TINNITUS is best described as phantom ear noise. Descriptive terms are as ubiquitous as the number of people with this affliction which most of us will experience either occasionally or progressively in our lives making it a universal problem. Some describe a roar, others a hum, buzz, hiss, water flowing, ringing, even clicks. The problem may come on gradually, suddenly, be intermittent affecting one ear or both. In many cases there is accompanying hearing loss. There was a time when tinnitus was blamed on “old age” and/ or industrial sound exposure. It is absolutely true an older population is more predisposed to the affliction but the age spectrum has certainly expanded.
Industry, guided by government safety regulations has cleaned house when it comes to hearing protection; but offsetting workplace noise improvements, there are now thousands of headsets bombarding younger ears with proven harmful high decibel readings. High speed motorsports with whining engines and recreational snow, land and water vehicles are all current contributors to hearing loss. Its rare that one would see a small child wearing protective ear baffles at a sports facility but the “roar of the crowd” from a hundred thousand enthusiastic fans is provably harmful. Hopefully, the near future will see this protection in common usage as demonstration of responsible parenting.
The important first step in diagnosing the problem is an attempt to determine a specific cause. In a young child this may involve a medical exam to determine the presence of a simple source such as ear wax compacting against the drum(s) preventing normal sound transmission. The same applies to allergies or infection causing middle ear fluid retention or Eustachian tube obstruction. Smokers are notoriously likely to have Eustachian obstructions from chronic inflammation. For reasons not fully understood, people with low thyroid and/or diabetes are more frequently predisposed to tinnitus.
The demographic where I want to focus primarily is seniors who can be divided in to two groupings, those with a benign age related problem and those with a more serious underlying internal pathology. A visit to the family physician may quickly solve the problem if it’s ear wax. A review of current medications is equally important. Aspirin can be a culprit as can some antibiotics, diuretics and cancer medications. Sometimes a clicking may indicate joint problems with the jaw. A clue here may be the appearance of the problem at night in association with teeth grinding. However, if the tinnitus is of sudden onset especially if accompanied by hearing loss and/or dizziness, immediate medical attention is imperative to forego a possible impending stroke. Pulsating hearing canal noises need to be assessed in
relation to atherosclerosis changes in neck and head blood vessels and/or elevated blood pressure. Alcohol consumption needs to be looked at because alcohol dilates blood vessels and affects blood pressure. Rarely, a benign type of ear tumor called an acoustic neuroma can be at fault. I’ve previously written about vertigo and Meniere’s disease and won’t revisit those.
Reassuringly, for most it is a nuisance condition probably best managed with sound countermeasures while avoiding loud sound sources in future. There is no medication specific for this problem though some individuals with high levels of anxiety, even depression may need these issues managed. Since most people describe the annoyance factor as most prevalent at bedtime, often a soothing background melody is adequate. My personal preference is seaside waves.
Written by: Dr. David Carll