What is Tinnitus?

This name is given to the experience of noises in the head and/or ears, when no corresponding external sound is present. Feelings of pressure and fullness or pain in or around the ears may accompany the tinnitus.

Fifty different sounds have been reported, from high-pitched hissing, sizzling, ringing and buzzing, to chirping, clicking, and low, rushing, booming, roaring, and engine-like sounds; also pulsing and thumping sensations. Several noises may be heard simultaneously.

Some cases of tinnitus involve extra-sensitive hearing, so that ordinary sounds are sensed as uncomfortably harsh and loud.

Who has Tinnitus?

More than 360,000 Canadians have tinnitus in an annoying form. About 150,000 find that these noises seriously impair the quality of their lives.

Tinnitus can begin at any age, including childhood. It affects people in all walks of life. It varies in intensity from mild to severe, and may heard intermittently or continuously.

People with normal hearing can also have tinnitus. Having tinnitus doesn’t mean that you will lose your hearing.

What causes it?

Tinnitus may have either a physiological or biochemical origin. Both factors may be involved.

Common Causes: hearing loss, exposure to loud noise, a blow to the head, whiplash injury, and any kind of physical and/or emotional stress.

Less Common: a non-malignant growth on the 8th nerve, fixation of the middle ear bones, and some relatively rare conditions that can be diagnosed by medical tests and scans…

Who can help?

Your family doctor (M.D.) can make sure you don’t have a health problem that may underlie the tinnitus, for example, high or low blood sugar, or hypertension.

An ear, nose & throat surgeon (M.D.) will exam you primarily to detect any condition, such as an acoustic neuroma or otosclerosis, that the presence of the tinnitus may suggest. The E.N.T. surgeon will decide whether a scan or further tests are needed. Note: Surgery can very seldom eliminate tinnitus, though it may be needed to deal with a few conditions, including those mentioned above.

Once these factors have been ruled out, most people feel reassured and find it easier to adjust to the tinnitus. For tinnitus that continues to be troublesome,practical help can be provided by:

An audiologist (M.Cl.Sc.),who can test and assess your hearing. (This is usually part of an E.N.T. examination.) The audiologist will try to determine whether the tinnitus might be eased by a hearing aid, a masker (a small, hearing aid-like device that may cover over or distract attention from the tinnitus), or a ‘tinnitus instrument’ that combines both functions. An audiologist can prescribe one of these for you and show you how best to use it.

A few Canadian audiologists are now qualified as counsellors in Auditory Re-training Therapy for the relief of tinnitus and extra-sensitive hearing.

A Hearing Aid Dispenser can also test hearing, and if a hearing aid, masker or combined unit is needed, will take a mould for a custom-fitted device. Hearing aid dispensers also fill prescriptions from audiologists.

If the tinnitus continues to make you uncomfortable, impairs your concentration, or disturbs your sleep…

A psychiatrist (M.D.) can provide supportive therapy and, as a physician, can prescribe any medication that might be needed to relieve the sleep disturbance, anxiety, or depression that can be either a cause or a consequence of tinnitus. In serious cases, psychiatric consultation is an important resource.


Relaxation Techniques: deep breathing, hypnosis, bio-feedback, systematic relaxation, therapeutic massage, Yoga, and some forms of physical exercise, most commonly swimming or walking, can reduce tension, stimulate endorphins, and promote better sleep.
Masking and Auditory Re-training. Maskers are little hearing aid-like devices that produce a soft, shushing sound. They may be used to cover over (‘mask’) the tinnitus with a more acceptable ‘white sound’.

Another, more recently developed method, Auditory Re-Training uses these same devices with the sound level set so as to be just audible, not masking the tinnitus. When followed for an extended period, this therapy can often induce subconscious ‘habituation’ , so that the tinnitus is no longer perceived as an intrusive, disturbing presence. This method has also been found helpful in reducing extra-senstive hearing.

Other kinds of sounds , such as tapes on a Walkman or small table-top ‘sound-soother’ machines, can provide background sound if quiet surroundings emphasize your tinnitus.

Medication: ‘Anti-depressant’ medications* , either tricyclic or SSRI type may help ease discomfort and improve well-being in serious cases.

Tranquilizers*are best for off-and-on use only, or for relatively short periods.

Anti-convulsives*, and occasionally, major tranquilizers*, also have a role in treating severe forms
( * = medications available only on prescription )

* ‘Alternative’ approaches such as naturopathy, acupuncture, vitamin and mineral supplements, have been of limitied use. However, an understanding and positive attitude on the part of any therapist or practitioner can in itself produce beneficial changes, usually temporary but occasionally long-lasting.

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