Tinnitus

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Each year about 1 in 10 adults nationwide has an episode of tinnitus that lasts longer than 3 months. Tinnitus isn’t a disease. Instead, it’s a symptom that something is wrong with your auditory system. The problem may exist somewhere in your ear, in the nerve that connects the inner ear to the brain or in the parts of the brain that make sense of sounds. 

Because tinnitus can arise from so many conditions, ranging from hearing loss to high blood pressure to medications, diagnosing the cause or causes can be a challenge. For many people, the ringing in their ears begins for no obvious reason. 

Researchers have been working on new ways to treat tinnitus. One National Institute of Health sponsored study has just begun recruiting active and retired military personnel of the U.S. Armed Forces to test the effectiveness of an experimental tinnitus therapy. Soldiers exposed to loud noise, including bomb blasts, can develop tinnitus due to tissue damage in hearing-related areas of the brain and ear. In fact, tinnitus is one of the most common service-related injuries among military personnel returning from Iraq and Afghanistan.

The experimental treatment in this study combines educational counseling with a sound-generation device.  Called tinnitus retraining therapy, the approach has shown promise in earlier trials and appears to ease the annoyance of tinnitus and its impact on people’s lives.

Tinnitus FAQ

What is tinnitus?

Tinnitus is commonly described as a ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It may be soft or loud, high pitched or low pitched. You might hear it in either one or both ears. Roughly 10 percent of the adult population of the United States has experienced tinnitus lasting at least five minutes in the past year. This amounts to nearly 25 million Americans.

What causes tinnitus?

Tinnitus (pronounced tin-NY-tus or TIN-u-tus) is not a disease. It is a symptom that something is wrong in the auditory system, which includes the ear, the auditory nerve that connects the inner ear to the brain, and the parts of the brain that process sound. Something as simple as a piece of earwax blocking the ear canal can cause tinnitus. But it can also be the result of a number of health conditions, such as:

  • Noise-induced hearing loss
  • Ear and sinus infections
  • Diseases of the heart or blood vessels
  • Ménière’s disease
  • Brain tumors
  • Hormonal changes in women
  • Thyroid abnormalities

Does having tinnitus mean I have hearing loss?

Tinnitus is sometimes the first sign of hearing loss. It also can be a side effect of medications. More than 200 drugs are known to cause tinnitus when you start or stop taking them.

People who work in noisy environments—such as factory or construction workers, road crews, or even musicians—can develop tinnitus over time when ongoing exposure to noise damages tiny sensory hair cells in the inner ear that help transmit sound to the brain. This is called noise-induced hearing loss.

Service members exposed to bomb blasts can develop tinnitus if the shock wave of the explosion squeezes the skull and damages brain tissue in areas that help process sound. In fact, tinnitus is one of the most common service-related disabilities among veterans returning from Iraq and Afghanistan.
Pulsatile tinnitus is a rare type of tinnitus that sounds like a rhythmic pulsing in the ear, usually in time with your heartbeat. A doctor may be able to hear it by pressing a stethoscope against your neck or by placing a tiny microphone inside the ear canal. This kind of tinnitus is most often caused by problems with blood flow in the head or neck. Pulsatile tinnitus also may be caused by brain tumors or abnormalities in brain structure.

What is the source of the sounds in my head?

Although we hear tinnitus in our ears, its source is really in the networks of brain cells (what scientists call neural circuits) that make sense of the sounds our ears hear. A way to think about tinnitus is that it often begins in the ear, but it continues in the brain.

Scientists still haven’t agreed upon what happens in the brain to create the illusion of sound when there is none. Some think that tinnitus is similar to chronic pain syndrome, in which the pain persists even after a wound or broken bone has healed.

Tinnitus could be the result of the brain’s neural circuits trying to adapt to the loss of sensory hair cells by turning up the sensitivity to sound. This would explain why some people with tinnitus are oversensitive to loud noise.

Tinnitus also could be the result of neural circuits thrown out of balance when damage in the inner ear changes signaling activity in the auditory cortex, the part of the brain that processes sound. Or it could be the result of abnormal interactions between neural circuits. The neural circuits involved in hearing aren’t solely dedicated to processing sound. They also communicate with other parts of the brain, such as the limbic region, which regulates mood and emotion.

Can I prevent tinnitus?

Noise-induced hearing loss, the result of damage to the sensory hair cells of the inner ear, is one of the most common causes of tinnitus. Anything you can do to limit your exposure to loud noise—by moving away from the sound, turning down the volume, or wearing earplugs or earmuffs—will help to lessen the likelihood that you will experience tinnitus.

Treatment

Are There Treatments for Tinnitus? 

Hearing Aids

Hearing aids often are helpful for people who have hearing loss along with tinnitus. Using a hearing aid adjusted to carefully control outside sound levels may make it easier for you to hear. The better you hear, the less you may notice your tinnitus. 

Counseling

Counseling helps you learn how to cope with your tinnitus. Most counseling programs have an educational component to help you understand what goes on in the brain to cause tinnitus. Some counseling programs also will help you change the way you think about and react to your tinnitus. 

Wearable Sound Generators

Small electronic devices fit in the ear and use a soft, pleasant sound to help mask the tinnitus. Some people want the masking sound to totally cover up their tinnitus, but most prefer a masking level that is just a bit louder than their tinnitus. The masking sound can be a soft “shhhhhhhhhh,” random tones, or music.

Tabletop Sound Generators

These are used as an aid for relaxation or sleep. Placed near your bed, you can program a generator to play pleasant sounds such as waves, waterfalls or rain, or the sounds of a summer night. If your tinnitus is mild, this might be all you need to help you fall asleep

Acoustic Neural Stimulation

Acoustic neural stimulation uses a palm-sized device and headphones to deliver a broadband acoustic signal embedded in music. The treatment helps stimulate change in the neural circuits in the brain, which eventually desensitizes you to the tinnitus. 

Cochlear Implants

Cochlear implants are sometimes used in people who have tinnitus along with severe hearing loss. A cochlear implant bypasses the damaged portion of the inner ear and sends electrical signals that directly stimulate the auditory nerve. The device brings in outside sounds that help mask tinnitus and stimulate change in the neural circuits.

Do you have NIHL?

What are the signs of NIHL?

When you are exposed to a loud noise or noises, you may slowly start to lose your hearing. Over time, sounds may become distorted or muffled, and you might find it difficult to understand other people when they talk or have to turn up the volume on the television. An extremely loud burst of sound can rupture the eardrum or damage the bones in the middle ear.

Loud noise exposure can also cause tinnitus, a ringing, buzzing, or roaring in the ears or head. Tinnitus may subside over time but can continue constantly or occasionally throughout a person’s life. Hearing loss and tinnitus can occur in one or both ears.

 

“I’ve had tinnitus for about 10 years, but since I started protecting my ears it hasn’t got any worse. Looking after your ears is unfortunately something you don’t think about until there’s a problem. I wish I’d thought about it earlier.”

Chris Martin, Lead Singer of Coldplay

Noise Induced Hearing Loss

What is noise-induced hearing loss?

Every day, we experience sound in our environment. Normally, these sounds are at safe levels that don’t damage our hearing. But sounds can be harmful when they are too loud, even for a brief time. These sounds can damage sensitive structures in the inner ear and cause noise-induced hearing loss (NIHL).

NIHL can be immediate yet take a long time to be noticeable. It may be temporary or permanent, and it can affect one ear or both ears. Even if you can’t tell that you are damaging your hearing, you could have trouble hearing in the future. Regardless of how it might affect you, noise-induced hearing loss is something you can prevent.

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