My Ears are Ringing! Tinnitus

Kelly C. Waldvogel, Au.D. Doctor of Audiology

Northwestern Medicine

Tinnitus What is tinnitus? What causes tinnitus? Factors that influence tinnitus. How do we manage tinnitus?

What is tinnitus? /’tinitəs,ti’nī-/ Sounds heard in the ear(s) that are

not present in the environment; “ringing in the ears”; phantom perceptions

Hissing, roaring, static, crickets, screeching, sirens, whooshing, pulsing, ocean waves, buzzing, clicking, etc.

Classifying tinnitus “normal tinnitus” having occasional tinnitus

that lasts a short time and goes away on its own

Significant tinnitus-having constant tinnitus, but it may fluctuate from day to day

Subjective tinnitus: meaning only the person can hear it • 95%

Objective tinnitus: an examiner can hear it using a stethoscope • 5%

How common is tinnitus? Approximately 15% of the world

population has tinnitus 10-20% of people seek medical help 70-90% of individuals with tinnitus

show some hearing deficit when tested

The incidence and prevalence of tinnitus increases with age and severity of hearing loss

What causes tinnitus?• Outer ear disorders• Inner ear disorders• Cardiovascular disease• High blood pressure• Multiple sclerosis• Kidney transplant/renal

disease• Lyme disease • Zinc deficiency

• Poor circulation• Hypothyroid/

hyperthyroid disorders• High cholesterol• Vascular disorders• Jaw joint disorders• Cervical or neck

disorders • Certain medications

*If an individual has one of the above, it does not mean that they will have tinnitus

Most common condition associated with Tinnitus

Hearing loss • Outer/Middle Ear:

ear wax, allergies, middle ear infection, etc

• Inner Ear: hearing loss, noise exposure, etc

However the specific cause of tinnitus is still unknown in many cases:

Difficulties arise when individuals experience the following as a result of tinnitus:• Difficulty sleeping and/or concentrating• Focusing/concentrating on speech• Anxiety• Frustration, depression• Annoyance, irritation• Stress

Where is the tinnitus coming from? Regardless of the initial cause of the

tinnitus it is perceived and processed in the brain

Because most people with tinnitus also show some hearing loss it is thought that it is related to auditory deprivation • Similar to phantom limb syndrome

Additionally, activation of the limbic or emotional system also contributes to tinnitus

Auditory or Hearing AreaLimbic or Emotional Area

Assessment of Tinnitus Visit an Audiologist Discussion of the time frame of

tinnitus symptoms and other associated symptoms

Hearing evaluation is completed Recommendations of treatment and

management for tinnitus and/or hearing loss• Referral to other medical providers as

needed

Tinnitus treatment/management There are currently no proven

medications that treat tinnitus HOWEVER, there are MANY ways to

help manage tinnitus and an individuals reaction to tinnitus• Hearing Devices with or without hearing

loss • Use of sound in quiet environments• Relaxation techniques

Questions?Audiology Services-Department of

Otolaryngology675 North Saint Clair Street, Galter 15-

200Chicago, IL 60611

Sources: Coles, R.R. (1984) Epidemiology of tinnitus. J Laryngol Otol

Suppl. 9, 7-15 Dobie, R.A. (2004). Overview: suffering from tinnitus. In:

Snow JB, editor. Tinnitus:Theory and Management. Lewiston, NY: BC Deker Inc. 1-7

National Institute on Deafness and Other Communication Disorders (2001, February) The noise in your ears: Facts about tinnitus (NIH Pub No 00-4896). Bethesda, MD

Sweetow, R.W. (2000) Cognitive-behavior modifiction In: Tyler RS. Editor. Tinnitus Handbook. San Diego: Singular Publishing Group, 297-311

Sweetow, R.W. and Widex A/S(2012) Widex Zen Therapy: Managing the effects of tinnitus.

All Images were obtained from Google Images