What is tinnitus?

Tinnitus is the perception of sound in ears or head in the absence of external stimuli.

How common is tinnitus?

Tinnitus affects 1/3 rd of all adults at some time in their lives. In the majority it is temporary.

What are the causes of tinnitus?

Any condition affecting the outer ,middle or inner ear can cause tinnitus

Do you suffer from tinnitus?

If so ask yourself the following questions to help yourself as well as your treating ENT doctor understand your condition better.

1. What is the type of sound?

• Clicking

• Buzzing

• Roaring

• Pulsatile appreciated with each heart beat

2. Where do you hear the sound?

• one ear

One sided tinnitus is of more concern as serious illness may be responsible for it.

• both ears

• in head

3. Can others too hear the sound?

This is called objective tinnitus and has definite pathophysiology and treatment.

4. Is it constant or intermittent

5. Is there any condition which worsens it?

6. Is there any condition which makes it better?

7. Do you suffer from any of the below listed conditions

• Anaemia[Low hemoglobin]

• High Blood pressure[BP][hypertension]

• Thyroid diseases

• Heart disease

• Hearing loss

• Fullness in ears

• Dizziness

• Headache

• Vision abnormalities

• Excess weight

• Recent weight loss

8. Is there any history of

• Noise exposure – sudden loud noise or prolonged noise exposure

• Injury to head or ears

• Temporomandibular joint [jaw joint] problems

• Ear infections

• Ear surgery

• Depression

9. Do you use any medications on a regular or on off basis?

Several drugs can produce tinnitus by being toxic to the inner ear [ototoxic drugs].Discuss your list of medications with your ENT doctor.

10. How much is it affecting your activities?

11. How much does it bother you?

What should you do if you have tinnitus?

1. Meet your physician for checking your blood pressure and cardiac status + general health.

2. Visit an ENT specialist in your locality

Your ENT doctor will examine your ear with an otoscope and perform a detailed head and neck examination

3. Your ENT doctor may order further investigations such as

• CT scan &/ MRI

• Audiometry

• Blood tests

What is the management for tinnitus?

Management involves first and foremost ruling out sinister causes such as tumours and subsequent targeted therapy depending on the individual case.

Treatment options include:-

• Dietary regulation

• Drug regulation

• Behavioural therapy and biofeedback

• Intratympanic therapy

• Medications

• Surgery depending on case

• Tinnitus retraining

• Masking therapy and Tinnitus maskers

• Stop smoking

Is there anything to do to lessen intensity of the tinnitus?

Any factor affecting overall health can affect the tinnitus.

• Avoid exposure to loud sounds and noises.

• Control blood pressure.

• Decrease salt intake.

• Avoid nerve stimulants such as coffee and colas (caffeine) and tobacco (nicotine).

• Reduce anxiety.

• Try to stop worrying about the tinnitus. Often, the more you worry and concentrate on the noise, the louder it will become.

• Get adequate rest and avoid fatigue.

• Exercise.

• Utilize masking noise. Tinnitus is usually more bothersome when the surroundings are quiet, especially when you are in bed. A competing sound such as a ticking clock, a radio, and a fan or white noise machine may help mask tinnitus.

• Discuss with your ENT doctor if you are taking aspirin or some other drug regularly as it may cause tinnitus and may need to be discontinued.

What may be done to prevent tinnitus?

• Do not use cotton ear buds (Q-tips) to clean your ear. This can cause a wax impaction which can cause tinnitus

• Control hypertension[high blood pressure[BP]] with medications as adivised by your doctor and regularly monitor your BP

• Protect your hearing at work. Wear ear plugs or earmuffs and follow hearing conservation guidelines set by your employer.

• When around any noise that bothers your ears (a music concert, sporting event, hunting) wear hearing protection or reduce noise levels.

• Even everyday noises, such as blow drying your hair or using a lawnmower, can require protection. Keep ear plugs or earmuffs handy for these activities.

Dr Sonia Suprabha Venugopal

Consultant ENT & Head & Neck Surgery

Website:

ENT Specialist Bangalore