Tinnitus Evaluation
Finding relief from tinnitus starts with a thorough assessment by an audiologist to identify the root cause. Embark on your path to tranquility today.
Tinnitus, a complex and often debilitating condition, impacts millions globally, manifesting as a persistent internal hum, buzz, or ringing that interrupts both moments of quiet and noise. With no external source, individuals endure a continuous assault on their auditory senses, ranging from mildly bothersome to severely disruptive, hindering concentration, sleep, and emotional well-being.
Navigating the path to relief, fraught with frustration and hopelessness, necessitates distinguishing between facts and myths about tinnitus to avoid ineffective decisions. Understanding the nuances, triggers, and available management strategies for tinnitus is essential for effectively managing symptoms, providing a glimmer of hope and a sense of peace amidst the seemingly never-ending noise.
As the absence of silence becomes unsettling, comprehending tinnitus becomes imperative in regaining a sense of control, serving as the initial crucial step toward a more tranquil existence and mitigating the impact of these unwelcome sounds.
When evaluating tinnitus, the audiologist strives to pinpoint the root cause of your symptoms. Tinnitus is a unique and personal experience for each individual. To provide you with an effective treatment plan, the audiologist must identify the specific site(s) of the issue within your hearing system and recommend the most suitable solution for your situation. Some of the potential causes of tinnitus that the audiologist aims to uncover include:
- Neurosensory hearing loss from exposure to loud noise, aging, or other factors.
- Conductive hearing loss due to problems with the outer or middle ear.
- Side effects of ototoxic drugs.
- Head or neck injuries.
- Dysfunction of the temporomandibular joint.
- Infections caused by bacteria or viruses.
- Challenges related to blood flow or neurological functions.
- Emotional distress, anxiety, or depression.
Tinnitus can arise from various hearing, psychological, or physical dysfunctions. Following a detailed assessment of your medical history, hearing abilities, and psychological well-being, the audiologist will work with you to pinpoint the potential cause of your tinnitus and develop a tailored treatment plan. Some of the recommendations that the audiologist may suggest include:
- Therapies to help you adapt to tinnitus.
- Hearing aids or other auditory amplification devices.
- Methods to protect your hearing.
- Referrals for medical, allied health, or psychological support.
After a thorough assessment to identify the root cause of your tinnitus, your audiologist will create a personalized treatment plan tailored to your specific needs. This approach focuses on not just alleviating symptoms but also addressing the underlying issues. With a range of advanced treatments and therapies, your audiologist is dedicated to helping you find relief and improve your quality of life. The following options may be part of your customized treatment plan:
- Tinnuts maskers
- Hearing Aids
- Tinnitus Retraining Therapy
- Cognitive Behavioural Therapy
- Biofeedback
- Repetitive Transcranial Magnetic Stimulation (rTMS)
- Neuromodulation
- Physiotherapists, osteopaths and dentists
- ENT doctor
- Medical management
- Medication
- Other solutions
Does your tinnitus sound like one of these noises?
Frequently Asked Questions
Tinnitus
Tinnitus is not a disease but rather a symptom. It is the perception of a sound in the ears or head, not related to external sound stimulation. It can be heard in one or both ears, or even in the head, lasting more than 5 minutes and happening more than once a week. A sudden, fleeting sound in the ear or head that disappears within 1 minute is not considered tinnitus. If the sound persists in your head for over 6 months, it may be classified as chronic or permanent tinnitus.
- Objective tinnitus: This type of tinnitus is less common. Here, tinnitus can be heard by the clinician and an often-medical cause can be associated with it. This sound sometimes called a somatisation is produced by the body is heard at the ear. Objective tinnitus can be of vascular, muscular or respiratory origin.
- Subjective tinnitus:The most common of the two tinnitus types. Here, tinnitus cannot be heard by the clinician, only the person who suffers can perceive the sound. Subjective tinnitus is usually related to dysfunction in the peripheral (ear) or central (brain) hearing system.
For the majority of cases, an underlying hearing loss is the source of tinnitus. Because of hearing loss, the brain receives less auditory stimulation (heard sounds) from the ear. To respond to this lack of external stimulation, the brain increases the volume of certain tones (example: high-pitched sound) to compensate for this lack of auditory stimulation. The brain thus translates this hyperactivity into a “ghost” sound, which is called tinnitus.
- Noise exposure: Whether noise at work (ex: machinery), auditory trauma (ex: shotgun) or recreational activity (ex: loud music), exposure to noise can cause temporary or permanent hearing loss with tinnitus.
- Presbycusis: A hearing loss caused by age is called presbycusis. With age, the small eyelashes found in the inner ear degenerate. This has the consequence of inducing hearing loss that can be accompanied by tinnitus.
- Sudden Hearing Loss: It can happen to people to experience sudden hearing loss. This may be due to a problem in the inner ear or a little further into the central auditory system that relayed the auditory information to the brain. Sometimes the cause of this hearing loss that can be accompanied by tinnitus is unknown.
- Conductive Hearing Problem: A plug of earwax in the ear canal can sometimes be the cause of tinnitus. Indeed, the plug has the effect of restraining the sound that goes through the ear and thus create a temporary hearing loss. Similarly, several diseases in the middle ear can cause the appearance of tinnitus (Otosclerosis, Otitis, Perforation of the eardrum, dysfunction of the eustachian tube).
- Diseases: Meningitis, inflammation of the brain’s meninges due to a bacterial or viral infection can cause tinnitus. Similarly, Meniere’s disease or labyrinthitis are two pathologies that cause dizziness that is often accompanied by tinnitus.
- Neurological: Tumors in the auditory nerve, such as acoustic neuromas, in one or two ears compress the auditory nerve and cause tinnitus. In addition, people with migraines, multiple sclerosis or other cervical problems can also develop tinnitus.
- Ototoxic Drugs: It is possible to have tinnitus after taking medication or ototoxic drugs. The drugs most likely to cause tinnitus are antibiotics, cardiac medications, antidepressants, diuretics and anti-inflammatories such as ibuprofen and aspirin.
- Lifestyle: Coffee or alcohol consumption, poor stress management, and poor nutrition may increase or maintain the presence of tinnitus.
The answer to this question is in the brain. First of all, it is important to understand that your brain is divided into several areas as a puzzle. All these areas are interconnected by connections such as electrical cables and each provides a particular function. The auditory area, responsible for hearing and other areas of the brain are connected to two main systems:
1) The autonomic nervous system which regulates all the automatic functions of the body such as heart rate, respiration and digestion.
2 )The emotional system that is responsible for creating and regulating emotions as well as behaviours. For example, when you feel hunger, thirst, fear, or joy, this is due to your limbic (emotional) system.
The emotional system and the autonomic nervous system are the dominant and responsible systems for the development of the disturbance caused by tinnitus. When you have tinnitus, the emotional system and the autonomic nervous system are activated using two ways:
1) The upper path that involves the conscious areas of the brain and is responsible for perception, analysis, evaluation, verbalization and fear. This is an important pathway in the initial phase of tinnitus, so when the person begins to become aware of his/her tinnitus.
2) The lower pathway involves the unconscious areas of the brain and is responsible for the emotions and automatic behaviours. This is an important loop in the chronic phase of tinnitus, so when the person begins to be disturbed by his/her tinnitus.
The two pathways will therefore activate the autonomic nervous system, the negative reactions and the patient’s disruption to his/her tinnitus. Tinnitus itself is not dangerous and does not cause any harm. The problem comes when tinnitus is associated with negative thinking, such as thinking tinnitus is an important disease or you’re going to become deaf, or when you say there’s nothing you can do. These negative thoughts reinforce the connection between tinnitus, the emotional system and the autonomic nervous system. They therefore produce a strong reaction in these systems, which makes your tinnitus become disturbing. So, if tinnitus is disturbing, it is not only due to an injury in the auditory system, but rather to the strength of the nerve connections between the emotional system and the autonomic nervous system. Conversely, people who do not complain about tinnitus do not have this strong connection between the limbic system and the autonomic nervous system.
No, tinnitus is often a good indicator of hearing loss, but it does not mean the patient is going deaf. Tinnitus does not directly cause hearing loss, but they often coincide.
- The exposure to loud noise. When using noisy machinery, protect your ears with proper hearing protection.
- Excessive consumption of alcohol and recreational drugs can magnify tinnitus for some people.
- The caffeine found in coffee, tea, chocolate and some soft drinks can also boost tinnitus.
- The vascular effects of nicotine that are found in tobacco products can amplify tinnitus.
- Aspirin, quinine, some antibiotics and several medications can boost tinnitus. When a doctor prescribes a medication, be sure to mention your tinnitus to discuss its possible side effects.
- Stress and anxiety. Many people notice a significant decrease in tinnitus when they are able to control their level of stress or anxiety
Hyperacusis is an increased or exaggerated sensitivity to sounds compared to the norm. Sometimes the hearing of affected people is normal, but their degree of tolerance is weakened compared to someone with good hearing. Although it can present itself, hyperacusis accompanies nearly half of patients who suffer from tinnitus. The origin of this pathology is not yet known. However, it seems that the hyperacusis is due to disturbance in the auditory system.