Tinnitus, or ringing
of the ears, is one of the most common presenting complaints in the Otolaryngologist's
office. Most people do notice at least some sound in their ears if they get
into a quiet room, but for some patients this can be so loud it interferes with
their life. Some people have difficulty sleeping because the tinnitus is so
bothersome.
Tinnitus is an actual electrical signal that is
generated either in the cochlea, or hearing nerve, or in the nerve that connects
the cochlea to the brain stem. It is very similar to the noise signals that
are present in telephone lines. It is much more common in older individuals
and persons having noise induced hearing loss. The degree of ringing perceived
in the ears often correlates with the degree of hearing loss that is present.
The problem related to tinnitus appears to be
one that for certain persons the sound is perceived much more loudly than it
is for other people. Current research is directed toward attempting to understand
why one person would be so much more severely affected than another and how
to change the problem. It is virtually impossible to make tinnitus go away,
but it is possible to assist people with decreasing the effect of tinnitus.
The principle mechanism to make tinnitus more
tolerable is that of masking noise. Simply put, you need to listen to something
besides the ringing in your ears. Some people accomplish this by keeping a radio
playing softly in the background. Other people tune a radio to the crackling
white noise between stations, and yet other people purchase a white noise
generator which can be tuned to sound like falling rain, surf at the seashore
or forest noises. For most people, this is an effective method of coping with
their tinnitus.
Hearing aids can be of benefit in managing the
tinnitus as they amplify useful environmental sound that gives something other
than ringing to focus the mind upon.
At present, there is no medicine or surgery that
has been proven to give benefit to patients who experience tinnitus. Hundreds
of medicines and several surgical procedures have been tried but none of these
are consistent in their effect, and thus we cannot recommend any particular
treatment as definitely effective. Taking Melatonin at bedtime has been shown
to assist with improvement in sleep and may help patients who are bothered by
their tinnitus at night. The herbal remedy, Gingko Biloba, is currently touted
as a tinnitus remedy and there are good anecdotal reports of its ability to
improve ringing. It is worth a try but is not as yet a proven treatment.
Avoidance of caffeine helps many patients with
tinnitus. For persons taking aspirin or Ibuprofen, a switch to Acetaminophen
would be potentially of benefit. Some patients experience tinnitus as a side
effect of their medication, so if you are on medications that can be switched
to another type of compound, you might talk to your doctor about this. In general,
a person with tinnitus should attempt to minimize the amount of medication they
take.
Stress and tiredness both tend to adversely affect
tinnitus. You will notice that your tinnitus is worse when you are fatigued
or under a great deal of stress. Minimizing your stress and staying well rested
can keep the symptoms quite tolerable. Tinnitus is one of those problems for
which there is not likely to be a miracle cure, but there will always be creative
ways to adapt to the problem and minimize its effect on your life.