What’s that sound? If you’ve ever been driven to the brink of insanity by the presence of a noise that only you can hear, then rest easy, because it’s not all in your head. Well, actually, it is in your head, but it doesn’t mean you’re crazy.
Tinnitus (pronounced “tin-itus” or sometimes “ti-night-us”) is the medical name for any persistent yet nonexistent ringing, buzzing, whistling, clicking, whooshing, or roaring sound in the ears. It’s the audio version of a phantom limb. It can be any kind of sound, from a low-pitched grumble to a high-pitched squeal, it can occur in one ear or both ears, and it can come and go or be present all the time. About one in five people experience this troublesome, imaginary noise.
Although it’s not usually serious, tinnitus is a symptom of something, usually ear damage. Subjective tinnitus, the most common form, is usually described as a ringing in the ear, and it’s caused most often by damage to the tiny hairs in the ear canal that “catch” and interpret sound waves. When these hairs get damaged, whether because of noise-related hearing loss or another cause, they can misfire and send sonic impulses to the brain even when the sound doesn’t exist. Sometimes tinnitus is temporary, such as immediately after someone attends an earsplitting concert or hears extremely loud noises, but after repeated exposure, the sounds can become permanent. According to the Mayo Clinic, tinnitus is most common in adults over age sixty-five, but anyone can develop the condition, especially people who listen to loud noises without ear protection, people of Caucasian ancestry, and men.
Clues About the Cause
Hearing loss and ear damage aren’t the only causes of tinnitus. Sometimes something as simple as earwax buildup can interfere with hearing and result in phantom noises. Problems with the cranial nerve (which controls balance and hearing) can also cause tinnitus, as can any disease or injury that affects the bones or nerves of the head and neck. Some people develop benign tumors (called acoustic neuromas) on their cranial nerve, which lead to tinnitus in only one ear. Inner-ear disorders such as Meniere’s disease, which causes balance and coordination problems, can bring about tinnitus, too. And if plaque buildup in the arteries causes turbulent blood flow (though it happens rarely), people with circulatory problems can even hear their own heartbeat in their ears. Some people never discover what causes their tinnitus, and it’s just something they learn to live with.
Many popular medications cause tinnitus symptoms as well. Salicylate drugs (including aspirin), as well as traditional NSAID pain relievers like Advil, Aleve, or acetaminophen, can cause tinnitus in people who take more than eight pills per day. Antibiotics, including vancomycin, tetracycline, and erythromycin, can have the same effects. Less common drugs that are also linked to tinnitus are certain chemotherapy agents, quinine and other pills that treat malaria, and certain diuretics. The good news is that tinnitus caused by drugs can be reversed easily, simply by discontinuing the medication.
For doctors attempting to diagnose the cause of a particular patient’s tinnitus, sometimes the sound itself is the best clue. Clicking noises are usually caused by muscle contractions near the ear. High-pitched buzzing or ringing sounds are associated with ear damage and hearing loss. Low-pitched tones are usually a result of bone problems in the inner ear. And the sound of the patient’s heartbeat is often symptomatic of an underlying blood vessel problem, such as atherosclerosis or high blood pressure.
Tinnitus may be bothersome, but it’s not life-threatening. The only times you should bring it to your doctor’s attention are if it begins suddenly and without an identifiable cause, if it’s accompanied by unexplained hearing loss, or if it makes you feel dizzy.
Pumping Up the Volume
Regardless of what causes tinnitus, there’s no doubt that a constant ringing in your ears is disruptive and stressful—some people’s tinnitus is so loud that it keeps them from sleeping and gets in the way of their daily conversations. There are two main ways to deal with it: curing it or drowning it out.
For some lucky people, tinnitus is reversible. Treating it is sometimes even as easy as removing some stubborn earwax. If it’s caused by a blood vessel disorder, a neuroma, or another underlying condition that can be remedied, treating the condition itself usually alleviates the tinnitus right away. It’s not always so simple, though, and many people have to learn to live with tinnitus by using an electronic device. Traditional hearing aids can amplify ambient sounds and voices, drowning out the phantom noises, and they are doubly handy for people whose tinnitus is accompanied by age- or noise-related hearing loss. The other solution for tinnitus is a masking device, such as a white-noise machine, which produces continuous sounds that can help block out tinnitus symptoms. Although neither of these options is a cure, they can both make tinnitus less noticeable by suppressing phantom noises with real ones.
There are ways to protect your hearing and minimize the likelihood that you’ll develop tinnitus. If the condition seems like continuous, low-level torture to you, avoid it by using ear protection regularly, staying away from loud noises (including music), and maintaining a healthy cardiovascular system, which keeps blood vessels functioning properly. But even if, after a lifetime of attending rock concerts, you’re plagued with the annoying soundtrack of tinnitus, at least it’s not fatal. Hopefully the music was worth it, because you’ll be hearing it in your head for a long time.