Tinnitus is the sensation of sounds like ringing in the ear that is noticeable with the absence of any external noise. The word means “ringing” in Latin. Tinnitus is a symptom of a condition and is not a disease itself and is not normally the sign of anything serious.

Tinnitus can result from any one of a number of different causes like foreign objects inside the ear, nasal allergies, ear infections, or build up of wax. Hearing loss that comes with aging can also bring on tinnitus as well as taking certain medications and other types of hearing loss due to genetics. Most commonly, tinnitus is the result of hearing loss brought on by noise.

The Characteristics or Symptoms of Tinnitus
Tinnitus can affect just one or both ears. In most cases, those affected by it describe it as a ringing sound, but can it also be characterized by:

· Whining
· Buzzing
· Roaring
· Hissing
· Whistling
· Tinging
· Wooshing

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Some people say that it also sounds like ticking, clicking, songs, beeping, or even the sound that frogs, crickets, or locusts make. The sounds can range from a more subtle background noise to a noise that can even be detected over loud external noises.

The sounds that tinnitus induces can come and go or be continuous, which can cause a lot of distress. Some people report that the intensity changes with movements of the eyes, jaw, tongue, head, or shoulders.

Most of those who have tinnitus have some level of hearing loss. They may not be able to pick up external sounds that are within the frequency range of the sounds they hear caused by the tinnitus. When the term “tinnitus” is used it is normally in reference to cases of phantom noises that are more severe.

There are two types of tinnitus:

· Subjective tinnitus – This is the most common type, and is tinnitus that only the patient can hear. It is usually related to outer, middle, or inner ear problems or by issues with auditory nerves in the brain that translates nerve signals as sounds.

· Objective tinnitus – With this type of tinnitus, a doctor can actually hear the sound during an exam. This is very rare.

Causes of Tinnitus
Objective tinnitus can be caused by muscle spasms in the ear that make clicking or cracking sounds near the middle ear. Some people who have objective tinnitus hear a sound that actually beats in rhythm with their pulse. This is what is known as pulsatile tinnitus and can happen when the flow of blood near the ear changes or there is an increase in blood turbulence. This increased turbulence can be brought on by atherosclerosis. It is rare, but pulsatile tinnitus can be a symptom of a serious condition like an aneurysm in the carotid artery.

There are many different possible causes for subjective tinnitus, most of which are related to disorders of the ear:

· Hearing loss related to age – Many people experience hearing loss as they age, normally near the age of 60. This type of hearing loss is known as presbycusis and it can cause tinnitus.

· Long-term exposure to loud noises – Common sources of hearing loss are loud noises such as from heavy equipment, firearms, and chainsaws. The use of earplugs or headphones in portable music devices can also cause noise-related hearing loss if the music is played loudly and for extended periods. This type of long-term exposure can cause permanent damage to the ears. Attending an occasional loud concert is considered short-term exposure and any hearing loss and associated tinnitus will usually go away.

· Earwax blockages – Too much earwax can build up in the ear canal and become too hard to wash away. This can irritate the eardrum or cause hearing loss, which can occasionally result in tinnitus.

· Medications – Certain oral medications like aspirin can cause subjective tinnitus. There are actually more than 260 medications that list tinnitus as a possible side effect.

Diagnosing Tinnitus
Doctors will conduct several different tests to determine the cause tinnitus that include an Audiological (hearing) exam. The extent of a patient’s tinnitus can be determined by playing sample sounds through headphones in one ear at a time and asking the patient what he or she hears. The tinnitus should be the same as or less than the noises that the patient hears. The results of this test are compared with other results that are considered normal for the age of the patient. This testing method can be used for objective and subjective tinnitus, but comparing the results with “normal” results does not work with subjective tinnitus.

When this type of test is used for someone with subjective tinnitus, they can often hear the sounds even when played at very low levels. This indicates that the tinnitus would be very difficult for them to hear. But if the patient is asked to focus only on the tinnitus and not the sound that is played, they will usually report that they can hear the sound even when the test noise is played at very high levels. This shows that their tinnitus is noticeable in environments that are both quiet and loud.

Treatment
The treatment for tinnitus is based on the underlying cause. For instance, if the tinnitus is due to an earwax blockage, removing the earwax should decrease the tinnitus. If a certain medication is the cause, the doctor will recommend stopping or reducing the dosage of the drug, or changing to a different one. For a patient with objective tinnitus who is diagnosed with a vascular condition, the treatment could be anything from medication to surgery to correct the condition.

Doctors often recommend the use of “white noise” or tinnitus masking devices to help disguise the tinnitus sound. There are dozens of possible treatments other than these that can help decrease tinnitus. Some of these include:

· Drugs and nutrients like benzodiazepines, tricyclics, zinc, anticonvulsants, melatonin, Ginko Biloba, and certain vitamin combinations.

· Psychological methods like cognitive behavioral therapy

· Electrical stimulation