Thursday, November 01, 2012 10:37 AM

Tinnitus is often described as chronic ringing, roaring, buzzing, humming, chirping, or hissing in the ears in the absence of environmental noise. Some experts insist that for Tinnitus to be legitimate as a condition it needs to last over 5 minutes.


Prevalence:
10-15% of adults, most often in the 60-79 year age group.
80 % of them don’t need any treatment.
20% are significantly affected – what can worsen the distress is the persons psychological reaction to it which can sometimes be out of proportion to its severity.


Commonest causes of Tinnitus:
Idiopathic – 40% have no known cause.
Age related hearing loss.
Loud noise exposure commonest preventable cause of Tinnitus. This is often more disabling than the hearing loss associated with it.
Head and neck trauma or illness – relatively common.


Common also:
Chronic sinusitis
Migraine  
Cervical spondylosis – neck arthritis
Abnormality in the ear eg ear polyp, menieres disease, ear wax
High blood pressure
Severe anaemia – very low iron
Atherosclerosis
Head injury
Stress can play a role – reduced mangnesium in the body
Psychological disorders  
Food or drugs eg Excess coffee, aspirin, non steroidal anti-inflammatory drugs, quinine in Tonic water
Many other drugs and less common health conditions


Cause not to miss:
Acoustic Neuroma -  rare but important tumour of the nerve of hearing. This is why seeing a specialist is important when tinnitus is new


Treatment of Tinnitus:
Always see your doctor if Tinnitus has just started. You can be referred to a specialist is there is the need to investigate further.

Detecting Acoustic neuroma – a condition not to miss. An early symptom of acoustic neuroma — an eighth cranial nerve tumor — one sided tinnitus starts before that side loses hearing and vertigo occurs. Then facial paralysis, headache, nausea, vomiting, and swelling of the optic disc at the back of the eye may also occur.

With atherosclerosis of the carotid artery, there is constant tinnitus that can be stopped by applying pressure over the carotid artery.

With cervical spondylosis – neck arthritis, the bony growths may compress the vertebral arteries, resulting in tinnitus. Typically, a stiff neck and pain aggravated by activity accompany tinnitus. Other features include brief vertigo or a spinning sensation, hearing loss,numbness, weakness, and pain that radiates down the arms.


Severe hypertension can cause two sided, high-pitched tinnitus
Ménière’s disease is most common in adults — especially in men between ages 30 and 60.  There are attacks of tinnitus, vertigo, a feeling of fullness or blockage in the ear, and fluctuating hearing loss. These attacks last from 10 minutes to several hours; they occur over a few days or weeks and are followed by a remission. Severe nausea, vomiting, sweating, and vertigos may also occur during attacks.


Drug treatments of Tinnitus:
Make sure that its not from a drug being taken
tranquillizers
antidepressants – for underlying depression


Some of the different alternative treatment of Tinnitus include:
Ginkgo  Bioloba - mixed studies
Zinc – effective for some
Magnesium
Optimize B12 levels
Acupuncture – mixed studies
Stress manangement if approapriate


Helpful techniques for some
Maskers - electronic devices to hide the tinnitus noises.
Listening to sounds - music, radio static (for sleeping), natural sounds, etc.


TAKE HOME MESSAGES ABOUT TINNITUS
In most people it causes no problems and doesn’t need treatment.

BEWARE  - Sudden onset  - one sided Tinnitus – must be checked by a specialist for serious conditions like a tumour.

LOUD NOISE – is a preventable cause of lifelong Tinnitus.