Making Sense of Sensory Loss

Tinnitus

Tinnitus, or 'ringing' in the ears, is a relatively common problem, quoted as affecting 10-20% of the general population. It is more common with increasing age (up to 30% of people over 65 reporting tinnitus in one study). For about 5% of the general population, tinnitus is severe enough to cause sufferers to seek help, with one in five of these people regarding their tinnitus as debilitating.

Exposure to loud noises, dental and jaw problems, middle-ear infections, tumours, some medications, stress and fatigue or even wax on the eardrum, can trigger tinnitus.

Tinnitus may be triggered by exposure to loud noise, may come and go, may be aggravated by other loud continuous or impulsive noise, or may be an indication that you have ear damage. It is not a disease. A hearing loss may be accompanied by tinnitus or ringing in your ears even though there is no external noise present. Tinnitus can be aggravated by stress, depression, sinusitis, middle ear disease, arthritis, injury, malocclusion (a condition in which there is an abnormal arrangement of the teeth, either within one jaw or in one jaw in relation to the other) and Temporo Mandibular Joint disorder, known as TMJ (dysfunction and/or degeneration affecting the jaw joint).

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Types of tinnitus:

Spontaneous tinnitus

Spontaneous tinnitus is a ringing that suddenly begins while you are in a quiet place. Usually it lasts for a short period. The presence of tinnitus does not mean you are going deaf.

Around 10% of the population experience persistent tinnitus triggered by emotional events. It may start during a period of unrelated depression or anxiety. It is thought that most tinnitus originates in the inner ear and cannot be heard externally.

Objective tinnitus

Occasionally tinnitus can be heard externally and it may be due to a spasm of the middle-ear muscles. It is then called objective tinnitus.

Troublesome tinnitus

Around 1% of the population has troublesome tinnitus. You cannot turn off this unwanted continuous background noise to focus on something else. It is unrelenting, worse at some times of the day, like when you are trying to sleep. It can create a very distressing condition, but with appropriate treatment, it CAN be modified and controlled.

Tinnitus associated with a hearing loss

Tinnitus will not cause a hearing loss but may be worse if it is associated with a hearing loss. Communication is often a strain if you are hard of hearing and this strain focuses the subconscious to pick up anything from the inner ear. It is a common mistake to assume that having a hearing loss is like permanent silence. Unfortunately, hearing loss is often accompanied by unwanted noises in the head also described as the sound of cicadas.

Hearing aids will help you to gradually,

• Ignore tinnitus by reducing the strain of listening
• Increase your awareness of environmental sounds.

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Things to avoid if you have tinnitus:

• Loud sounds - exposure to them can make tinnitus worse
• Large amounts of aspirin are known to cause tinnitus or make it worse
• Caffeine - it can cause tinnitus to become louder. Caffeine is present in coffee, tea, cola drinks, chocolate, cocoa and some medicines
• Excessive alcohol consumption can make tinnitus worse
• Smoking - nicotine can make tinnitus worse.

What can you do about tinnitus?

• Consult your doctor - Your doctor may refer you to an Ear Nose and Throat (ENT) specialist to investigate the cause
• Reduce stress - Stress has a significant impact on the perception of tinnitus because it leads to the heightened sensitivity of the brain to all sounds. It is worth evaluating your lifestyle so it includes enjoyable and relaxing activities
• Medication - Certain medications have been shown to improve tinnitus
• Mineral supplements - zinc and magnesium are frequently used in the medical treatment of tinnitus.

Occasionally treatment by a clinical psychologist is necessary in the management of tinnitus. This may involve tinnitus retraining therapy (TRT), cognitive behaviour therapy and even hypnosis. TRT aims to effect a reversal of negative thoughts about tinnitus and encourages the central nervous system, by habituation, to alleviate the impact of the tinnitus preferably to the point where it is no longer of significance.

A coordinated approach to tinnitus management through your audiologist and clinical psychologist may recommend devices such as tinnitus maskers and white noise machines, which work to minimise the effect of your tinnitus.

Where can I go for help?

• Your GP - can refer you to a specialist for tinnitus management - usually an ear, nose and throat (ENT) specialist or an audiologist
• DVA - You may be eligible for assistance from DVA.
  Contact: DVA Hearing Services on 1800 686 126 for more information.
  If you use TeleTYpewriter (TTY) equipment call: 1800 500 496
   
  How can DVA Hearing services help? - Through the Office of Hearing Services, DVA offers 2 separate services:
  - Hearing assessments, hearing aid fitting and rehabilitation
  - Tinnitus management.

To make an appointment for a free hearing check (for pensions and war veterans) or for more information, contact:

Australian Hearing on 13 17 97

On the web

Australian Hearing:
www.hearing.com.au

Australian Tinnitus Association:
www.tinnitus.asn.au

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