Tinnitus (Ringing in the Ears)

What Is Tinnitus?
It is usually described as a ringing noise, but in some individuals it takes the form of a high pitched whining, buzzing, hissing, humming, or whistling sound, or as ticking, clicking, roaring, “crickets” or “locusts”, tunes, songs, or beeping. It has also been described as a “whooshing” sound, as of wind or waves. Around 15% of people experience this at some stage of life and it’s more likely to occur after the age of 60.

What Causes it?
Most tinnitus comes from damage to the microscopic endings of the hearing nerve in the inner ear. The health of these nerve endings is important for acute hearing, and injury to them brings on hearing loss and often tinnitus. If you are older, advancing age is generally accompanied by a certain amount of hearing nerve impairment and tinnitus. If you are younger, exposure to loud noise is probably the leading cause.

There are many causes for “subjective tinnitus,” the noise only you can hear. Some causes are not serious (a small plug of wax in the ear canal might cause temporary noise in the ear). Tinnitus can also be a symptom of stiffening of the middle ear bones (otosclerosis).

Why is it Worse At Night?
During the day, the distraction of activities and the sounds around you make your ear ringing less obvious. When your surroundings are quiet, the noise may seem louder and more constant. Fatigue and stress may also make it worse.

How Can it Be Treated?
Once you have had a thorough evaluation, an essential part of treatment is your own understanding of the tinnitus, i.e., what has caused it, and your options for treatment. Every case is different. Some patients are able to ignore their tinnitus or notice that it goes away over time. Other individuals find it very bothersome and distracting. Clinical evidence shows that the use of hearing aids provides two benefits: it makes the patient less aware of the tinnitus, and it improves communication by reducing the annoying sensation that sounds and voices are masked by tinnitus.

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