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Tinnitus is the medical name for noises or ringing in the ears. Tinnitus may be continuous or may come and go. It may present as a high squeal or whine or clicking and may be heard in one or both ears. When the ringing is constant, it can be annoying and distracting. Tinnitus is very common. In fact, more than 7 million people are afflicted so severely that they cannot lead normal lives.


Most tinnitus is only heard by the one who has tinnitus. There are some causes of tinnitus that may be heard by a physician. Tinnitus of this type is called objective tinnitus. Examples of objective tinnitus include abnormal blood vessels in the ear or by muscle spasms which may sound like clicks or cracklings inside the middle ear.

There are many known causes of tinnitus. The most common known cause is from hearing loss. You may not realize that you have a hearing loss. Dr. Pasha routinely orders an audiogram or hearing test for tinnitus patients to see if you have a significant loss of hearing. Hearing loss from advanced age and loud noise exposure are the most common forms of hearing loss that causes tinnitus. Although hearing loss is common with tinnitus patients many causes of tinnitus cannot be identified.

Other common causes of tinnitus include:

  • Medications: especially aspirin containing medications
  • Stress: stress may be a trigger for tinnitus
  • Ear Wax (Cerumen): a plug of wax in the ear may cause temporary tinnitus until it is removed
  • Ear Infections: fluid behind the eardrum may cause ringing in the ear
  • Allergies: allergic rhinitis has been associated with tinnitus
  • Medical Problems: diabetes, high-blood pressure, thyroid disorders have all been shown to cause noise in the ears
  • Tumors: tumors of the ear are a rare cause of tinnitus

Initially, Dr. Pasha will assess you to see if you have a known medical condition that may cause noise in your ears. He will check your ears to see if you have an infection or anything else that may cause tinnitus. After your exam, Dr. Pasha commonly orders an audiogram or hearing test to see if you have a hearing loss. Many people have a hearing loss especially in the high frequencies (high pitches) without being aware of their loss. In some cases, Dr. Pasha may ask for a MRI or CAT scan to rule out other potential causes of tinnitus.

Treatment for tinnitus can be challenging depending on the cause. If the tinnitus is temporary such as from an earwax plug or from an ear infection, removal of the plug or treating the infection typically eliminates the ringing. In most cases, however, since there is no specific cause there is no specific treatment for tinnitus.

People with hearing loss may find that their hearing aids reduce tinnitus and occasionally cause it to go away. Even a person with a minor hearing deficit may find that hearing aids relieve his tinnitus. However, a thorough trial before purchase is advisable if the primary purpose is the relief of tinnitus. Often, when the hearing aid is removed, the head noise returns to its former level.

Tinnitus is louder when it is quiet. When there is background noise your mind does not focus on the tinnitus. A competing sound such as a ticking clock or a radio may help mask head noises, making them less noticeable. Dr. Pasha may suggest listening to music at low volume or by dialing between two FM stations for the purpose of picking up subdued static, again at low volume. Such static may be extremely soothing, with a soft, rushing kind of sound known as white noise. Other patients prefer small electrical devices, which produce soothing background noise such as the sound of waves or rain.

There are several things one can do for tinnitus. Most therapy is based on two types of techniques, masking and reducing stress. First, remember that the auditory (hearing) system is one of the most delicate and sensitive mechanisms of the human body. Since it is a part of the general nervous system, its responses are affected to some degree by the anxiety state of the person involved.

Here are some things you can do to lessen tinnitus:

  • Avoid loud sounds and noises.
  • Get your blood pressure checked. If it is too high, seek your doctor’s help to get it under control.
  • Decrease your intake of salt (which impairs good blood circulation). Avoid salty foods and do not add salt to your food in cooking or at the table.
  • Avoid nerve caffeine and tobacco (nicotine).
  • Exercise daily. It improves your circulation.
  • Get adequate rest and avoid fatigue.
  • Use biofeedback techniques. Tinnitus will not cause you to go deaf or result in losing your mind or your life. Recognize your head noises as an annoying but minor reality, and then learn to ignore them as much as possible. Biofeedback involves concentration and relaxation exercises designed to teach voluntary control of the circulation to various parts of the body and how to relax muscle groups throughout the body. When this type of control is accomplished, it may be effective in reducing the intensity of tinnitus in some patients.
  • Reduce nervous anxiety, which may further stress an already tense hearing system.

The tinnitus masker is a small electronic instrument built into or combined with a hearing aid. It generates a competitive but pleasant sounds which for some individuals, masks the tinnitus by reducing awareness of head noise.

Over 50 million Americans experience tinnitus to some degree. The American Tinnitus Association is a national nonprofit organization dedicated to advancing tinnitus research and educating patients and professionals through conferences, books, brochures, videos, and the quarterly journal Tinnitus Today. The website is www.ata.org.


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