Tinnitus is the perception of sound without any obvious source producing it. Up to one fifth of the population may experience tinnitus. Although the problem may often be mild, it nevertheless can be such a nuisance that the patient might want to seek relief.
Causes of Tinnitus
Normally, neural processes help tune auditory memory in the brain. Tinnitus often occurs because of dysfunction with the auditory system or its nerve pathways leading to the brain such that there is abberant processing of signals. Most cases of tinnitus are described as subjective tinnitus, one with no true identifiable sound source. This can occur due to environmental factors, such as exposure to excessively loud noise on work or leisure settings, as well as auditory conditions, including Meniere's disease and ototoxicity from aminoglycoside antibiotics. Rarely, tinnitus is characterized as objective tinnitus with an identifiable source of sound inside or outside the auditory system, such as sufficient narrowing of the carotid artery, that a physician can detect.
Symptoms May Vary
Patients with tinnitus vary in the ways they describe the abnormal sound in their ears. Commonly reported sound qualities include ringing, buzzing, roaring, or hissing. The sound may be in one ear or both ears, continuous or intermittent, and pulsating or nonpulsating. In severe cases, tinnitus can make patients anxious, depressed, and unable to sleep.
Evaluation by Physician
Once the physician learns that a patient is having tinnitus, the next step is to further evaluate the symptom. Additional information from the patient history can help narrow down the possible causes, as does a physical examination. One important diagnostic modality is an audiogram to assess the patient's hearing ability. Sometimes, imaging with computed tomography (CT) or magnetic resonance imaging (MRI) can be used to rule out specific causes of tinnitus that can be seen in the head.
Treatment for Tinnitus
There are various options for treating tinnitus, although no one treatment modality is considered standard for all cases of tinnitus. If there is an underlying cause for the tinnitus, such as a tumor along the eighth cranial nerve (acoustic neuroma), that should be addressed. Otherwise, one may attempt to learn cognitive techniques in order to distract oneself from the tinnitus. Methods of stress management, such as relaxation, may help with mental and emotional disturbances associated with tinnitus. Other methods may include masking, a technique to cover up the tinnitus using another externally produced sound, and hearing aids to amplify sounds other than the tinnitus. Generally, patients are treated with not one but several of these options.
References
 |
