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I wrote about hearing loss some months back, but in that column I did not discuss an associated hearing problem called tinnitus.
Tinnitus is the perception of a sound that has no external source and almost always is associated with decreased hearing. The sensation is often described as humming, ringing, hissing, static, roaring, or clicking. It is present in 10-25 percent of people older than 18 (over 50 million Americans), and increases with age, peaking in the 70s. It is extremely bothersome in less than 10 percent of people, but when it is, it can impair sleep, interfere with concentration and social interactions, and can be associated with anxiety and depressive disorders. Different parts of the hearing system can cause tinnitus.
My personal tinnitus is hissing, greater in my left ear than the right. Most times I am able to ignore it. Some days it’s worse than others. The loudness, severity, and effect of tinnitus are dynamic and change over time, progressing in severity in some people and decreasing and even resolving in others. It appears least intense when my brain is distracted with work, and most intense during quiet times such as at night when I am not focused on anything and preparing for sleep.
Preventive causes of tinnitus include excessive noise exposure as well as high doses of non-prescription medications such as aspirin and acetaminophen, and prescription medication including certain diuretics and antibiotics.
Little evidence supports the usefulness of often advertised medications. There is also no evidence that dietary supplements, including ginkgo biloba, melatonin, zinc, lipoflavonoids, and vitamin supplements are beneficial.
What may be beneficial is hearing aids that include sound generators, along with directive counseling to reduce attention and emotional responses to tinnitus. Hyperactive nerves in the brainstem may be responsible for some forms of tinnitus, and electrical therapy may quiet them.
In some people, removal of wax or hair from the ear canal, treatment of middle ear fluid, or treatment of arthritis in the jaw joint can improve tinnitus.
Tinnitus sufferers, especially those with new onset, should be evaluated by expert hearing specialists.
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