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Understanding Tinnitus: Ringing in the Ears 

More than 50 million people are bothered by tinnitus and approximately 20 percent of those people are severely affected by it. 

Tinnitus is a sound that is heard without any external stimulation. It can be high or low-pitched; it may sound like humming, clicking, buzzing, whistling, chirping or roaring. The sound may come and go and sometimes people say the loudness of their tinnitus changes. Tinnitus is a symptom, not a disease and is not threatening to one’s health. 

Most tinnitus can only be heard by the person experiencing it. This is called subjective tinnitus. The cause of subjective tinnitus is generally unknown; however, more than 90 percent of cases with subjective tinnitus have hearing loss. Sometimes tinnitus can be heard by an examiner using a stethoscope. This type of tinnitus is called objective tinnitus and is not very common. 


Objective Tinnitus  

Objective tinnitus is often rhythmic and may be synchronous with the pulse or with respiration. It may be caused from blood flow through the vessels in the surrounding area. Objective tinnitus may also be associated with abnormal clonic muscular contractions of the palatal or middle ear muscles. This may sound as an intermittent series of sharp, regular clicks, or with palatal myoclonus, as a fairly regular, continuous clicking sound. 


Subjective Tinnitus  

Subjective tinnitus is the most common type. Usually, once this type of tinnitus starts, it will decrease or totally stop over time and only persists in 25 percent of the cases. Hearing trauma may cause permanent hearing loss and tinnitus, which begins immediately after the incident of noise exposure. Other documented causes of tinnitus are: cardiovascular disorders, metabolic disorders (anemia, thyroid disease or diabetes) neurologic disorders, head trauma, medication or drugs, dental disorders, stress/depression and debris on the eardrum. 


Tinnitus that Changes Pitch  

This type of tinnitus may occur when moving the mouth or clenching teeth and can be the result of tension in the sternocleidomastoid muscle. It responds well to craniosacral therapy. First, rule out temporal mandibular joint dysfunction (TMJ). Also, have a dentist check for a tooth abscess or impacted wisdom tooth.  


Managing Tinnitus  

The management of tinnitus is as varied as the causes. Notice this section is not titled the cure of tinnitus but rather the management of it. People with tinnitus may want to avoid loud sound without hearing protection. Avoid caffeine, smoking, taking aspirin and medications that cause tinnitus. Treatments may include stress management, biofeedback, medications, electrical stimulation, surgery, hearing aid or tinnitus masker. It is recommended that the tinnitus sufferer use a fan or other noise maker in the bedroom when sleeping to mask the tinnitus. You may want to try to sleep in an elevated position with one or two pillows to help with any head congestion. Research all medications and supplements you take to see if tinnitus can be a side effect. A website to check out is, and go to side effects for the drug you list. 


Stress and Tinnitus  

Stress and tinnitus seem to go hand in hand. Stress can cause tinnitus and tinnitus can cause stress. If you are experiencing a short-term increase of stress in your life and have noticed you now have tinnitus, it usually will decrease when the stress decreases. If you have tinnitus that comes and goes and really does not give you any grief, then you may be fine with the management ideas listed earlier above. Another scenario is fluctuating tinnitus, which could feel like it’s driving you crazy! How do you deal with something you are unable to escape from no matter how hard you try?  


What Do You Do?   

Know you are not alone in your suffering. Rule out any of the causes listed earlier in this article. Make an appointment with an audiologist to have a hearing evaluation and discuss the tinnitus. See your physician to rule out any medical causes for the tinnitus. Take notes with you to the appointment describing the sound you hear, how often you hear it and what makes the sound better or worse. Note your foods and see if there is a relationship between an increase in tinnitus and what you had eaten the day before. There are numerous websites that offer support to individuals with tinnitus. Be careful about buying products over the counter or on the internet that profess to cure tinnitus. Your physician or audiologist can help you find the best management options for your particular situation. QCBN 


By Karon Lynn, Au.D. 

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