Health Tips

Have you ever experienced a brief moment of “ringing in the ears”? That phenomenon is known as tinnitus — depending on its severity, it can be a highly uncomfortable and annoying problem for some people.

How was it like to experience tinnitus?

Tinnitus is the perception of a ringing, buzzing, hissing, or roaring sound in one or both ears when in the absence of an external source. It may be continuous or intermittent (occasional), can be pulsing or steady, and can range in severity from a soft buzz to a loud ring. To listen to the sound of tinnitus, check out this video clip.

Although tinnitus can be annoying, it is not usually a sign of a serious problem. Rarely, tinnitus can be a sign to a more sinister underlying cause.

Photo by Jaee Kim on Unsplash

Causes of tinnitus

Tinnitus can be caused by damage to the tiny hairs on auditory cells within the inner ear or it can be a result of problems not related to the hearing system.

Hearing system-related tinnitus

As mentioned, damage to the auditory cells in the inner ear may lead to tinnitus. Such damage can be triggered by the following factors:

• Normal aging that leads to age-related hearing loss

• After an exposure to a very loud noise, which results in noise-induced hearing loss

• Side effects of certain medications, e.g. rapid infusion of furosemide (a diuretic), quinine (a medication for treating arrhythmia; previously used for treating malaria), aminoglycosides antibiotics such as gentamicin and streptomycin and platinum-based chemotherapy (cisplatin, carboplatin and oxaliplatin). Nonetheless, the number of drugs that genuinely cause tinnitus is extremely small, and these are outlined below. For most medications mentioned here, there is no scientific evidence to either support or refute claims that they cause tinnitus.

• Stiffening of the bones in the middle ear (otosclerosis)

• Tumors within the auditory system, 

• Diseases, such as Ménière’s disease, blood vessels or neurologic disorders, and genetic or inherited inner ear disorders.

Non-hearing system-related tinnitus

Other reasons, such as disorders of the jaw joint (called the temporomandibular joint), severe depression, anxiety, and neck injuries can cause tinnitus as well.

Treatment of tinnitus

If you think you may have tinnitus, consult a doctor for further diagnosis and treatment. 

Tinnitus does not have a cure yet, but treatments that help many people cope better with the condition are available. Most doctors will focus on the following treatment strategies:

Treating the underlying problems

If the doctor managed to diagnose what exactly is causing you the tinnitus, then fixing the underlying causes could relieve the tinnitus.

• Hearing loss — Use of hearing aids such as cochlear implants can help people with age-related hearing loss. If it’s because of medications, doctors may consider stopping the use of medication. However, you should not stop your own medication without consulting a healthcare professional first.

Photo by Mark Paton on Unsplash

• Depression — Depression is common in people with tinnitus. Safe and effective treatments for depression are available and antidepressant medications may improve the symptoms of tinnitus in some people. Antidepressants can also improve a person's ability to cope with the problem.

Behavioral therapies

A number of behavioral therapies can help a person to live with long-term tinnitus.These therapies, however, may require a doctor’s referral to auditory experts.

• Tinnitus retraining therapy — Tinnitus retraining therapy (TRT) involves retraining the hearing system to accept the sounds associated with tinnitus as normal, natural sounds. The goal is for the person to become unaware of their tinnitus unless they consciously choose to focus on it.

• Masking — Not our daily mask wearing to prevent COVID-19, masking, in the context of tinnitus, is a device that resembles hearing aids and produces low-level sounds, which help to reduce or eliminate the tinnitus noise in some patients. 

• Biofeedback and stress reduction

• Cognitive behavioral therapy

Other therapies

• Electrical stimulation

• Acupuncture

• Vitamins and minerals — Niacin (Vitamin B3) can potentially improve blood flow in the ear and may help with tinnitus. However, no controlled studies have shown a significant benefit of niacin or other vitamins for tinnitus therapy. Zinc and copper are antioxidants that may improve the health of auditory cells. Some people report improved benefits with the use of these vitamins and minerals, however no scientific evidence so far has demonstrated their values.

A word from DOC2US

If you have any questions related to tinnitus, you can consult our professional doctors and healthcare professionals on DOC2US. DOC2US is a mobile application that allows you to talk to a doctor or any healthcare professionals via text chat at any time and from anywhere. For better communication, you can even send our online doctor images or voice messages related to your medical inquiry.

Download DOC2US app on Apple App Store, Google Play Store and Huawei App Gallery; or use our web chat at https://web.doc2us.com/

Note: DOC2US is not for medical emergencies. In the event of urgent medical conditions, please call 999.

Disclaimer: As a service to our users and general public, DOC2US provides health education contents. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

References

1. UpToDate - Treatment of tinnitus

2. UpToDate - Etiology and diagnosis of tinnitus

3. NIDCD - Tinnitus

4. British Tinnitus Association - Drugs and tinnitus

Cover image credit: Photo by Jaee Kim on Unsplash

Written by

Ms Joyce Toh