In rare cases, the doctor can also hear the noise with a stethoscope or a small recording device placed inside the ear canal. This “objective” tinnitus is mostly linked to abnormalities of the inner ear or disturbances in the blood flow within arteries in the neck or head.
In over 95 per cent of cases, though, tinnitus is subjective – only you can hear the noise. This can be associated with repeated exposure to loud noise and the progressive hearing loss of ageing. Exposure to noisy environments commonly affects workers in heavy industries, musicians, and individuals exposed to violent sounds (such as bomb blasts) or who suffered from head or ear trauma.
Unhealthy noisy environments are likely to be responsible over time for significant damages the sensory cells (hair cells) in the inner ear. These cells are sensitive to external vibrations and transmit the “perception of sound” to the auditory nerve and then to the brain. The damaged hair cells may progressively become oversensitive and generate signals without external vibrations, leading to one of the possible explanations of tinnitus. This could explain why some people with tinnitus are oversensitive to loud noise.
Any abnormal process happening on or near the auditory system – from the external, middle and inner ear, the auditory nerve and the brain structure involved in hearing – can induce various types of tinnitus. It could be simple earwax or a foreign body in the ear canal, infection in the ear or sinuses, abnormal blood vessels, Menierere’s disease (caused by the excessive production of fluid in the compartments of the inner ear), jaw hyperactivity or neck arthritis. Rarely does tinnitus result from a tumour developing on the auditory nerve (acoustic neuroma) or in the brain.
Tinnitus is often present in people with hypertension, diabetes and hypercholesterolemia. These illnesses favour the process of atherosclerosis (plaque deposits within the arteries) and may hasten the ageing process of the inner ear. Finally, over 200 medicines may also induce tinnitus.
Some tinnitus may spontaneously disappear, but in most cases, the symptom persists for a long time and in some cases even worsens. Severe chronic tinnitus may negatively impact daily life as it frequently leads to difficulties in concentrating or sleeping.
If you suffer from tinnitus, you may soon be referred to an ENT specialist. After thorough clinical examination, the physician may request additional tests to assess your audition and balance. Some investigations may be used to confirm the diagnosis or rule out others. When a specific cause is found, its treatment often totally eliminates the tinnitus.
However, in many cases, no specific abnormality is ever found and the treatment may only be partially effective in reducing tinnitus. In such cases, people have to “live with it”. There are various therapeutic options that are nevertheless effective in dealing with tinnitus and include the placement of electronic sound generators, hearing aids, acoustic neural stimulation, some medications and counselling programs. Most treatments aim at controlling tinnitus by desensitising the symptom and making it less annoying and sometimes almost “forgettable”.
Prevention of tinnitus starts by limiting your exposure to noisy environments and avoiding high intensity music or violent noises.