Tinnitus

Clinic

• Tinnitus is the perception of sound when no corresponding external sound is present, often described as a ringing, it may also sound like a clicking, buzzing, hissing or roaring. It may be soft or loud, low- or high-pitched, and may seem to come from one or both ears or from the head itself.
• It may interfere with concentration, and in some cases is associated with anxiety and depression.
• Usually associated with a degree of hearing loss and decreased comprehension of speech in noisy environments.
• It is common, affecting about 10–15% of people. Most, however, tolerate it well, and it is a significant problem in only 1–2% of all people.
• Rather than a disease, tinnitus is a symptom that may result from various underlying causes and may be generated at any level of the auditory system and structures beyond that system.

Causes

• The most common causes are hearing damage, noise-induced hearing loss or age-related hearing loss, known as presbycusis. Other causes include
  • Ear infections
  • Disease of the heart or blood vessels
  • Ménière's disease
  • Brain tumors
  • Acoustic neuromas
  • Migraine
  • Temporomandibular joint disorders
  • Exposure to certain medications
  • Previous head injury
  • Earwax
  • Emotional stress, more common in those with depression.

Associated factors

Ear problems and hearing loss

• Conductive hearing loss
  • Acoustic shock
  • Loud noise or music
  • Middle ear effusion
  • Otitis
  • Otosclerosis
  • Eustachian tube dysfunction

• Sensorineural hearing loss
  • Excessive or loud noise; e.g. acoustic trauma
  • Presbycusis (age-associated hearing loss)
  • Ménière's disease
  • Endolymphatic hydrops
  • Superior canal dehiscence
  • Acoustic neuroma
  • Mercury or lead poisoning
  • Ototoxic medications

• Neurologic disorders:
  • Arnold–Chiari malformation
  • Multiple sclerosis
  • Head injury
  • Giant cell arteritis

• Temporomandibular joint dysfunction

• Metabolic disorders:
  • Vitamin B₁₂ deficiency
  • Iron deficiency anemia

• Psychiatric disorders
  • Depression
  • Anxiety disorders

• Other factors:
  • Vasculitis
  • Some psychedelic drugs can produce temporary tinnitus-like symptoms as a side effect:
  • Intracranial hyper or hypotension caused by, for example, encephalitis or a cerebrospinal fluid leak

Remedies

Spig