Tinnitus is a hearing problem that is characterised by hearing sounds that are not coming from the external environment. These may also be called phantom sounds. The most common description of tinnitus is a ringing in the ears, but some people describe a buzzing, clicking, hissing, or roaring sound. The pitch and volume can vary, and it can affect one or both ears.

Tinnitus is a relatively common problem affecting millions of people. Normally it lasts for just a few minutes, but in other cases, it can be persistent.

What are the Types of Tinnitus?

Tinnitus is broken down into one of two types.

- Subjective tinnitus means only the patient hears the sounds. Though the exact cause is unknown, subjective tinnitus appears to be related to issues in the part of the brain that processes and interprets sounds.
- Objective tinnitus means that another person, such as a doctor, can hear the sounds as well. This can occur with changes to the flow of blood through blood vessels near the ear.

Subjective tinnitus is much more common than objective tinnitus.

What are the Causes of Tinnitus?

Tinnitus frequently occurs along with other ear problems; it is a symptom of up to 75% of ear disorders. It very commonly occurs along with hearing loss and has many of the same causes. Tinnitus is regularly correlated with acquired hearing loss that is related to aging, noise exposure, or ototoxic drugs.

Like hearing loss, tinnitus can be caused by a blockage in the ear from earwax or a foreign object. Ear infections, sinus infections, or problems with pressure in the Eustachian tube can induce tinnitus.

Though less common, tinnitus can be tied to other health issues like thyroid problems, anemia, cardiovascular issues, brain tumours, head injury, diabetes, and Menieres disease. Stimulants (including caffeine), alcohol, and smoking are not considered to be causes of tinnitus, but they can make it worse.

The diagnostic process for tinnitus is similar to that of hearing loss. A physical examination and review of the patient’s symptoms and medical history provide the doctor with a base level of information. A stethoscope may be used to check for objective tinnitus. Audiometry is usually employed to evaluate overall hearing. A CT scan, MRI, and/or angiography (a test looking at blood vessels) can be conducted to check for possible causes.

How is Tinnitus Treated?

As with hearing loss, treatment for tinnitus depends on the cause of the condition. Effectively treating an underlying cause can eliminate tinnitus. Some medications may be prescribed to try to decrease or eliminate tinnitus.
When tinnitus cannot be eliminated, treatments may be used to minimise its impact. These can include methods to amplify other noises such as the use of a tinnitus masker, hearing aids, background music, or a white noise machine.

Another strategy for coping with tinnitus involves counselling and/or techniques for relaxation. These approaches can help a person manage stress and avoid focusing on the sounds.

How is Tinnitus Diagnosed?

Testing methods are much like those for hearing loss

Hypercausis
Hyperacusis is sound intolerance; moderately loud sounds are uncomfortable or painful. About 85% of those with hyperacusis also have tinnitus. Its subtypes are: loudness hyperacusis; annoyance hyperacusis (misphonia) – such as the noise made by someone chewing or repetitive sounds such as pen-clicking; fear hyperacusis (phonophobia); and pain hyperacusis (piercing headaches). Hyperacusis may also have visual triggers. It can be managed through lifestyle and judicious use of earplugs.

There are phenomena when people can hear sounds that no-one else can. These sounds exist, however, most people have learned to channel them out. This could be something like an underground heating system, children playing fields away. this is an extremely tiring and stressful condition.
 

How Can Hearing Problems be Prevented?

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