Do not listen to any doctors or friends who say nothing can be done!! A lot can be done to help people experiencing tinnitus.
Tinnitus comes in various forms:
- Most common is a tonal type with a single sound / note e.g. Like a hum or ringing noise. This usually occurs due to an underlying hearing loss either in the inner ear or middle ear but can occur with normal hearing. Sometimes the onset is sudden after exposure to a very loud noise.It is sometimes secondary to a musculo-skeletal problem in the head and neck e.g. Stiff neck, jaw problems or can simply occur due to stress and again may just occur with no obvious cause. Everybody has noises in their ears, which you can record with fine microphones, but most people do not hear it as it is masked by the outside ambient noise in the environment. In hearing loss, less external noise gets in and one is more likely to hear the internal sounds.
- Sometimes it is pulsatile like a heartbeat; this form of tinnitus is usually secondary to a hearing loss in the middle ear e.g. Glue ear or a perforation. Pulsatile tinnitus should be investigated to look for a hearing loss and because it can be due to an abnormality of a blood vessel.
- Clicking type noise – rare but due to involuntary muscle contractions in the middle ear or palate (like an involuntary tic). Causes a machine gun type rattle intermittently.
- Roaring noise – usually the sound of one’s nasal breathing heard very loudly in the ear. This occurs when the Eustachian tube is abnormally open (patulous) allowing the noise to travel up to the middle ear. Usually occurs after sudden weight loss or in pregnancy.
- Unilateral Tinnitus. If the tinnitus is one sided I would recommend investigating with an MRI scan to look for a benign swelling that can occur on the balance or hearing nerve. This is called an Acoustic Neuroma or more correctly a Vestibular Schwannoma. This is an extremely rare cause of tinnitus and in most cases if we detect a swelling it is managed by observation alone. I stress it is extremely rare and extremely unlikely to cause any long term problems even if present. However most people with tinnitus have looked on the internet and are concerned about this.
Management of Tinnitus
Treatment of tinnitus falls into various categories:
- Medical examination and relevant investigations including a hearing test
- Reassurance – often all that is required.
- General advice. Factors such as stress, tiredness and diet(coffee, tea, alcohol, salt, cheese, chocolate) all have a significant effect on the level of tinnitus and taking care to reduce these factors often helps significantly.
- Medical treatment – e.g. Of any ear infection, hearing loss, muscular or dental problem
- Correction of hearing loss where appropriate to allow more external sounds into the ear to mask the tinnitus. This usually takes the form of hearing aids or occasionally surgery. Sometimes all that is required is removal of wax!
- Tinnitus retraining therapy – by an experienced hearing therapist, involves education, correction of hearing loss, reassurance, management of any underlying anxieties and cognitive behavioural therapy where indicated.
The above approach leads to a 90% success rate in getting the tinnitus to either disappear or to a level that does not bother people.
If you would like any further information, please do not hesitate to contact me.
Mr Philip J Robinson MB, FRCS, FRCS (Otol)
PA: Mrs Beverley Bloor
Tel: 0117 9804050
Spire Bristol Hospital
Tel: 0117 9804070