TINNITUS - Full extract 

Tinnitus means noises in the ear or head, when no external noise is present. It is audible only to the person concerned and may be described as ringing, buzzing or whistling, although a variety of other descriptions are also given.

Most people experience brief episodes of tinnitus at times, perhaps with a heavy cold or after hearing a loud noise. However, for about 75,000 Australians, it is a condition that seriously disrupts their life.

The hearing mechanism is a complicated piece of anatomy. Inside the outer opening of the ear is a small canal that contains a varying amount of wax and comes to a blind end at the eardrum.

Next is the middle ear space, where three tiny bones or ossicles pick up the vibrations of the eardrum caused by soundwaves and conduct them to the inner part of the ear. Here a complex sensory apparatus converts the vibrations to nerve impulses, which are then relayed by the auditory nerve to the brain.

In most cases the precise cause of tinnitus is never fully established. Any disturbance along the hearing pathway can cause it, and several factors may be responsible. As such, it is often a difficult condition to treat.

Probably the most common cause of tinnitus is a history of prolonged noise exposure, often in an industrial work situation. There may be some associated nerve deafness.

Exposure to loud noise can cause tinnitus, for instance in people who work in the music industry. Sudden exposure to bursts of loud noise may also cause tinnitus, but fortunately this is usually temporary.

Any disturbance of the inner ear can cause the problem. Some viral infections cause inflammation in the inner ear and may lead to tinnitus, as well as dizziness and vomiting. Some medications like aspirin and quinine can also cause tinnitus. Caffeine, smoking and even certain foods can aggravate the condition. Wax in the external canal may temporarily cause noises in the ear, as can middle ear problems due to infections and allergies.

Many people with tinnitus fear that they are about to have a stroke or might have a brain tumour, but it is very uncommon to detect a serious underlying cause. However, a full medical check-up is essential. After confirming that there are no medical problems like high blood pressure or medication side-effects, the GP will usually arrange a referral to an ENT (ear, nose and throat) specialist or an audiologist for further assessment.

It is not unusual to be aware of a slight pulse in the ear when going off to sleep. However, a loud pulsating tinnitus should always be mentioned to the doctor in case it is due to a narrowed blood vessel or some other problem.

When treating tinnitus it is important to establish whether there is an associated hearing loss. A hearing aid may be recommended because improving the hearing of external sounds can dampen the effect of tinnitus. Reduced hearing in one ear is particularly important, and requires further investigation to make sure there is no underlying problem with the auditory nerve on that side. Persistent tinnitus often leads to considerable stress and this may further aggravate the condition. As with any chronic health problem, better understanding may make it easier to manage.

Fortunately, there are a number of techniques that can help. Masking techniques of various types may be useful, for instance setting an FM radio between stations at night to create a static noise. The basis of masking is that exposure to external noises can help block out the perception of tinnitus. A small device called a tinnitus masker can be worn behind the ear to create a similar effect. Hobbies and activities that distract from the tinnitus may be useful. Relaxation techniques, biofeedback, hypnotherapy and acupuncture may also bring about an improvement.

Health Tip:
* It tinnitus has been diagnosed, find out as much as you can about the condition. For details about regular seminars and personal instruction from staff very experienced in the management of tinnitus, contact the HEAR service at the Victorian Deaf Society (03) 9657 8199

Dr. Andrew Pattison: Common Consultations
North East Valley Division General Practice, Melbourne, Australia.   Disclaimer
  - Last modified: August 18, 2001