Tinnitus, pronounced either "Tin-IGHT-us" or "Tin-it-us," is a term used to describe the perception of sound in one or both ears when no actual sound is present. It is often referred to as "ringing in the ears," as the term comes for the Latin word "to ring like a bell." Although described as ringing, the sound can be perceived to be more like a roar, whistling, or clicking. The sound can be constant or intermittent and can range in volume from subtle to shattering. Over 50 million Americans experience tinnitus to some degree, 12 million seek medical treatment for it, and over 2 million are debilitated by it.

The exact causes are not known, but a number of contributing factors have been identified. Noise-induced hearing loss, ear wax build up, medications, ear or sinus infections, jaw misalignment, cardiovascular disease, tumors, and head or neck trauma have all been identified as contributing to the condition.

Cells in the ear damaged by excessive noise cannot be repaired or replaced. Up to 90% of tinnitus cases are thought to result from cumulative exposure to noise over 90 decibels. Excessive ear wax build up can impair hearing and make tinnitus worse. If excess ear wax appears to be your problem, you should speak to your doctor about manually cleaning out your ears rather than trying to do it yourself, as you can pack the ear wax harder and make the situation worse. Certain medications can damage the otic nerve temporarily or permanently. Be sure to mention that you have tinnitus before your doctor prescribes medication, to avoid any that may worsen the condition. Many people, including children, may experience temporary tinnitus associated with an ear or sinus infection, which goes away when the infection is treated. Temporomandibular joint (TMJ) disorder results when the jaw is misaligned and may cause damage to cranial nerves and contribute to tinnitus. About 3% of tinnitus patients experience pulsatile tinnitus which results in a rhythmic noise in time with the heartbeat. Pulsatile tinnitus can indicate a problem with circulation in the arteries in the head. Certain tumors in and around the ear are rare causes of tinnitus. Trauma to the neck or head can also produce tinnitus as well as headaches, vertigo, or memory loss.

Treatments are as varied as the causes. For some people hearing aids can resolve tinnitus by amplifying background sounds that mask it. Related to hearing aids are masking devices which produce a low-level sound to mask the tinnitus. Also related is tinnitus retraining therapy in which an in-the-ear sound generator is used for 8 to 12 hours a day but gradually reduces the time over a 12 to 24 month period. Cognitive therapy focuses on the patient's reaction to tinnitus rather than the sound itself. The goal is to eliminate negative responses to the sound and is usually used in combination with masking or retraining. Biofeedback is a relaxation technique that trains people to control certain autonomic body responses such as blood pressure. This is another means of reducing stress in response to tinnitus. Many people report a reduction in the sound in their ears when this stress is reduced. Tinnitus due to TMJ problems may be resolved by realigning the jaw. Cochlear implants are used as a last resort for deaf or near-deaf people, as the implant destroys the remaining hearing cells in the cochlea but can provide relief from the ringing. Medications have not demonstrated much effectiveness. Some people have gotten relief with acupuncture, craniosacral therapy, and hypnosis. Others have tried supplements with zinc, gingko biloba, and B vitamins. The effectiveness of these supplements has been difficult to confirm in studies.

Reference: http://www.ata.org/, the web site for the American Tinnitus Association.

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