By Dr. Scott Saunders
Salvador is a truck driver in his mid-thirties who rides his bike to my office. He came to see me for a skin condition, but noted that he was unable to work because of “screaming” in his ears. We had his hearing tested and he was normal in all ways. Legally, he was able to continue his work, but felt so distracted by the noise that he didn’t feel safe behind the wheel.
In Latin, tinnire means “to ring,” as in ringing a bell. Tinnitus is the medical term for hearing noise when no external sound exists.
- It can be ringing, hissing, clicking, or any sort of noise.
- It may be intermittent or constant, mild or severe in intensity; sometimes it is so deafening the individual may hear nothing else.
- It can vary from a low roar or throbbing to a high-pitch sound. It may be subjective, audible only to the patient, or objective which is audible to others.
- It may or may not be associated with a hearing impairment. It affects 1 in 5 people worldwide, and as much as 1/3 of those over 65.
Tinnitus isn’t a disease; it’s a symptom that has multiple causes.
What causes Tinnitus?
These first causes are actually less common, but often need help from a doctor to diagnose and treat.
1. Meniere’s disease
Meniere’s disease is a problem with the inner ear that seems to be related to the fluid in the inner ear. Both sides are affected with tinnitus that people often describe as “a freight train going through my head.” It is always associated with vertigo or dizziness.
Stiffening of the bones in the middle ear can cause intermittent sounds and diminish hearing.
A hole in or a rupture of the eardrum sometimes causes unusual noises like wind blowing.
Anything that reduces the hearing can increase the perception of tinnitus. The following give a 30% hearing loss that causes a relative amplification of tinnitus.
- Excess wax
- A foreign body in the ear canal
- Fluid in the middle ear
- Damage to the “ear bones”
One woman came to my office with tinnitus, hearing loss and dizziness on one side only. She had been to an ear specialist who told her it was nothing and her HMO wouldn’t pay for an MRI. She had been getting worse over several years so I ordered a brain scan, which she had to pay for! “Why did I even get insurance?!” she questioned. Sure enough, she had
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