Tinnitus is the perception of sound in the human ear in the absence of corresponding external sound(s).
According to estimates by the American Tinnitus Association, at least 12 million Americans have tinnitus.
Tinnitus can be perceived in one or both ears or in the head.
It is often described as a ringing noise in the ear.
Often patients have described it as a whining, buzzing, hissing, humming, whistling sound, or as ticking, clicking, roaring, "crickets" or "locusts", tunes, songs, or beeping, or a "whooshing" sound, as of wind or waves.
Tinnitus is not itself a disease but a symptom resulting from a range of underlying causes, including ear infections, foreign objects or wax in the ear, and injury from loud noises. Tinnitus is also a side-effect of some oral medications, such as aspirin, and may also result from an abnormally low level of serotonin activity.
The sound perceived may range from a quiet background noise to a signal loud enough to drown out all outside sounds. The term 'tinnitus' usually refers to more severe cases.
In a minority of cases of people with Tinnitus, a clinician can perceive an actual sound (e.g., a bruit) emanating from the patient's ears. This is called objective tinnitus.
The inner ear contains thousands of minute hairs which vibrate in response to sound waves and cells which convert neural signals back into acoustical vibrations. The sensing cells are connected with the vibratory cells through a neural feedback loop, whose gain is regulated by the brain.
This loop is normally adjusted just below onset of self-oscillation, which gains the ear spectacular sensitivity and selectivity. If something changes, it's easy for the delicate adjustment to cross the barrier of oscillation and tinnitus results. This can actually be measured by a very sensitive microphone outside the ear.
One of the possible mechanisms of how things can change in the ear is damage to the receptor cells. Although receptor cells can be regenerated from the adjacent supporting Deiters cells after injury in birds, reptiles, and amphibians, in mammals it is believed that they can be produced only during embryogenesis.
Although mammalian Deiters cells reproduce and position themselves appropriately for regeneration, they have not been observed to transdifferentiate into receptor cells except in tissue culture experiments.[15][16] Therefore, if these hairs become damaged, through prolonged exposure to excessive decibel levels, for instance, then deafness to certain frequencies occurs. In tinnitus, they may falsely relay information at a certain frequency that an externally audible sound is present, when it is not.
The mechanisms of subjective tinnitus are often obscure. While it is not surprising that direct trauma to the inner ear can cause tinnitus, other apparent causes (e.g., TMJ and dental disorders) are difficult to explain. Recent research has proposed that there are two distinct categories of subjective tinnitus: otic tinnitus, caused by disorders of the inner ear or the acoustic nerve, and somatic tinnitus, caused by disorders outside the ear and nerve but still within the head or neck. It is further hypothesized that somatic tinnitus may be due to "central crosstalk" within the brain, as certain head and neck nerves enter the brain near regions known to be involved in hearing.
While most discussions of tinnitus tend to stress physical mechanisms, there is strong evidence that the level of an individual's awareness of their tinnitus can be stress-related, and so should be addressed by improving the state of the nervous system generally, using gradual, unobtrusive, long-term treatments.
Tinnitus can have many different causes, but most commonly results from otologic disorders - the same conditions that cause hearing loss.
The most common cause is noise-induced hearing loss, resulting from exposure to excessive or loud noises.
Some Causes of tinnitus include:
Otologic problems and hearing loss:
Conductive hearing loss
External ear infection
Cerumen (earwax) impaction
Middle ear effusion
Sensorineural hearing loss
Excessive or loud noise
Presbycusis (age-associated hearing loss)
Meniere's disease
Acoustic neuroma
Ototoxic medications
Analgesics:
Aspirin
Nonsteroidal anti-inflammatory drugs
Antibiotics:
Neurologic disorders:
Multiple sclerosis
Head injury
Skull fracture
Closed head injury
Whiplash injury
Temporomandibular joint disorder
Metabolic disorders:
Thyroid disorder
Hyperlipidemia
Vitamin B12 deficiency
Psychogenic disorders:
Depression
Anxiety
Fibromyalgia
Hypertonia (Muscle Tension)
Thoracic outlet syndrome
Lyme disease
Hypnogogia
Sleep paralysis.
Because tinnitus and hearing loss can be permanent conditions, precautionary measures are advisable. If a ringing in the ears is audible after exposure to a loud environment, such as a rock concert or work place, it means that damage is being done. Prolonged exposure to noise levels as low as 70 dB can result in damage to hearing.
If it is not possible to limit exposure, earplugs or ear defenders should be worn. For musicians and DJs, special musicians' earplugs can lower the volume of the music without distorting the sound and can prevent tinnitus from developing in later years.
There are many treatments that are effective for tinnitus resulting from a particular cause, but none are effective in every case.
Conversely, it should be noted that tinnitus may resolve without any treatment.
Nutrition for Tinnitus:
Supplementing B vitamins, especially B12, B6 and B5 (pantothenic acid), will sometimes help people who suffer from Tinnitus.
Foods to Avoid:
Foods that are hot, spicy, or rich foods; coffee, teas and colas containing caffeine, and alcohol should be avoided by people with Tinnitus.
Some people have reported that Acupuncture is of help.
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