiny bones in the middle ear. These bones are important for transmitting sound to the inner ear of hearing but can sometimes fixate or stiffen, reducing their functionality. This can cause tinnitus in some cases.

Acoustic neuromas (also called vestibular schwannomas) are rare, benign growths on the auditory nerve. As they grow, they apply pressure to the nerve, potentially causing hearing loss or tinnitus. These growths tend to be one-sided so if you notice any change in hearing or ringing in one ear, get it checked by your local audiologist as quickly as possible.

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Head Injuries

Any injury to the head or neck can impact our sensory systems. Depending on where the injury occurs and the severity of the injury, it can sometimes cause tinnitus and hearing loss.

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Head Injuries

Head and neck injuries can cause an array of problems and hearing loss or tinnitus may not be the first noticeable symptom. Depending on the type and severity of the injury, there can be damage to the structures of the ear, the nerves going to the brain, or the centers of the brain responsible for understanding sound. Talk to your local audiologist if you are concerned about tinnitus following a head or neck injury.

Blood Vessels

Blood Vessels

Our ears are incredibly sensitive to blood flow so any changes to the function of our blood vessels can cause problems with our hearing.

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Blood Vessels

Atherosclerosis can cause the arteries and veins supplying the inner ear to loose flexibility. When this happens, it causes the blood flow to be more forceful which can be perceived as a heartbeat sound in the ear.

Changes in blood pressure, particularly high blood pressure, can make tinnitus more noticeable.

Narrowing of a blood vessel can cause "kinking", resulting in irregular flow of blood and possible tinnitus.

Medications

Medications

Certain types of medications have been known to cause or worsen tinnitus. Higher doses tend to make the perception of tinnitus worse.

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Medications

Some powerful antibiotics like erythromycin, vancomycin, and neomycin can cause tinnitus2.

Certain cancer medications are linked to tinnitus: methotrexate and cisplatin.

Diuretics, some antidepressants, and aspirin are also known to cause tinnitus.

Talk to your local audiologist if you noticed the onset or a change in your tinnitus after starting or adjusting your medications.

Risk Factors

There are some attributes that may put you at higher risk for developing tinnitus.

Associated Conditions

Although tinnitus is not a condition on it's own, it can disrupt day-to-functions. Every person will experience tinnitus differently and the impact on daily activities varies dramatically from one person to the next. Some with tinnitus, may also experience:

Diagnosis

The process of diagnosing tinnitus starts with a physical exam of your ears, head, and neck. A solid review of your health history and experience with tinnitus is a critical component to the diagnosis. It is important to be as specific as you can about your tinnitus: when it started, how long you've had it, whether it changes pitch or volume, what ear you hear the tinnitus in, and whether there are any things that seem to make it worse. Your audiologist will also go through a variety of tests to assess your auditory health and tinnitus.

Learn more about our tinnitus assessments here.

Treatment

There is no cure for tinnitus; however, there are ways to successfully manage it. Just as every person's experience with tinnitus is unique, so is the treatment. For some, it's as simple as forgetting about it. For others, a combination approach with different methods is best. 

You can trust when seeing your local audiologist that you'll receive a unique treatment approach that is right for you.

Explore different tinnitus treatment options

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Sound Therapy

There are many different types of sound therapy to help manage tinnitus that vary from free phone apps to personally fit devices.

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Sound Therapy

If you're new to exploring the sound therapy options for tinnitus, it might be worth exploring apps for your smart phone. Most of these apps are designed to help mask the sound of your tinnitus but they can also work to calm anxiety and help clear your mind. Check out or blog post on some of our favorites. 

Depending on the severity of your tinnitus and whether there are other underlying problems, personalized sound devices might be the right thing for you. Your audiologist can help you learn more about these options as they are extremely personalized and specific for your unique needs.

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Cognitive Behavioral Therapy (CBT)

CBT is an important component to tinnitus treatment. It helps us reframe the value and importance of tinnitus to help minimize the impact on daily function.

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Cognitive Behavioral Therapy (CBT)

There are lots of programs around the world to help with tinnitus management. Talk with your audiologist about what type of program may be right for now. Whether an online program or a one-on-one setting is best for you, we'll help you sort out what's the best fit for your needs.

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Ear Wax Removal

It's possible you might have an underlying problem with your ears like earwax buildup.

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Ear Wax Removal

During your physical exam with your audiologist, they will take a good look in your ears using an otoscope. This will let us know if there's any type of blockage or other ear condition that may need to be treated. If there is a buildup of earwax, most of the time your audiologist can remove it during your appointment. If a referral to an ear, nose, and throat specialist (otolaryngologist) is required, we will help you find the nearest one.

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Heart Conditions

As our ears are very sensitive to changes in blood flow, you'll want to make sure your ticker is in great health.

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Heart Conditions

Depending on what type of heart conditions you might have, your audiologist can help direct you to get the care you need. It's important that your heart is working as optimally as possible.

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Change Medications

Sometimes treating tinnitus means a change to your medications.

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Change Medications

Your audiologist can help you assess your history with medications to see if there might be a link. It's always a good idea to chat with your doctor if you have concerns or notice a change in your hearing or tinnitus following changes to medications.

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Tinnitus Retraining Therapy (TRT)

TRT incorporates important aspects of the neurophysiological components of tinnitus and is a combination approach of sound therapy and psychological training.

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Tinnitus Retraining Therapy (TRT)

TRT is an involved process that requires consistent work and effort to be effective. The combination of sound therapy and psychological impact helps reduce the person's perception and level of importance of tinnitus. 

References

Mayo Clinic. Tinnitus. Accessed 17 May 2020. https://www.mayoclinic.org/diseases-conditions/tinnitus/symptoms-causes/syc-20350156

Wise, KJ, Bard, PA, & OBeirne, GA. (2015). Tinnitus Healthcare in New Zealand. New Zealand Medical Journal:128(1423).

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