What causes tinnitus of the ear, what causes a hissing noise in the ear - How to DIY

Tinnitus (pronounced ti-ni-tis), or ringing in the ears, is the sensation of hearing ringing, buzzing, hissing, chirping, whistling, or other sounds. Although tinnitus is often associated with hearing loss, it does not cause the loss, nor does a hearing loss cause tinnitus. Some instances of tinnitus are caused by infections or blockages in the ear, and the tinnitus can disappear once the underlying cause is treated. Certain drugs -- most notably aspirin, several types of antibiotics, anti-inflammatories, sedatives, and antidepressants, as well as quinine medications; tinnitus is cited as a potential side effect for about 200 prescription and nonprescription drugs.
Tinnitus can worsen in some people if they drink alcohol, smoke cigarettes, drink caffeinated beverages, or eat certain foods.
Tinnitus is the perception of an insistent, unpleasant ringing, buzzing or other consistent noise, located in or near the skull but without a definable external source.
Tinnitus is often perceived as a ringing or persistent high tone very close to or within the ear. Tinnitus is often regarded as a symptom of auditory conditions, such as damage to the tissues in the ear that control the perception of tones and frequencies.
An increasing number of researchers argue that tinnitus is a disorder of the connections between the inner ear and certain areas of the brain. Some scientists had developed a theory that tinnitus was associated with deficiencies in vitamin B12. Chronic inflammation of the middle ear (otitis media) may also be associated with some cases of tinnitus. Tinnitus related to otitis media may be improved by surgery to correct damage caused by this inflammation. Constant stress — whether from a traffic-choked daily commute, unhappy marriage, or heavy workload — can have real physical effects on the body. If you find daily tasks difficult to do because you suffer from stiffness, swelling, or pain in your hands, the right exercises can help get you back in motion. If a growth or mole looks like a melanoma, the doctor will take a biopsy to confirm the diagnosis. Some people don't have a health care power of attorney or living will because they don't realize how important these documents are.
When you think of risk factors for hearing loss, over-the-counter pain relievers probably aren't among them. Erectile dysfunction (ED) becomes more common in men in middle age, but the range of treatments means most men can find something that works for them. A study found that one in 10 people who take protective aspirin may not really qualify, because the risk of heart attacks and strokes wasn't great enough to justify the risk of unwanted bleeding associated with aspirin. Constant noise in the head -- such as ringing in the ears -- rarely indicates a serious health problem, but it sure can be annoying.
Tinnitus (pronounced tih-NITE-us or TIN-ih-tus) is sound in the head with no external source. Almost everyone has had tinnitus for a short time after being exposed to extremely loud noise. While there's no cure for chronic tinnitus, it often becomes less noticeable and more manageable over time.
Sound waves travel through the ear canal to the middle and inner ear, where hair cells in part of the cochlea help transform sound waves into electrical signals that then travel to the brain's auditory cortex via the auditory nerve. Most people who seek medical help for tinnitus experience it as subjective, constant sound, and most have some degree of hearing loss. Tinnitus can arise anywhere along the auditory pathway, from the outer ear through the middle and inner ear to the brain's auditory cortex, where it's thought to be encoded (in a sense, imprinted). Most tinnitus is "sensorineural," meaning that it's due to hearing loss at the cochlea or cochlear nerve level. Musculoskeletal factors — jaw clenching, tooth grinding, prior injury, or muscle tension in the neck — sometimes make tinnitus more noticeable, so your clinician may ask you to tighten muscles or move the jaw or neck in certain ways to see if the sound changes. Tinnitus that's continuous, steady, and high-pitched (the most common type) generally indicates a problem in the auditory system and requires hearing tests conducted by an audiologist. Your general health can affect the severity and impact of tinnitus, so this is also a good time to take stock of your diet, physical activity, sleep, and stress level — and take steps to improve them.
If you're often exposed to loud noises at work or at home, it's important to reduce the risk of hearing loss (or further hearing loss) by using protectors such as earplugs or earmuff-like or custom-fitted devices.
In addition to treating associated problems (such as depression or insomnia), there are several strategies that can help make tinnitus less bothersome. There is no FDA-approved drug treatment for tinnitus, and controlled trials have not found any drug, supplement, or herb to be any more effective than a placebo.


The most effective approaches are behavioral strategies and sound-generating devices, often used in combination.
Not all insurance companies cover tinnitus treatments in the same way, so be sure to check your coverage.
In fact, some people with tinnitus experience no difficulty hearing, and in a few cases they even become so acutely sensitive to sound (hyperacusis) that they must take steps to muffle or mask external noises. For reasons not yet entirely clear to researchers, stress and fatigue seem to worsen tinnitus. But ringing in the ears that does not get better or go away is an ear condition called tinnitus. Age-related hearing impairments, or disorders of the circulatory system around the ear, may also be related to this complaint.
Some scientists conclude that tinnitus is in fact related to damage of the nervous tissue in or around the auditory cortex of the brain. A recent study including 100 patients with tinnitus found that 63 of these had low vitamin B12 levels. As the natural molecule histamine is associated with the regulation of both inflammation and some auditory nervous tissue, drugs that block its receptors in the brain are currently proposed as treatments for tinnitus. Darius Kohan is renowned for his otology expertise and has been highlighted on several outlets such as a CBS spotlight on tinnitus and is often cited in WEB MD and other medical outlets. You can help ease the symptoms by educating yourself about the condition — for example, understanding that it's not dangerous. When hair cells are damaged — by loud noise or ototoxic drugs, for example — the circuits in the brain don't receive the signals they're expecting. Things that cause hearing loss (and tinnitus) include loud noise, medications that damage the nerves in the ear (ototoxic drugs), impacted earwax, middle ear problems (such as infections and vascular tumors), and aging. One of the most common causes of tinnitus is damage to the hair cells in the cochlea (see "Auditory pathways and tinnitus"). She or he will take a medical history, give you a physical examination, and do a series of tests to try to find the source of the problem. Pulsatile tinnitus calls for a thorough evaluation by an otolaryngologist (commonly called an ear, nose, and throat specialist, or ENT) or neurotologist, especially if the noise is frequent or constant. You may also be able to reduce the impact of tinnitus by treating depression, anxiety, insomnia, and pain with medications or psychotherapy. No single approach works for everyone, and you may need to try various combinations of techniques before you find what works for you.
CBT uses techniques such as cognitive restructuring and relaxation to change the way patients think about and respond to tinnitus. Masking devices, worn like hearing aids, generate low-level white noise (a high-pitched hiss, for example) that can reduce the perception of tinnitus and sometimes also produce residual inhibition — less noticeable tinnitus for a short time after the masker is turned off. Other treatments that have been studied for tinnitus include transcutaneous electrical stimulation of parts of the inner ear by way of electrodes placed on the skin or acupuncture needles, and stimulation of the brain using a powerful magnetic field (a technique called repetitive transcranial magnetic stimulation, or rTMS). In severe cases, however, tinnitus can cause people to have difficulty concentrating and sleeping. In such a case, other therapies -- both conventional and alternative -- may bring significant relief by either decreasing or covering up the unwanted sound. The noise causes permanent damage to the sound-sensitive cells of the cochlea, a spiral-shaped organ in the inner ear.
Others have found associations between increased activity in further brain regions, age of tinnitus onset and distress caused by the syndrome. However, treating this deficiency had no significant effects on the complaint in these patients. Other new and emerging treatments for tinnitus focus on the potential indicated by the studies into its links with abnormal brain activity, as mentioned earlier. Some medications (especially aspirin and other nonsteroidal anti-inflammatory drugs taken in high doses) can cause tinnitus that goes away when the drug is discontinued.
In about 10% of cases, the condition interferes with everyday life so much that medical help and psychotherapy are needed. This stimulates abnormal activity in the neurons, which results in the illusion of sound, or tinnitus. Tinnitus can also be a symptom of Mnire's disease, a disorder of the balance mechanism in the inner ear.
She or he will also ask you to describe the noise you're hearing (including its pitch and sound quality, and whether it's constant or periodic, steady or pulsatile) and the times and places in which you hear it.
If you have age-related hearing loss, a hearing aid can often make tinnitus less noticeable by amplifying outside sounds.


The aim is to habituate the auditory system to the tinnitus signals, making them less noticeable or less bothersome. Today, the term TRT is being used to describe modified versions of this therapy, and the variations make accurate assessment of its effectiveness difficult.
A specialized device isn't always necessary for masking; often, playing music or having a radio, fan, or white-noise machine on in the background is enough. Carpenters, pilots, rock musicians, street-repair workers, and landscapers are among those whose jobs put them at risk, as are people who work with chain saws, guns, or other loud devices or who repeatedly listen to loud music. The sound may keep time with your heartbeat, it may keep pace with your breathing, it may be constant, or it may come and go. Tinnitus may have a significant negative impact on the life quality of those affected by it.
Different research groups have concluded that chronic tinnitus may be associated with an impaired connection between the cerebral cortex, which controls advanced functions such as memory, perception of the environment and cognition, and the thalamus, which supplies the cortex with sensory information. A recent study, including 974 patients, indicated that hearing aids were preferable and more effective in treating blast-related tinnitus compared to noise generators. Presuming further research confirms the findings of these studies, deep brain stimulation (a form of implant placed in the brain to correct this activity) may be a viable option for severe treatment-resistant tinnitus.
Many people can hear their heartbeat — a phenomenon called pulsatile tinnitus — especially as they grow older, because blood flow tends to be more turbulent in arteries whose walls have stiffened with age.
If the auditory pathways or circuits in the brain don't receive the signals they're expecting from the cochlea, the brain in effect "turns up the gain" on those pathways in an effort to detect the signal — in much the same way that you turn up the volume on a car radio when you're trying to find a station's signal. The main components of TRT are individual counseling (to explain the auditory system, how tinnitus develops, and how TRT can help) and sound therapy. Individual studies have reported improvements in as many as 80% of patients with high-pitched tinnitus. Although there's not enough evidence from randomized trials to draw any conclusions about the effectiveness of masking, hearing experts often recommend a trial of simple masking strategies (such as setting a radio at low volume between stations) before they turn to more expensive options. Electrodes attached to the skin feed information about physiological processes such as pulse, skin temperature, and muscle tension into a computer, which displays the output on a monitor. In two small trials, rTMS compared with a sham procedure helped improve the perception of tinnitus in a few patients.
The most common cause of tinnitus is hearing loss that occurs with aging, but it can also be caused by living or working around loud noises. As many as 50 to 60 million people in the United States suffer from this condition; it's especially common in people over age 55 and strongly associated with hearing loss.
Pulsatile tinnitus may be more noticeable at night, when you're lying in bed, because more blood is reaching your head, and there are fewer external sounds to mask the tinnitus.
The resulting electrical noise takes the form of tinnitus — a sound that is high-pitched if hearing loss is in the high-frequency range and low-pitched if it's in the low-frequency range. Tinnitus can be a side effect of many medications, especially when taken at higher doses (see "Some drugs that can cause or worsen tinnitus"). A 2010 review of six studies by the Cochrane Collaboration (an international group of health authorities who evaluate randomized trials) found that after CBT, the sound was no less loud, but it was significantly less bothersome, and patients' quality of life improved. A device is inserted in the ear to generate low-level noise and environmental sounds that match the pitch, volume, and quality of the patient's tinnitus. In a Cochrane review of the one randomized trial that followed Jastreboff's protocol and met the organization's standards, TRT was much more effective in reducing tinnitus severity and disability than a technique called masking (see below). Patients learn how to alter these processes and reduce the body's stress response by changing their thoughts and feelings. This syndrome may also have deleterious effects on the emotional, psychological and functional status of the patient. Many people worry that tinnitus is a sign that they are going deaf or have another serious medical problem, but it rarely is. If you notice any new pulsatile tinnitus, you should consult a clinician, because in rare cases it is a sign of a tumor or blood vessel damage.
This kind of tinnitus resembles phantom limb pain in an amputee — the brain is producing abnormal nerve signals to compensate for missing input.
Hearing loss treatments depend on the cause and include hearing aids, sound-amplifying devices, and antibiotics if the cause is an infection.
There are a variety of causes of hearing loss besides congenital hearing loss, including ear infections, genetic disorders, illnesses that trigger hearing loss, head injuries, medications, and more.

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