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Ringing in the Ears (Tinnitus): Basic Information

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I sometimes hear ringing in my ears. Is this unusual?

Not at all. Tinnitus is the name for these head noises, and they are very common. Nearly 36 million other Americans suffer from this discomfort. Tinnitus may come and go, or you may be aware of a continuous sound. It can vary from pitch from a low roar to a high squeal or whine, and you may hear it in one or both ears. When the ringing is constant it can be annoying and distracting . More than 7 million people are afflicted so severely that they cannot lead normal lives.

Can other people hear the noise in my ears?

Not usually, but sometimes they are able to hear a certain type of tinnitus. This is called objective tinnitus, and it is caused either by abnormalities in blood vessels around the outside of the ear or by muscle spasms which may sound like clicks or cracklings inside the middle ear.

What causes tinnitus?

There are many possibile causes for subjective tinnitus, the noise only the patient can hear. Some causes are not serious. (For instance, a small plug of wax might cause temporary tinnitus.) Tinnitus can also be a symptom of more serious middle ear problems such as infection, a hole in the eardrum, an accumulation of fluid or stiffening (otosclerosis) of the middle ear bones. Tinnitus can also be a symptom of a head and neck aneurysm or acoustic neuroma, either of which can be life threatening. These problems often involve a loss of hearing. Tinnitus may also be caused by allergy, high (or low) blood pressure, a tumor, diabetes, thyroid problems, injury to the head or neck, and a variety of other specific causes including: anti-inflamatories, antibiotics, sedatives/antidepressants and aspirin. (Aspirin can be a possible cause of tinnitus if over used, depending on the size of the patient. Talk to your doctor if you take aspirin and your ears ring.) The treatment will be quite different in each case. It is important to see a physician who specializes in ear disorders (an otolaryngologist) to attempt to determine the cause of your tinnitus, and what kind of treatment, if any, may be needed.

What is the most common cause of tinnitus?

Most tinnitus comes from damage to the microscopic endings of the hearing nerve in the inner ear. The health of these nerve endings is important for acute hearing, and injury to them brings on hearing loss and often tinnitus. Advancing age is generally accompanied by a certain amount of hearing nerve impairment-and even tinnitus. Exposure to loud noises is probably the leading cause of tinnitus in today's world, and it often damages hearing as well. Unfortunately, many people are unaware of, or unconcerned about, the harmful effects of excessively loud industrial noise, firearms noise, high intensity music and other loud noises. Stereo headsets played too loudly appear to be an increasing cause of ear damage in otherwise healthy young people.

What is the treatment of tinnitus?

In most cases, there is no specific treatments for noises in the ear or head. If an otolaryngologist finds on examination that your tinnitus has a specific cause, he may be able to remove the cause and thus eliminate the noise. This investigation may require a fairly extensive workup including x-rays, balance testing and laboratory work. However, most causes of tinnitus cannot be identified. Occasionally, medicines may help the noise even though no cause can be identified. The medicines used are many. Frequently, the patient is requested to take a medicine to see if it helps.

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