Tinnitus

Tinnitus Aurium, Ringing in the Ears

What is tinnitus?

Tinnitus is an annoying sensation of noise in the ear or head when no sound is actually present. Tinnitus aurium literally means "ringing of the ears. " It is usually associated with hearing loss.

Virtually all individuals with hearing loss have tinnitus in one form or another. The individual may have abnormal physical findings such as arthritis, hypertension, cardiac disorders, or traumatic distortion and may be under treatment with various drugs that cause tinnitus. Most commonly tinnitus is associated with noise exposure.

How is it diagnosed?

Tinnitus signs and symptoms

The noises described in tinnitus vary and have been described as ringing, buzzing, whistling, roaring, rushing, humming, hissing, clicking, or other sounds when there is no apparent source of such noise.

The noise can be continuous or intermittent, and they can vary in loudness. They may be in synchrony with the heartbeat.

History: The history is important because certain reversible problems may be discovered such as recurrent exposure to loud noise, drugs producing tinnitus (aspirin, quinine, and quinidine), barotrauma from scuba diving, kidney disease with ototoxic drug treatment (certain drugs that have a direct toxic effect on the inner ear), or lymphoma treatment involving ototoxic drugs.

Physical exam: In at least 90% of individuals, no clinical findings can be identified (subjective tinnitus). On occasion, the examiner is able to hear the noise (objective tinnitus). Examination of the ears usually reveals no abnormalities.

A stethoscope placed over the individual's ear, temporal area, or neck may be used to hear a pulsating sound. In these cases, appropriate evaluation of the vascular system of the head is necessary to detect vascular tumors.

Tests: Audiometry can test for hearing loss. As a person ages, there is a fall-off in hearing perception. Audiometry can determine if there is an abnormal loss of hearing. CT scan and MRI of the head and neck are sensitive scans that can detect abnormalities of the inner and middle ear and the auditory nerve.

How is Tinnitus treated?

Tinnitus is easily treated if the cause is earwax, a foreign object, or mild middle ear infection. However, in many cases, treating the underlying cause of the symptom may or may not have an effect on the ear noise. One form of treatment is to cover up the unwanted noise with competing music or, in some cases, to use a device worn like a hearing aid that produces sound more pleasant than that in the ear.

Medications

Klonopin (Clonazepam), Valium (Diazepam)

What might complicate it?

Loud noises, nicotine, aspirin, caffeine and alcohol may aggravate the condition. Tinnitus may be the first symptom of a serious condition such as a vestibular tumor.

Predicted outcome

If treating the underlying cause of the symptom does not have an effect on the ear noise, the individual must learn to tolerate the symptom.

Alternatives

Other possible diagnoses include infectious diseases, ear obstructions, otosclerosis, Meniere's disease, acoustic trauma, hereditary deafness or occupational hearing loss.

Appropriate specialists

Audiologist, otolaryngologist and psychologist.

Notify your physician if

  • You or a family member has symptoms of tinnitus.
  • Feelings of distress about tinnitus worsen.

Last updated 23 June 2011


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