Audiology

Understanding Tinnitus: A Guide for Patients

Tinnitus, often described as a ringing, buzzing, or hissing sound in the ears, is a common condition that can significantly impact an individual’s quality of life.

July 16th, 2024
2 minute read

Understanding Tinnitus: A Guide for Patients

Tinnitus, often described as a ringing, buzzing, or hissing sound in the ears, is a common condition that can significantly impact an individual’s quality of life. It is crucial to have a comprehensive understanding of tinnitus audiology to provide effective hearing solutions and education to patients. In this guide, we will delve into the nuances of tinnitus, its causes, diagnosis, and the latest treatments available.

What is Tinnitus?

Tinnitus is the perception of sound when no external sound is present. It is a symptom rather than a disease itself and can manifest in various forms. For some, it is a minor annoyance, but for others, it can be debilitating, affecting sleep, and concentration, and even leading to depression.

Types of Tinnitus

Tinnitus can be categorized into two main types:

Subjective Tinnitus: The most common form where only the patient can hear the sound.
Objective Tinnitus: A rare form where the sound can be heard by the patient and others. This may be caused by internal functions in the body’s circulatory (blood flow) or somatic (musculoskeletal movement) systems.

Causes and Risk Factors

Understanding the causes of tinnitus is vital in providing tailored hearing solutions. While the exact physiological cause or causes of tinnitus are not known, there are several likely sources, which can be broadly categorized into otologic, neurologic, infectious, drug-related, or traumatic causes.

Common Causes of Tinnitus

Hearing Loss: Often, tinnitus and hearing loss go hand in hand. Damage to the hair cells in the cochlea can trigger tinnitus.
Loud Noise Exposure: Exposure to loud noises can cause permanent hearing loss and tinnitus.
Medications: Certain medications are known to induce tinnitus as a side effect.
Earwax Blockage: A buildup of earwax can cause hearing loss or irritation of the eardrum, leading to tinnitus.
Ear Bone Changes: Stiffening of the bones in your middle ear may affect your hearing and bring on tinnitus.

Risk factors for tinnitus include age, gender, smoking, and cardiovascular problems. Stress and fatigue can often worsen tinnitus as well.

Diagnosing Tinnitus

Diagnosing tinnitus involves a thorough clinical evaluation and the use of specific tests. Audiologists play a crucial role in this process.

Audiological Evaluation

An audiological evaluation is essential for determining the presence and severity of hearing loss which may be associated with tinnitus. This evaluation typically includes

Pure-tone Audiometry: To assess the hearing thresholds across a range of frequencies.
Speech Audiometry: To determine the patient’s ability to hear and understand speech.
Tympanometry: To evaluate the middle ear’s function.

Additional Tests

Depending on the evaluation’s findings, other tests may be necessary, such as:

Otoacoustic Emissions (OAEs): For inner ear hair cell function.
Auditory Brainstem Response (ABR): For neurological abnormalities.
Magnetic Resonance Imaging (MRI): To identify any structural problems in the auditory pathway.

Tinnitus Education and Management

Educating patients about tinnitus is an integral part of management. Audiologists should provide resources that help patients understand their condition and the available treatment options.

Tinnitus Retraining Therapy (TRT)

Tinnitus Retraining Therapy combines sound masking and counselling to help patients habituate to their tinnitus, perceiving it as less bothersome over time.

Hearing Aids

For those with hearing loss, hearing aids can amplify environmental sounds, making tinnitus less noticeable.

Sound Therapy

Sound therapy uses external noise to alter a patient’s perception of or reaction to tinnitus. This can include white noise machines, specialized ear-level maskers, and even music therapy.