One of the main symptoms often found in a person with a hearing impairment or even normal hearing individuals includes a phantom noise heard by one in the ear(s) and no one else. Tinnitus is referred to as noise in the ears which can be ringing, buzzing, and/or a whooshing type of sound (1). While most forms of tinnitus are subjective in that they are heard by the patient themselves, it can also be present in a more objective and rare form. When it is pulsing or beating in nature it is referred to as pulsatile tinnitus and often requires further medical investigation. Tinnitus can occur in both children or adults, one ear or both, intermittent or constant and when it spans over 3 months it is known as chronic.
In most cases, tinnitus is not correlated with severe medical problems. However, in some cases, it can be bothersome to the point where it affects a person’s activity of daily living and in rare cases can lead to anxiety and depression experienced by individuals and greatly impact one’s quality of life.
There are many causes for tinnitus. However, research indicates the most common cause is prolonged noise exposure. Followed by head/neck injuries and infections being the second and third most common leading cause of tinnitus (2). While there is still a lot of research being conducted to understand the causes and potential cure for tinnitus, the pathophysiological theory of tinnitus suggests that the central nervous system is the generator of tinnitus at the level of the peripheral auditory cortex. Medical diagnostic imaging studies indicate abnormal neural activity at the auditory cortex can be the result of lesions in the central auditory system including sensory damage to cochlear hair cells or neural lesions in neurons in the vestibulocochlear nerve (CVIII). In turn, this leads to overstimulation at the level of the auditory cortex and the perception of tinnitus in patients (2). Also, the disruption in the normal functioning of the neural feedback loop from the inner ear and auditory brainstem to the peripheral auditory cortex may lead to abnormal perception of tinnitus (2).
As there is no cure currently for tinnitus some of the most common treatments include hearing aids, various forms of sound therapy, psychotherapy, and/or in some cases cognitive behavioral therapy or tinnitus retraining therapy has been beneficial. There is no medication primarily used for tinnitus reduction, however, in some cases, antidepressants have been shown to be beneficial (3). A systematic review that examines tinnitus management reveals a combination approach leads to the best outcomes for individuals significantly impacted by tinnitus. This may include the use of hearing aids, sound-generated maskers, and tinnitus retraining therapy needs as one or more successful outcomes in combination for successful tinnitus interventions and lead to the best possible outcomes.
Research has shown that one of the main benefits of treating hearing loss with properly fit hearing aids provide consistent stimulation in the form of sound and can provide a masking effect for tinnitus patients. Also, for those with a hearing impairment, hearing aids can help improve communication. Both methods help reduce the sensation of tinnitus (4). Furthermore, hearing external sounds with appropriately fit hearing aids can be known to restore neural function by restrengthening neural connections to the brain which may result in increased neural plasticity by providing consistent stimulation of the auditory pathways. This can help rewire the peripheral auditory pathway and may lead to a perceived reduction in the perception of tinnitus short or long-term for patients with hearing loss (4).
Furthermore, it is important to use conservative measures in the form of hearing protection in loud environments to help protect your ears as much as possible from prolonged noise exposure. Also, if you are experiencing ringing in your ears that is acute or chronic, a periodic audiological examination conducted by a hearing aid practitioner, audiologist, or physician may be useful to check the functioning of the ears and overall health of the peripheral auditory pathways. In turn, it can be beneficial in understanding potential causes and treatments available for tinnitus and for the best hearing health possible.
References
- What is tinnitus? – causes and treatment. National Institute of Deafness and Other Communication Disorders. Accessed August 7, 2023. https://www.nidcd.nih.gov/health/tinnitus.
- Atik A. Pathophysiology and treatment of tinnitus: an elusive disease. Indian J Otolaryngol Head Neck Surg. 2014;66(Suppl 1):1-5. doi:10.1007/s12070-011-0374-8
- Hoare DJ, Kowalkowski VL, Kang S, Hall DA. Systematic Review and Meta‐analyses of randomized controlled trials examining tinnitus management. The Laryngoscope. 2011;121(7):1555-1564. doi:10.1002/lary.21825
- Del Bo L, Ambrosetti U. Hearing aids for the treatment of tinnitus. Tinnitus: Pathophysiology and Treatment. Published online 2007:341-345. doi:10.1016/s0079-6123(07)66032-4
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