Harpreet Thandi

‘Tinnitus’ is a term used to describe hearing sounds which are not actually present in the ‘real world’. As the result of miscommunication between the sounds the ears pick up and how they get translated to the brain, it is colloquially named, the ‘Music of the brain.’ These sounds can vary considerably, from buzzing and hissing, to more rarely music or noises in time with the sufferer’s pulse (pulsatile tinnitus). This creates sensitivity to daily sounds (hyperacusis) and reduced hearing overall.


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Causes The causes of tinnitus are far-ranging. Generally, anything that affects the brain or ears can cause tinnitus. Common causes include damage to the inner ear and middle ear infection or a build-up.

Most cases occur from damage to the inner ear. This includes the cochlea and the auditory nerve. As fluid moves into the cochlea, its sensitive hair cells pick up the sound. The auditory nerve sends this signal to the brain. If the cochlea gets damaged some parts stop sending information. Certain parts stop working and others still send information to the rest of the brain. This reduction creates ‘noise’ leading to tinnitus. This damage occurs naturally with age or due to excessive sound exposure. Other cases include earwax build up or perforated eardrum, Middle ear infection-e.g. glue ear; because of fluid build-up. More rarely, Otosclerosis creates abnormal growth of bones, whilst Meniere’s disease leads to hearing loss and vertigo. It can also be caused by gunfire, anaemia, high blood pressure, some medications, and unique genetic conditions Rarer causes include head injury, exposure to loud or sudden noises-e.g. gunfire or fireworks, and anaemia, where the red blood cell count decreases so much that it interferes with sound perception. Hypertension and atherosclerosis – high blood pressure and narrowing of the arteries are also potential causes – as are Hyperthyroidism and hypothyroidism which are related to the thyroid glands. Some medications, including chemotherapy, antibiotics, diuretics, non-steroidal anti-inflammatory drugs (NSAIDS) and aspirin in very high dosages may also lead to tinnitus. Genetic conditions such as Paget’s disease, which affects bone renewal, and acoustic neuroma creates non-cancerous growth that affects hearing in the inner ear, have also been associated with tinnitus.


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Preventing Tinnitus It’s very difficult to prevent tinnitus if the precise reasons for it are not obvious. If it comes from an underlying medical condition this needs solving. If there is earwax or build up within the ear, this needs treating. Generally, hearing protection needs to be worn and risks need assessing appropriately. The inner ear needs protecting. Exposure to loud music should be minimised if not avoided, and care should be taken to prevent damage to the cochlea. Obviously, this is a big issue for musicians. You can wear hearing protection in loud environments as a safety precaution. Along with this, counselling is important to help a sufferer understand how to carry out specific procedures if they are less obvious.


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Treatment for suffers There are some treatments that can reduce damage, preserve hearing, and hopefully prevent tinnitus. These are typically reserved for people who are experiencing the more severe symptoms of hearing loss or ringing in their ears. Correcting hearing loss reduces the extent of tinnitus by increasing the range of frequencies that are heard Once you develop even the slightest amount of hearing loss, this must be taken seriously – otherwise the brain picks up sounds from the damaged inner ear – leading to tinnitus because of this mismatch. An audiologist or specialist will assess the hearing loss. A hearing aid and/or corrective surgery may then be required. The outcome of these corrections is the ability to hear more frequencies, which are now audible, minimising the sound of tinnitus. Sound therapy involves creating background sound to distract suffers from tinnitus Tinnitus is often heard almost like background noise. This is a big problem because it means you hear buzzing in a quiet environment. Sound therapy takes empty space and fills it with a neutral sound. This helps to drown out the tinnitus sound and has been very successful. The sampled sound varies from background noises to nature. White noise may also be used to help overcome tinnitus. It’s often harder for suffers to sleep; in extreme cases the sound can be so distracting as to make sleep a difficulty. One option is pillows fitted with sound generators to aid sleep. Alternatively, hearing aids are sometimes used to create these sounds over the use of traditional headphones due to practicality. CBT and TRT can change the way you think about your problems Cognitive behavioural therapy (CBT) is traditionally used to overcome anxiety and depression. The idea is to change the way you think about certain behaviours. Tinnitus retraining therapy (TRT) helps you change your brain’s response to tinnitus.


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Sources you can look at: http://www.nhs.uk/Conditions/Tinnitus/Pages/Treatment.aspx Useful NHS Tinnitus information http://www.hearing.nihr.ac.uk/public/auditory-examples-sounds-of-tinnitus

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