What Is Tinnitus?
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. Rarely, however, tinnitus can represent a serious medical health condition.
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 affected person can hear the noise.
Some Head Noise Is Normal
If a person goes into a soundproof booth and normal outside noise is diminished, he or she becomes aware of these normal sounds. We usually are not aware of these normal body sounds, because outside noise masks them. Anything, such as ear wax or a foreign body in the external ear, that blocks these background sounds will cause us to be more aware of the sounds in our heads.
What Causes Tinnitus?
Tinnitus can originate from any of the following areas: the outer ear, middle ear, inner ear; or it can be due to abnormalities in the brain. Common causes of tinnitus include the following:
* Fluid, infection, or disease of the middle ear bones or ear drum (tympanic membrane)
* Damage to the microscopic endings of the hearing nerve in the inner ear (advanced aging is generally accompanied by a certain amount of hearing nerve impairment)
How Is Tinnitus Evaluated?
A medical history, physical examination, and a series of special tests can help determine precisely where the tinnitus is originating. It is helpful for the doctor to know if the tinnitus is constant, intermittent, or pulsating (synchronous with the heartbeat, referred to as pulsatile tinnitus), or if it is associated with hearing loss or loss of balance (vertigo or vestibular balance disorders). All individuals with persisting unexplained tinnitus need a hearing test (audiogram). Patterns of hearing loss may lead the doctor to the diagnosis.
Other tests, such as the auditory brain stem response (ABR), a computerized test of the hearing nerves and brain pathways, computer tomography scan (CT scan), or magnetic resonance imaging (MRI scan) may be needed to rule out a tumor occurring on the hearing or balance nerve. These tumors are rare, but they can cause tinnitus.
What Is the Treatment 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 tinnitus (what has caused it, your specific symptoms, and options for treatment).
Tinnitus Medications
In many cases, there is no specific treatment for tinnitus. It may simply resolve on its own, or it may be a permanent disability that the person will have to "live with." Some otolaryngologists (ear specialists) 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. The drug gabapentin (Neurontin, Gabarone) was studied in high doses and was found to reduce the annoyance level of the tinnitus in some patients, but it did not decrease the volume of the noise and was not found to be better than placebo.
In patients who suffer from related depression, nortriptyline (Pamelor, Aventyl) is the most helpful treatment. Selective serotonin reuptake inhibitor (SSRI) antidepressants appear to have a better safety record compared to tricyclic antidepressants. Sertraline (Zoloft) at fixed doses and paroxetine (Paxil) at low doses have been shown to be helpful. In a 2009 study by Jalai, alprazolam (Xanax) improved VAS (visual analog scale) scores in patients with tinnitus who did hot have anxiety or depression disorders.
Relief Remedies for Tinnitus
Some common and easy remedies, such as the following, may be of benefit to some individuals:
* Reduce or avoid caffeine and salt intake, and quit smoking.
* Some individual's with tinnitus have been found to have lower zinc levels and may benefit from zinc supplementation.
* Melatonin may help those who suffer with tinnitus, particularly those with disturbed sleep due to tinnitus.
* Ginkgo biloba has been touted as a natural tinnitus remedy, but to date, controlled studies have not shown to be effective.
* Some behavioral and cognitive therapies that have been successful include retraining therapy, masking, and behavioral therapy.
Is There Anything to Lessen the Intensity of Tinnitus?
* Avoid exposure to loud sounds and noises.
* Control your blood pressure.
* Decrease your salt intake.
* Avoid nerve stimulants such as coffee and colas (caffeine) and tobacco (nicotine).
* Reduce your anxiety.
* Stop worrying about the tinnitus. The more you worry and concentrate on the noise, the louder it will become.
* Get adequate rest and avoid fatigue.
* Exercise regularly.
* Utilize a masking noise (for example, a competing sound such as a ticking clock, a radio, a fan, or white noise machine).
* Biofeedback may help or diminish tinnitus in some individuals.
* Avoid aspirin or aspirin products in large quantities.
No comments:
Post a Comment