Tinnitus

"Tinitus" redirects here. For the Norwegian radio show, see Tinitus (radio show).

Tinnitus
Pronunciation
SpecialtyOtorhinolaryngology, audiology, neurology
SymptomsHearing sound when no external sound is present[1]
ComplicationsPoor concentration, anxiety, depression[2]
Usual onsetGradual[3]
CausesNoise-induced hearing loss, ear infections, disease of the heart or blood vessels, Ménière's disease, brain tumors, inner ear tumors, emotional stress, traumatic brain injury, excessive earwax[2][4]
Diagnostic methodBased on symptoms, audiogram, neurological exam[1][3]
TreatmentCounseling, sound generators, hearing aids[2][5]
Frequency~12.5%[5]

Tinnitus is a condition when a person hears a ringing sound or a different variety of sound when no corresponding external sound is present and other people cannot hear it.[1] Nearly everyone experiences faint "normal tinnitus" in a completely quiet room; but this is of concern only if it is bothersome, interferes with normal hearing, or is associated with other problems.[6] The word tinnitus comes from the Latin tinnire, "to ring".[3] In some people, it interferes with concentration, and can be associated with anxiety and depression.[7][8]

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Tinnitus is usually associated with hearing loss and decreased comprehension of speech in noisy environments.[2] It is common, affecting about 10–15% of people. Most tolerate it well, and it is a significant problem in only 1–2% of people.[5] It can trigger a fight-or-flight response, as the brain may perceive it as dangerous and important.[9][10][11]

Rather than a disease, tinnitus is a symptom that may result from a variety of underlying causes and may be generated at any level of the auditory system as well as outside that system. The most common causes are hearing damage, noise-induced hearing loss, or age-related hearing loss, known as presbycusis.[2] Other causes include ear infections, disease of the heart or blood vessels, Ménière's disease, brain tumors, acoustic neuromas (tumors on the auditory nerves of the ear), migraines, temporomandibular joint disorders, exposure to certain medications, a previous head injury, and earwax. It can suddenly emerge during a period of emotional stress.[4][3][2][12][13] It is more common in those with depression.[3]

The diagnosis of tinnitus is usually based on a patient's description of the symptoms they are experiencing.[3] Such a diagnosis is commonly supported by an audiogram, and an otolaryngological and neurological examination.[1][3] How much tinnitus interferes with a person's life may be quantified with questionnaires.[3] If certain problems are found, medical imaging, such as magnetic resonance imaging (MRI), may be performed. Other tests are suitable when tinnitus occurs with the same rhythm as the heartbeat.[3] Rarely, the sound may be heard by someone other than the patient by using a stethoscope, in which case it is known as "objective tinnitus."[3] Occasionally, spontaneous otoacoustic emissions, sounds produced normally by the inner ear, may result in tinnitus.[14]

Measures to prevent tinnitus include avoiding chronic or extended exposure to loud noise, and limiting exposure to ototoxic drugs and substances.[2][15] If there is an underlying cause, treating that cause may lead to improvements.[3] Otherwise, typically, tinnitus management involves psychoeducation or counseling, such as talk therapy.[5] Sound generators or hearing aids may help.[2] No medication directly targets tinnitus.

  1. ^ a b c d Levine RA, Oron Y (2015). "Tinnitus". The Human Auditory System – Fundamental Organization and Clinical Disorders. Handbook of Clinical Neurology. Vol. 129. pp. 409–431. doi:10.1016/B978-0-444-62630-1.00023-8. ISBN 978-0-444-62630-1. PMID 25726282.
  2. ^ a b c d e f g h "Tinnitus". NIH – National Institute on Deafness and Other Communication Disorders (NIDCD). 6 March 2017. Archived from the original on 3 April 2019. Retrieved 20 September 2019.
  3. ^ a b c d e f g h i j k Baguley D, McFerran D, Hall D (November 2013). "Tinnitus". The Lancet. 382 (9904): 1600–1607. doi:10.1016/S0140-6736(13)60142-7. PMID 23827090.
  4. ^ a b Han BI, Lee HW, Kim TY, Lim JS, Shin KS (March 2009). "Tinnitus: characteristics, causes, mechanisms, and treatments". Journal of Clinical Neurology. 5 (1): 11–19. doi:10.3988/jcn.2009.5.1.11. PMC 2686891. PMID 19513328. About 75% of new cases are related to emotional stress as the trigger factor rather than to precipitants involving cochlear lesions.
  5. ^ a b c d Langguth B, Kreuzer, PM, Kleinjung, T, De Ridder, D (September 2013). "Tinnitus: causes and clinical management". The Lancet Neurology. 12 (9): 920–930. doi:10.1016/S1474-4422(13)70160-1. PMID 23948178. S2CID 13402806.
  6. ^ "Tinnitus – noises in the ears or head". ENT kent. Archived from the original on 28 September 2021. Retrieved 20 January 2021.
  7. ^ Salazar JW (2019). "Depression in Patients with Tinnitus: A Systematic Review". Otolaryngol Head Neck Surg. 161 (1): 28–35. doi:10.1177/0194599819835178. PMC 7721477. PMID 30909841.
  8. ^ Bhatt JM (2016). "Relationships Between Tinnitus And The Prevalence Of Anxiety And Depression". Laryngoscope. 127 (2): 466–469. doi:10.1002/lary.26107. PMC 5812676. PMID 27301552.
  9. ^ "Taming tinnitus".
  10. ^ "Why Does My Tinnitus Get Worse when I'm Stressed?". 17 May 2021.
  11. ^ House PR (2008). "Personality of the Tinnitus Patient". Ciba Foundation Symposium 85 – Tinnitus. Novartis Foundation Symposia. Vol. 85. pp. 193–203. doi:10.1002/9780470720677.ch11. ISBN 978-0-470-72067-7. PMID 7035099.
  12. ^ Esmaili AA, Renton J (1 April 2018). "A review of tinnitus". Australian Journal of General Practice. 47 (4): 205–208. doi:10.31128/AJGP-12-17-4420. PMID 29621860.
  13. ^ Mazurek B, Haupt H, Olze H, Szczepeck A (2022). "Stress and tinnitus—from bedside to bench and back". Frontiers in Systems Neuroscience. 6 (47): 47. doi:10.3389/fnsys.2012.00047. PMC 3371598. PMID 22701404.
  14. ^ Cite error: The named reference Hen2005 was invoked but never defined (see the help page).
  15. ^ Rizk HG, Lee JA, Liu YF, Endriukaitis L, Isaac JL, Bullington WM (December 2020). "Drug-Induced Ototoxicity: A Comprehensive Review and Reference Guide". Pharmacotherapy. 40 (12): 1265–1275. doi:10.1002/phar.2478. PMID 33080070. S2CID 224828345.