Hearinginfo.org  © Copyright. No copying without prior written permission	Diseases and Disorders of the Ear
Tinnitus - Ringing in the ears

Introduction to Tinnitus

Tinnitus is a sensation of sound which is present when there is no external sound source present. It may be a constant sound (cicadas, whistles, etc.) or less commonly a pulsating sound. Tinnitus is often present with a hearing loss of some form, but not always.

Causes of Tinnitus

Causes of Tinnitus are varied. External causes of tinnitus can be from working around noisy machinery, gunfire, drug toxicity, ear trauma, and infections to name a few. The natural aging process of deteriorating hearing functions can also cause tinnitus.

• Acoustic Nerve Filter Breakdown Causes of Tinnitus:
  •  When nerves transmit electrical impulses between the inner ear and the brain, they generate a very low level "noise" of their own. Normally this nerve activity is filtered out by parts of the brain before it reaches the brain's centers of awareness. If these filters are damaged due to the external causes, these filters no longer function and the person is made aware of this normally suppressed noise. In these cases the brain becomes super-sensitive to normal background nerve activity and perceives this as noise.
     
• Abnormal Body Function Causes of Tinnitus:
  • Sometimes abnormal body function levels may cause tinnitus. Abnormal blood flow due to high blood pressure, or inflammation in the ear.
  Pulsating tinnitus can be present because a conductive hearing loss is causing someone to hear normal blood-flow in vessels near the ear.

Tinnitus enhancement/aggravation factors

Tinnitus can worsen or be aggravated by any of the following conditions:

• If under stress or overtired
• Headaches
• Depression
• High doses of aspirin
• Kanamycin (antibiotic) and certain anti-cancer drugs, can cause permanent tinnitus
• Any inflammation in the neck, jaw joints, teeth or sinuses.
• Certain Foods: drinking coffee, or eating foods that stimulate the nervous system

Treatment for tinnitus

For the most part, there is no treatment for tinnitus unless there are specific organic causes that can be alleviated (broken eardrum, infection etc.) As long as the tinnitus is not too overwhelming, most people come to terms with it by doing normal day-to-day activities and slowly pushing the sounds to the background. A favorite tactic is to keep the radio or TV on constantly, except when retiring. It is when things get quite and normal background noises recede that the tinnitus comes to the fore. Lack of sleep is one of the frustrating side effects of tinnitus as the sufferers have such a hard time getting to sleep.

When the tinnitus is accompanied by hearing loss, the underlying hearing deficit can be compensated for with surgery or prophylactics (e.g. hearing aids) such as by repairing a hole in the ear drum, or performing surgery on the ossicles (the three bones of the middle ear). Sometimes these measures also reduce the tinnitus.

Some people find tinnitus maskers helpful. These  look like hearing aids which are designed to generate "white" noise into the ear with tinnitus as a masking sound.

Tinnitus Treatment with Botox?

Preliminary research by scientists from the California Ear Institute and Bridges Medical Clinic in California (2006) lends credence to other work that suggests the popular anti-wrinkle treatment, Botox, may ease tinnitus symptoms. The researchers are quick to note that more study is needed, but the initial results are intriguing.

Botox is a well-known treatment for skin wrinkles and frown lines, but it has also been applied to serious medical conditions like strabismus, spasmodic altered voice production, failure of the voice muscles to relax, and cervical dystonia. Additionally, Botox is thought to block not only acetylcholine in migraine sufferers, but inhibit the release of other neurotransmitters and neuropeptides important in the autonomic pathway. These successes in blocking autonomic pathways—which are, as mentioned earlier, linked to tinnitus—led researchers to examine Botox as a potential tool in tinnitus treatment.