1) First of all, how is it pronounced? Tin-ni-TIS or ti-NITE-is??? It’s pronounced
either ti-NIGHT-us
or TIN-i-tus.
Both pronunciations are correct. The word is of Latin origin, from tinnire meaning "to ring or
tinkle like a bell."
2) Exactly what is Tinnitus? Tinnitus is the medical
term for the perception of sound in one or both ears or in the head when no
external sound is present. It is often referred to as "ringing in the
ears," although some people hear hissing, roaring, whistling, chirping or
clicking. Tinnitus can be intermittent or constant-with single or multiple
tones-and its perceived volume can range from subtle to shattering. It is important to remember that Tinnitus
itself is NOT a disease, but rather a symptom of something else.
3) How prevalent is it?
According to the latest census by the CDC, approximately
50 million people in the United States experience tinnitus to
some degree. Of these, about 16 million have it severe enough tinnitus to seek
medical attention and about two million patients are so seriously debilitated
that they cannot function on a "normal," day-to-day basis.
4) What affect does
tinnitus have on someone’s lifestyle? The
affects can range from barely noticing it at all, to severe debilitation,
anxiety, depression, and even thoughts of suicide. Most commonly, tinnitus can
interfere with concentration, especially in quiet, communication if it’s loud
enough, and sleep – being able to fall and or stay asleep.
5) What role does
depression play in tinnitus? Depression
is the “Catch-22” of tinnitus. Although depression does not necessarily “cause”
tinnitus, it can make your reaction to it exaggerated. You begin to perceive
the tinnitus as going from bad to worse. And that can add to depression. Tinnitus
severity is a very personal and subjective thing. A person’s overall
personality contributes to their perception and management of their tinnitus.
It can be a vicious cycle.
6) Are there
different types of tinnitus?
Tinnitus
is divided into Subjective tinnitus and Objective tinnitus. Most people
experience Subjective Tinnitus, that is, tinnitus that is only heard by the
person. This type of tinnitus can be a ringing, buzzing, crickets, humming….It
can be in one ear or both ears, it can be constant or permanent. Objective
tinnitus can actually be heard by someone else, such as a doctor. This tinnitus
is usually pulsatile – like a heartbeat – and is usually caused by a
circulatory problem. Sometimes it can also be a clicking sound and caused by
muscular contractions or even the cracking of the jaw. Some tinnitus can even be caused by certain
head movements.
7) What are some of
the more common – and maybe not so common – causes of tinnitus?
The
most common cause of subjective tinnitus is hearing loss, or some type of
damage to the auditory system. This damage can be caused by wax, middle ear
problem, growths, certain ototoxic drugs or, most commonly, noise. Other causes
can be system wide such as high cholesterol, high blood pressure, certain viral
or bacterial diseases such as Lyme Disease, thyroid disease, sinus problems,
fibromyaglia, TMJ, allergies.…
8) You mentioned
Ototoxic drugs. Exactly what are those? Ototoxic
drugs are medications that are harmful or damaging to the ear. They can cause
hearing loss, balance disorders, and/or tinnitus. They can be antibiotics,
diuretics, blood pressure meds, psychotropic drugs. etc. The effects depend on
dosage and duration and can be permanent or temporary. It is important to
discuss your medications with your physician if you experience any side effects
or worsening of symptoms. It is very important NEVER TO STOP OR CHANGE A DOSE
without speaking to your doctor.
9) If someone thinks
they have tinnitus, what should they do? Well,
the first thing they should do is talk to their physician. Tinnitus should not
be ignored. Remember, tinnitus is a SYMPTOM, not a disease, so you should
always rule out a medically treatable cause of the tinnitus. Unfortunately,
most physicians don’t know much about tinnitus and will usually just brush you
off and tell you to just live with it.. Next step should be to see an
audiologist who specializes in tinnitus, who can take a complete history and do
a complete audiological and tinnitus evaluation. You will consult other medical
professionals as well, such as an otolaryngologist, possibly a neurologist, or
even a psychologist or psychiatrist.
10) What is a
Tinnitus Evaluation? There
are several parts to a Tinnitus Evaluation. An Audiologist does the
Audiological evaluation to determine any hearing loss. Then the Tinnitus itself
is evaluated for pitch, loudness, masking and residual inhibition, that is –
can the tinnitus be suppressed by any other sounds? There are also various
questionnaires to be completed such as the Tinnitus History, Tinnitus Handicap
Inventory and the Tinnitus Function Index. All these questionnaires help in
determining how the tinnitus affects lifestyle, how it affects communication,
how depressed the tinnitus patient is, etc. Also part of the evaluation is a
complete physical exam including bloodwork, possibly even CT and MRI scans if
indicated.
11) Are there any
other hearing problems that can accompany tinnitus? Yes,
very often people with tinnitus also claim they are sensitive to certain sounds
that these sound “hurt” their ear, or that normal sounds are unbearably loud. Others
complain that they actually avoid certain sounds because they elicit such a
negative response, such as fear, pain, etc. Hyperacusis is defined as a
collapsed tolerance to normal environmental sounds such as a baby crying or
turning the pages of a newspaper. Misophonia is an actual hatred of certain
sounds because of the intense emotional response. Hearing someone eating with
their mouth open, sneezing, coughing, sniffling or chewing….You can feel
enraged when someone makes repetitive noises like tapping, clicking a pen,
typing on a keyboard, eating crunchy foods or making other sounds.
12) What treatment
options are available for tinnitus? If
there is no medical treatment available, assuming any medical reason has been
ruled out, there are several options for treatment. The most successful ones
involved some type of sound therapy, such as hearing aids if there is a hearing
loss, or a sound machine…that makes the tinnitus less noticeable. We don’t want
to mask or cover up the tinnitus, but rather we want you to “habituate” or get
used to the tinnitus so you no longer notice it. The second part of treatment
of treatment involves some type of counseling, or cognitive behavioral
intervention to alter your response to the tinnitus. This can also involve
meditation and relaxation techniques. Very important is to avoid pills or drugs
or treatments that claim an immediate and complete cure. If it’s too good to be
true, it is. And we don’t really “cure” tinnitus at this point, we “treat” it.
13) Is there any way
to prevent tinnitus? Well,
since the leading cause of tinnitus is hearing loss, the best thing to do is
take care of your hearing. Avoid noise, keep healthy, try to avoid or limit
certain medications, exercise, avoid or limit stress.
14) Are there any
resources for the public to learn more about tinnitus?
The
best resource is the American Tinnitus Association ATA.org. There is a wealth
of info on their site as well as a list of professionals who evaluate and treat
tinnitus.
