Tinnitus is a ringing, swishing, or other type of noise that seems to originate in the ear or head. In many cases it is not a serious problem, but rather a nuisance that eventually resolves. It is not a single disease, but a symptom of an underlying condition. Nearly 36 million Americans suffer from this disorder. In almost all cases, only the patient can hear the noise.

Alternative Names of Tinnitus are: ear noise, head noise, ringing in the ears, Meniere disease, pulsatile tinnitus, subjective tinnitus, objective tinnitus, hearing loss.

Complications of Tinnitus

Tinnitus can significantly affect quality of life. It affects people differently, but may be linked to:

• Fatigue
• Stress
• Sleep problems
• Trouble concentrating
• Memory problems
• Depression
• Anxiety and irritability

Treating these linked conditions may not affect tinnitus directly, but it can help you feel better.

Causes of Tinnitus

Tinnitus can arise in any of the following areas: the outer ear, the middle ear, the inner ear, or by abnormailities in the brain. Some tinnitus or head noise is normal. If one goes into a sound proof booth and normal outside noise is diminished, one becomes aware of these normal sounds. We are usually not aware of these normal body sounds, because outside noise masks them. Anything, such as wax or a foreign body in the external ear, that blocks these background sounds will cause us to be more aware of our own head sounds. Fluid, infection, or disease of the middle ear bones or ear drum (tympanic membrane) can also cause tinnitus. One of the most common causes of tinnitus is damage to the microscopic endings of the hearing nerve in the inner ear. Advancing age is generally accompanied by a certain amount of hearing nerve impairment, and consequently tinnitus. Today, loud noise exposure is a very common cause of tinnitus, and it often damages hearing as well. Unfortunately, many people are unconcerned about the harmful effects of excessively loud noise, firearms, and high intensity music. Some medications (for example, aspirin) and other diseases of the inner ear (Meniere's syndrome) can cause tinnitus. Tinnitus can in very rare situations be a symptom of such serious problems as an aneurysm or a brain tumor (acoustic tumor).

Signs & Symptoms of Tinnitus

With tinnitus, you hear a noise that no one around you hears. This noise is usually a buzzing or ringing type sound, but it may be a clicking or rushing sound that goes along with your heartbeat. The sound is sometimes accompanied by hearing loss and dizziness in a syndrome known as Meniere's disease.

Diagnosis of Tinnitus

• Initial evaluation will include a complete history and physical examination of the head and neck including the various nerves in the area.
• A complete hearing test (audiogram) will also be performed. Depending on the type of tinnitus, either a special audiogram known as an auditory brainstem response (ABR) or a brain scan such as a computerized tomography (CT) scan or magnetic resonance imaging (MRI) may also be required.
• In some cases, your blood pressure and possibly some blood tests for hyperthyroidism may be taken. In very rare instances, a spinal tap may be performed to measure the fluid pressure in the skull and spinal cord.

Treatments of Tinnitus

• After a careful evaluation, your doctor may find an identifiable cause and be able to treat or make recommendations to treat the tinnitus. Once you have had a thorough evaluation, an essential part of treatment is your own understanding of the tinnitus (what has caused it, and your options for treatment).
• In many cases, there is no specific treatment for tinnitus. It may simply go away on its own, or it may be a permanent disability that the patient will have to "live with." Some otolaryngologists have recommended niacin to treat tinnitus. However, there is no scientific evidence to suggest that niacin helps reduce tinnitus, and it may cause problems with skin flushing.

Prevention of Tinnitus

The only real prevention for tinnitus is to avoid damaging your hearing. Most causes other than hearing loss do not have prevention strategies.
According to the American Tinnitus Association, there are several things you can do to protect yourself from excessive noise-related tinnitus:

1. Protect your hearing at work. Your work place should follow Occupational Safety & Health Administration (OSHA) regulations. Wear ear plugs or earmuffs and follow hearing conservation guidelines set by your employer.
2. When around any noise that bothers your ears (a concert, sporting event, hunting) wear hearing protection or reduce noise levels.
3. Even everyday noises such as blow drying your hair or using a lawnmower can require protection. Keep ear plugs or earmuffs handy for these activities.

When to seek Medical Advice

Most newly noticed tinnitus should be evaluated by a physician. Because tinnitus is usually a symptom of something else, if it begins suddenly, see your doctor. This is particularly important if the tinnitus is only heard on one side.

Although the majority of cases of tinnitus are not caused by any acute problems, certain symptoms need to be evaluated to determine whether or not a more serious medical condition is causing the symptoms.