What Causes Ringing In The Ears?

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Tinnitus may sound like it is coming from your ears, but treatment is aimed at the brain.

Tinnitus (pronounced tih-NITE-us or TIN-ih-tus) is the name for hearing a sound that is not physically present in the environment. Some researchers have also described tinnitus as a “phantom auditory perception.” People with tinnitus most often describe it as ringing, buzzing, cricket sounds, humming, and whooshing, although many other descriptions have been used. To hear some sound samples access the American Tinnitus Association website, where they have put together files of different manifestations of tinnitus to listen to for education purposes.

Tinnitus is quite common; as many as 30 million Americans have the condition. Of this 30 million, 20% report to be disabled by it. An audiologist may test two people who report identical loudness and frequency of tinnitus yet one person suffers from it and the other barely notices it.  Tinnitus is believed to be caused by inner ear cell damage. Cilia in your inner ear move in relation to the pressure of sound waves. This triggers these cells to release an electrical signal through a nerve from your ear (auditory nerve) to your brain. Your brain interprets these signals as sound. If the hairs inside your inner ear are bent or broken, they can "leak" random electrical impulses to your brain, causing tinnitus. The important thing to remember about tinnitus is that the brain’s response to these random electrical signals determines whether or not a person is annoyed by their tinnitus or not.  Magnetoencephalography (MEG, for short) studies have been used to study tinnitus and the brain.

MEG takes advantage of the fact that every time neurons send each other signals, their electric current creates a tiny magnetic field. MEG allows scientists to detect such changing patterns of activity in the brain 100 times per second. These studies indicated tinnitus affects the entire brain and helps with understanding why certain therapies are more effective than others.

Common Causes of Tinnitus:

1. Noise exposure. Exposure to loud noises can damage the outer hair cells, which are part of the inner ear. These hair cells do not grow back once they are damaged. Even short exposure to very loud sounds, such as gunfire, can be damaging to the ears and cause permanent hearing loss. Long periods of exposure to moderately loud sounds, such as factory noise or music played through earphones, can result in just as much damage to the inner ear, with permanent hearing loss and tinnitus. Listening to moderately loud sounds for hours at a young age carries a high risk of developing hearing loss and tinnitus later in life.

2. Medication. Some medications are known to be ototoxic while others list tinnitus as a side effect without causing permanent damage to the ear structures. New medications come out so often that it is difficult to maintain an up to date listing; another option, if you are experiencing tinnitus and are curious if it could be your medication, is to talk to your pharmacist or look up your specific prescriptions online through a website such as www.drugs.com.

You should never stop a medication without consulting with your physician, even if you think it may be contributing to your tinnitus.

3. Age-related hearing loss.

4. Earwax blocking the ear canal. When too much earwax accumulates, it becomes too hard to wash away naturally, causing hearing loss or irritation of the eardrum, which can lead to tinnitus.

Less Common Causes of Tinnitus:

1. Meniere's disease. Tinnitus can be an early indicator of Meniere's disease, an inner ear disorder that may be caused by abnormal inner ear fluid pressure. A feeling of ear fullness, vertigo, and hearing loss are other symptoms of Meniere’s disease.

2. Ear bone changes. Stiffening of the bones in your middle ear (otosclerosis) may affect your hearing and cause tinnitus. This condition, caused by abnormal bone growth, tends to run in families.

3. TMJ disorders. Problems with the temporomandibular joint, the joint on each side of your head in front of your ears, where your lower jawbone meets your skull, can cause tinnitus.

4. Head injuries or neck injuries. Head or neck trauma can affect the inner ear, hearing nerves or brain function linked to hearing. Such injuries generally cause tinnitus in only one ear.

5. Acoustic neuroma. This noncancerous (benign) tumor develops on the cranial nerve that runs from your brain to your inner ear and controls balance and hearing. Also called vestibular schwannoma, this condition generally causes tinnitus in only one ear.

If you are experiencing tinnitus, it is important to have a complete hearing evaluation. In some cases, your audiologist will refer you to an ENT specialist to rule out underlying medical conditions that require treatment before discussing treatment options with you.

Sources:

Tinnitus: Ringing in the Ears and What to do About it.Harvard Health Publications. Retrieved September 22, 2014 from  http://www.health.harvard.edu/diseases-and-conditions/tinnitus-ringing-in-the-ears-and-what-to-do-about-it

http://www.ata.org/for-patients/about-tinnitus 404

Tinnitus Prevalence. American Academy of Audiology. Retrieved September 23, 2014 from http://www.audiology.org/news/tinnitus-prevalence

Zimmer, Carl. (2010, October 27). Ringing in the Ears Goes Much Deeper. Discover Magazine. Retrieved September 21, 2014 from http://discovermagazine.com/2010/oct/26-ringing-in-the-ears-goes-much-deeper

Wright EF, Bifano SL. The Relationship between Tinnitus and Temporomandibular Disorder (TMD) Therapy. Int Tinnitus J. 1997;3(1):56-61

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