The ear is a complicated piece of anatomy. Simply put, sound waves pass through the ear canal, causing the eardrum to vibrate, moving the middle ear’s small bones. The movement of the last small bone taps on the cochlea — the spiralled tube known as the inner ear — which is filled with liquid and microscopic cells, including stereocilia that have hair-like endings. When sound reaches the cochlea, vibrations move the hairs creating a nerve signal understood by the brain as sound. When everything is working well, messages are received loud and clear. But with so many moving parts, there are many ways and degrees to which we can do damage to our hearing. This article explores tinnitus, one of the possible side effects of not properly protecting our hearing. According to the U.S. Centers for Disease Control, approximately 15% of the general public, or 50 million Americans, experience some form of tinnitus in their lifetime.
What is tinnitus?
Tinnitus is the “perception” of sound. It can occur secondary to different situations and, depending on the type can originate in different places within the auditory system. It often presents as a persistent ringing or buzzing in the ear, but those suffering from tinnitus can experience it quite differently. Some describe the sound in their ear as roaring, rushing, hissing, chirping, beeping, buzzing, whistling, or clicking. Tinnitus can be a temporary (acute) or ongoing (chronic) health ailment. The sound may be high-pitch, low-pitch, or even multi-toned. It might be barely noticeable, but it could also be incredibly loud. Either way, it is a very unpleasant, disturbing feeling.
What causes tinnitus?
Tinnitus is not a disease, but it is a condition that could be a symptom of another underlying health issue. It can be the result of many things, but the most common cause of tinnitus is damage to the tiny sensory hair cells in the cochlea. This can be the result of the normal aging process, but more commonly, it is also caused by prolonged exposure to excessively loud noise and in conjunction with noise-induced hearing loss (NIHL).
Noise Induced Hearing Loss (NIHL)
NIHL results from exposure to loud noise in one traumatic experience or over a cumulative period. Loud noise is qualified as anything over 85 dBA – for example, farm machinery, construction tools, gunfire, amplified music, drilling or explosive devices, and much more. The louder and longer you are exposed to this level of noise, the higher your risk of developing tinnitus. It may not present as a symptom right away, and it may be temporary at first, but for those who spend long periods of time exposed to these kinds of noise levels, taking adequate precautions by wearing hearing protection is highly recommended.
Tinnitus can also be a symptom of head or neck trauma. Patients who suffer a severe injury to the head or neck can suffer from nerve, muscle, and blood flow issues that could all result in the perception of tinnitus. It is also common to report having tinnitus after suffering a traumatic brain injury. More specifically, it is possible to damage the brain’s auditory processing areas and pathways following concussive shock, which can generate tinnitus symptoms.
Outer and middle ear obstructions can also cause tinnitus symptoms to surface. Blockages caused by excessive ear wax, dirt, foreign objects, or head congestion can cause pressure to build up in the ear or create a closed compartment that naturally amplifies sound. This is also the reason why many of us notice our tinnitus at night when we put our heads on a pillow. When closing off the ear canal by lying on a pillow, we create a closed cavity that amplifies the natural biological sounds we all experience regularly but don’t generally perceive. In cases where the ear canal or middle ear is obstructed, tinnitus symptoms generally subside once the blockage is removed.
How to Get Rid of Tinnitus? Ototoxic Medications
Tinnitus is also a potential side-effect of some prescription medications. Ototoxicity is a condition in which damage to the inner ear or auditory system is caused by a drug or chemical agent. Ototoxicity can include hearing loss, tinnitus, and disruptions to the balance system, which is also part of the inner ear. Tinnitus secondary to ototoxicity can cause acute, short-lived symptoms or, in some cases, permanent effects. Drugs known to be ototoxic for some individuals include some antibiotics, non-steroidal anti-inflammatory drugs, quinine-based medications, certain cancer medications, water pills, and diuretics.
What to do
Loud or prolonged exposure to dangerous noise will always pose a threat to our hearing health. We can’t always control the sounds around us, but we can take precautions to help protect our ears. Be prepared. If you know you will be exposed to loud noise – whether at work or at play – wear hearing protection like earplugs. Educate yourself on noise. Know how long it is safe to be exposed to various decibel levels. For example, the average rock concert, loud symphony, or sporting event can reach 129 dB. Most mobile devices can go as loud as 120 dB. It is only safe to listen at this level for a maximum of 10 minutes. That same mobile device can also use a pretty decent sound meter in the form of an application. Use it to determine how loud your environment is. If you have tinnitus, it is important to know your triggers. For some sufferers, red wine, caffeine, and loud noise can make symptoms worse. And turn down the volume. Sometimes you need to give your ears some rest.
Finally, might it be time to consider having your hearing tested? Most of us are careful never to miss our annual physical, but when was the last time you had your hearing checked? For many, it was probably as a child. This may be because testing is typically performed by professionals in specialized clinics, and it may seem inconvenient, or wait times could be lengthy. However, new advances in hearing testing technology are making it possible for more healthcare providers to perform diagnostic hearing testing right in the doctor’s office or even at your place of work.
SHOEBOX Consult is an automated, web-based audiometer that functions almost like playing a game. Ask your doctor for a hearing test and about SHOEBOX today.
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Renée is a licensed audiologist and CAOHC-certified Professional Supervisor (PS/A) whose professional background includes clinical experience in cochlear implants, pediatric audiology, global hearing health, adult rehabilitation, auditory neuropathy, FM system optimization, ototoxicity, and the genetics of hearing loss. As the Director of Audiology, she is responsible for clinical applicability, audiological testing program review, education, and support guidance for SHOEBOX Audiometry.