Causes of Tinnitus

Tinnitus is a ringing, swishing, or other type of noise that seems to originate in the ear or head. In many cases it is not a serious problem, but rather a nuisance that eventually resolves. Rarely, however, tinnitus can represent a serious health condition.It is not a single disease, but a symptom of an underlying condition.

Common causes of tinnitus 

In many people, tinnitus is caused by one of these conditions:

  • Age-related hearing loss. For many people, hearing worsens with age, usually starting around age 60. Hearing loss can cause tinnitus. The medical term for this type of hearing loss is presbycusis.
  • Exposure to loud noise. Loud noises, such as those from heavy equipment, chain saws and firearms, are common sources of noise-related hearing loss. Portable music devices, such as MP3 players or iPods, also can cause noise-related hearing loss if played loudly for long periods. Tinnitus caused by short-term exposure, such as attending a loud concert, usually goes away; long-term exposure to loud sound can cause permanent damage.
  • Ear bone changes. Stiffening of the bones in your middle ear (otosclerosis) may affect your hearing and cause tinnitus. This condition, caused by abnormal bone growth, runs in families.
  • Earwax blockage. Earwax protects your ear canal by trapping dirt and slowing the growth of bacteria. When too much earwax accumulates, it becomes too hard to wash away naturally (cerumenal impaction), causing hearing loss or irritation of the eardrum, which can lead to tinnitus.

Other causes of tinnitus 
Some causes of tinnitus are less common. These include:

  • Meniere’s disease. Doctors think this inner ear disorder is caused by abnormal inner ear fluid pressure or composition.
  •  Head injuries or neck injuries. These neurological disorders can affect the inner ear, hearing nerves or brain function linked to hearing. Head or neck injuries generally cause tinnitus in only one ear.
  • Stress and depression. These conditions are commonly associated with tinnitus and seem to aggravate it.
  • TMJ disorders. Problems with the temperomandibular joint, the joint on each side of your head in front of your ears, where your lower jawbone meets your skull, can cause tinnitus.
  • Acoustic neuroma. This noncancerous (benign) tumor develops on the cranial nerve that runs from your brain to your inner ear and controls balance and hearing. Also called vestibular schwannoma, this condition generally causes tinnitus in only one ear.

Presbycusis: Causes, Symptoms and Preventions

Presbycusis is the loss of hearing that gradually happens in most individuals when they get older. Hearing loss is a common disorder associated with aging. About 30-35 percent of adults between the ages of 65 and 75 years have a hearing loss. Presbycusis most often develops in both ears, affecting them equally. The hearing loss associated with presbycusis is usually greater for high-pitched sounds. It may be difficult for someone to hear the nearby chirping of a bird or the ringing of a telephone.hearing loss

What cause presbycuis?

Presbycusis is normally caused by gradual changes in the inner ear. The cumulative effects of repeated exposure to daily traffic sounds or construction work, noisy offices, equipment that makes noise, and loud music can also cause presbycusis, or appear as a side effects of some medicines.

Presbycusis may be caused by changes in the blood supply to the ear because of heart disease, diabetes and high blood pressure. The cause may be due to a decreased blood supply to the inner ear. This lack of blood supply could dampen the growth of the tiny hairs of the inner ear.

Lifestyle habits may play a role in who is affected by presbycusis. Habits such as smoking tobacco and heavy drinking can diminish hearing capabilities in some people.

Symptoms

The most common symptoms of presbycusis are:

•        The speech of others seems mumbled or slurred.

•        It is difficult to hear and tell apart high-pitched sounds such as “s” and “th”.

•        Hearing ringing sounds in the ear

•        Conversations are difficult to understand, especially when there is background noise.

•        Certain sounds seem annoying or overly loud.

•        A man’s voice is easier to hear than the higher pitches of a woman’s voice.

Preventions

The two most obvious preventative measures that can be taken to avoid presbycusis include wearing ear defenders if you work in a noisy place, and also turning the volume down when listening to music

Acoustic Trauma – Causes, Symptoms, Diagnosis and Treatment

Definition of Acoustic trauma:

Acoustic trauma is injury to the hearing mechanisms in the inner ear due to very loud noise.

What are the causes and risks of the condition?

Most cases of occupational hearing loss develop gradually. Common environmental factors that contribute to hearing loss include the following:
# harmful gases, such as carbon monoxide
# heat
# a loud, intense burst of sound, such as a gunshot
# loud noise over a long period of time
# metals, such as lead, arsenic, manganese, and mercury
# solvents, such as toluene and other chemicals used in manufacturing

Individuals who are exposed to noise along with one of the other environmental factors may experience more significant hearing loss.

Symptoms & Signs of Acoustic Trauma

The person with occupational hearing loss may have a feeling of fullness in the ears. Sounds may seem muffled. He or she cannot hear very well, especially at high frequencies. There is usually a high-frequency ringing in the ears.

Most people recover their hearing completely within 24 to 48 hours. However, even when hearing returns, hair cells are permanently damaged. People who are exposed to noise repeatedly over a long time will have those noise injuries build up. The result is a hearing loss at high frequencies that slowly gets worse. These people may not even be aware that anything is wrong with their hearing.

Some sounds are so loud that high-frequency hearing is immediately and permanently lost. Examples include explosions, artillery fire, fireworks, and gunshots. Some people seem to be more prone to injury from noise exposure. The same noise that causes hearing loss in them may present no difficulty for others. Hearing that does not return after an acute noise injury is called a permanent threshold shift.

How is the condition diagnosed?

Diagnosis of occupational hearing loss begins with a medical history and physical exam. The healthcare provider may order the following tests:
# an otoacoustic emissions test, which measures how well the hair cells are working
# a standard hearing test
# an X-ray of the head or a cranial CT scan to detect underlying problems

Acoustic Trauma Treatment

What are the treatments for the condition?

Treatments for occupational hearing loss include the following:
# aural rehabilitation, which teaches the individual how to work with hearing loss
# hearing aids
# protective equipment to reduce further hearing damage
# workplace redesign to minimize further hearing loss

What are the side effects of the treatments?

There are no side effects from the treatment options listed.

What happens after treatment for the condition?

Many people with hearing aids have a hard time communicating when there is a lot of background noise. Other people should be encouraged to speak into the less-impaired ear of the person. Gestures and facial expressions can also help, when used appropriately. The person may need assistance dealing with adjustment to hearing loss. He or she may have emotional reactions such as anger, frustration, and loneliness.

How is the condition monitored?

The healthcare provider may order periodic hearing tests to detect further hearing loss. Any new or worsening symptoms should be reported to the healthcare provider.

Author: Mark Loury, MD
Editor: Jonas Linh

Acoustic trauma is a damage to the ear caused by noise

Acoustic trauma can be caused by a sudden and powerful sound like an explosion. Explosions often lead to damaged ear drums and consequently conductive hearing loss.

Many people have experienced a period of reduced hearing after exposure to loud sounds, for example after a concert or a visit to a discotheque or after having worked with noisy equipment. This kind of hearing impairment is often temporary. After some time the trauma will stop.

If Acoustic trauma continues, it will typically lead to hearing impairment within a relatively narrow frequency around 4 kHz. In other words, the person will be unable to hear within a certain range of high frequency tones.

In certain daily situations, this may not bother people. But in more noisy environments, they may have problems hearing. Sometimes a hearing aid can be of help to people suffering from permanent Acoustic trauma.

Sudden Deafness – Ayurvedic Herbal Treatment

Sudden deafness, also known as Sudden Sensorineural Hearing Loss (SSHL), is a rapid loss of hearing which may occur all at once or over a period of up to three days. SSHL is defined as a loss of at least 30 decibels in three connected frequencies, and usually occurs in only one ear. It may be accompanied by dizziness and ringing in the ears. Only about 10% of affected individuals have known causes which include infections, trauma, immune disorders, circulatory or neurological disorders or drugs toxic to the ears. While most people recover spontaneously within a few weeks, about 15% experience progressively worsening symptoms. Standard management includes removal of the known cause, antibiotics, steroids and inhalation of a mixture of carbon-dioxide and oxygen.

The Ayurvedic treatment of SSHL consists of treating the known cause of the condition and giving symptomatic treatment for the hearing loss. Infections related to the ears and upper respiratory tract can be treated using medicines like Sukshma-Triphala, Sitopaladi-Powder, Tribhuvan-Kirti-Ras, Kamdudha-Ras, Sutshekhar-Ras, Shwas-Kas-Mishran-Ras, Ras-Sindur, Yashtimadhuk (Glycyrrhiza glabra), Kantakari (Solanum xanthocarpum) and Pippali (Piper longum). Immune disorders can be treated using medicines like Tulsi (Ocimum sanctum), Ashwagandha (Withania somnifera), Pippali, Manjishtha (Rubia cordifolia), Guduchi (Tinospora cordifolia), Yashtimadhuk, Bhumiamalaki (Phyllanthus niruri), Suvarna-Malini-Vasant, Laghu-Malini-Vasant and Madhu-Malini-Vasant.

The treatment of circulatory disorders is important while managing SSHL since it is believed that a reduction in blood circulation to the internal organs in the ears could contribute primarily to the sudden loss of hearing. Medicines are used to remove blood clots, reduce blood toxins and obstruction, and inflammation of the arterial walls. These medicines include Tapyadi-Loh, Ekangveer-Ras, Maha-Yograj-Guggulu, Saarivadi-Vati, Punarnava-Mandur, Manjishthadi-Qadha, Saarivasav, Arogya-Vardhini, Lashunadi-Vati, Suvarna Bhasma, Panchamrut-Parpati, Amalaki (Emblica officinalis), Haridra (Curcuma longa), Nimba (Azadirachta indica), Saariva (Hemidesmus indicus), Guggulu (Commiphora mukul), Patol (Trichosanthe dioica), Patha (Cissampelos pareira), Musta (Cyperus rotundus ), Kutki (Picrorrhiza kurroa) and Daruharidra (Berberis aristata). Neurological causes can be treated using medicines like Bruhat-Vat-Chintamani, Maha-Vat-Vidhvans-Ras, Vat-Gajankush-Ras, Vish-Tinduk-Vati and Agni-Tundi-Vati.

In addition, symptomatic treatment for SSHL includes the use of medicines like Kaishor-Guggulu, Panch-Tikta-Ghrut-Guggulu, Punarnavadi-Guggulu, Maha-Rasnadi-Guggulu, Saarivadi-Vati, Punarnava-Mandur, Abhrak-Bhasma, Suvarna-Bhasma, Raupya -Bhasma, Mukta-Bhasma and Pathyadi-Qadha. These medicines improve the perfusion of the inner ear and also increase the functioning of the auditory nerve.

A judicious use of Ayurvedic medicines can thus be used to treat refractory patients of SSHL who do not improve spontaneously or with conventional treatment.

Dr. A. A. Mundewadi is Chief Ayurvedic Physician at Mundewadi Ayurvedic Clinic based at Thane, Maharashtra, India. He is available as an online Ayurvedic Consultant at ayurvedaphysician.com