Tinnitus

Tinnitus

National Organization for Rare Disorders, Inc.

Important

It is possible that the main title of the report Tinnitus is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.

Synonyms

  • Subjective Tinnitus

Disorder Subdivisions

  • None

General Discussion

Tinnitus is a common condition characterized by the sensation of sound for which there is no external source outside the individual. In other words, people with Tinnitus perceive sound when no environmental or external sounds are present. These sounds have been described as clicking, buzzing, and/or ringing. Tinnitus commonly occurs as a side effect of certain drugs and because of other underlying disorders (secondary), especially those of the middle and inner ear (i.e., cochlea). In rare cases, no underlying cause can be found and the condition is termed "idiopathic" Tinnitus. Infection, obstruction of blood vessels near the ear, and/or environmental factors have also been implicated as a cause of Tinnitus.

Symptoms

People with Tinnitus typically hear sounds that are apparent only to them. Environmental or external sound stimuli are not present. A wide variety of sounds associated with Tinnitus have been described such as ringing, clicking, hissing, chirping, buzzing, whistling, roaring, and/or whirling. These sounds may be present at all times, or they may come and go. Some people with Tinnitus report that the sounds are most obvious when environmental sounds are low (i.e., during the night). Others with this disorder describe the sounds as loud, even in the presence of other external sounds. The sounds associated with Tinnitus may coordinate with the person's heartbeat (pulsative). The subjective description of the degree of loudness or annoyance varies greatly among affected individuals. Frequently, people with Tinnitus also have an associated hearing loss.

Causes

A variety of ear disorders, both of the middle and inner ear, have been associated with Tinnitus. Impaired auditory nerve function or obstruction of the blood vessels around the ear have also been implicated in this condition. Other causes may include middle ear infection and/or tumors in the area of the auditory nerve. Side effects of certain medications may play a role in producing the symptoms of Tinnitus. These include erythromycin, salicylates (i.e., aspirin), caffeine, quinidine, indomethacin, carbamazepine, propranolol, levodopa, aminophylline, interferon, and other medications. Many people who are routinely exposed to loud noises levels (i.e., machine shops or airline engines) may suffer from noise-induced hearing loss and Tinnitus. Environmental toxins, head injury, temporomandibular disorders, major depression, and/or alcohol abuse have also been implicated as possible causes of Tinnitus.



Pulsative Tinnitus may be caused by vascular abnormalities, arteriovenous malformations, or certain types of tumors (glomus jugulare). The pulsing sounds are associated in these cases with the person's heartbeat.

Affected Populations

Tinnitus is a common hearing disorder that affects males and females in equal numbers. It is estimated that more than 37 million people in the United States have this condition. Many cases are temporary and symptoms disappear when the medication that causes the Tinnitus is changed, under the supervision of a physician.

Standard Therapies

Individuals with Tinnitus may be urged to undergo a thorough clinical evaluation and other specialized tests to determine the exact cause of the condition. High resolution computed tomography (HRCT) may be recommended when an abnormality of the inner ear is suspected (cochlear anomaly). Magnetic resonance imaging (MRI) may be suggested to investigate the possibility of a tumor in the ear (e.g., acoustic neuroma) or vascular malformation as a cause of Tinnitus. If Tinnitus is caused by a side effect of medication, a physician may switch the patent to another medication or discontinue it according to medical circumstances.



Treatment of the underlying primary disorder may help to improve or cure Tinnitus. For example, if Tinnitus is due to increased pressure within the auditory nerve, surgery may be performed to relieve the pressure on the nerve. If Tinnitus occurs in association with major depression, treatment with antidepressant drugs may help to relieve the symptoms of Tinnitus. Care should be taken to chose an antidepressant that does not cause Tinnitus as a side effect.



Some people with Tinnitus may obtain relief through the use of recordings of background sounds that they find particularly pleasant (e.g., ocean surf). In some cases, a special audiologic device which is worn like a hearing aid, may be prescribed. This device produces sounds that are more pleasant to the individual than the sounds associated with Tinnitus. In other cases, a hearing aid may be recommended to help suppress or diminish the sounds associated with Tinnitus.



There is no medical procedure or drug that can cure Tinnitus when the underlying cause of the condition has not been determined (idiopathic). Other treatment is symptomatic and supportive.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.



For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:



Tollfree: (800) 411-1222

TTY: (866) 411-1010

Email: prpl@cc.nih.gov



For information about clinical trials sponsored by private sources, contact:

www.centerwatch.com



The results of past clinical trials, sponsored by either public or private auspices may be accessed at: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed

References

TEXTBOOKS

Beers MH, Berkow R., eds. The Merck Manual, 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999:665.



Berkow R., ed. The Merck Manual-Home Edition.2nd ed. Whitehouse Station, NJ: Merck Research Laboratories; 2003:1261.



Kasper, DL, Fauci AS, Longo DL, et al., eds. Harrison's Principles of Internal Medicine. 16th ed. McGraw-Hill Companies. New York, NY; 2005:182, 184.



RECENT REVIEW ARTICLES

Bennett M, Kertesz T, Yeung P. Hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss and tinnitus: a systematic review of randomized controlled trials. J Laryngo Otol. 2005;119:791-98.



Smith PF, Darlington CL. Drug treatment for subjective tinnitus: serendipitous discovery versus rational drug design. Curr Opin Investig Drugs. 2005;6:712-16.



Lockwood AH. Tinnitus. Neurol Clin. 2005;23:893-900.



Hannan SA, Sami F, Wareing MJ. BMJ. 2005;330:237.



Waddell A. Tinnitus. Clin Evid. 2004 Jun;(11):718-28. Update in: Clin Evid. 2004 Dec;(12):798-807.



FROM THE INTERNET

Tinnitus. MedlinePlus. Last updated and reviewed: 28 April 2006. 2pp.

www.nlm.nih.gov/medlineplus/tinnitus.html

Resources

Vestibular Disorders Association

PO Box 13305

Portland, OR 97208-4467

USA

Tel: (503)229-7705

Fax: (503)229-8064

Tel: (800)837-8428

Email: veda@vestibular.org

Internet: http://www.vestibular.org



American Tinnitus Association

522 S.W. Fifth Avenue Suite 825

Portland, OR 97207

United States

Tel: (503)248-9985

Fax: (503)248-0024

Tel: (800)634-8978

Email: tinnitus@ata.org

Internet: http://www.ata.org



Better Hearing Institute

1444 I Street NW

Suite 700

Washington, DC 20005

United States

Tel: (202)449-1100

Fax: (703)684-6048

Tel: (800)327-9355

Email: mail@betterhearing.org

Internet: http://www.betterhearing.org



American Hearing Research Foundation

8 South Michigan Avenue Suite 1205

Chicago, IL 60603-4539

USA

Tel: (312)726-9670

Fax: (312)726-9695

Email: sparmet@american-hearing.org

Internet: http://www.american-hearing.org/



NIH/National Institute on Deafness and Other Communication Disorders

31 Center Drive, MSC 2320

Communication Avenue

Bethesda, MD 20892-3456

Tel: (301)402-0900

Fax: (301)907-8830

Tel: (800)241-1044

TDD: (800)241-1105

Email: nidcdinfo@nidcd.nih.gov

Internet: http://www.nidcd.nih.gov



Genetic and Rare Diseases (GARD) Information Center

PO Box 8126

Gaithersburg, MD 20898-8126

Tel: (301)251-4925

Fax: (301)251-4911

Tel: (888)205-2311

TDD: (888)205-3223

Internet: http://rarediseases.info.nih.gov/GARD/



American Academy of Audiology

11730 Plaza America Drive, Suite 300

Reston, VA 20190

Tel: (703)790-8466

Fax: (703)790-8631

Tel: (800)222-2336

Email: infoaud@audiology.org

Internet: http://www.audiology.org



Cogan's Contact Network

PO Box 145

Freehold, NJ 07728-0145

USA

Tel: (732)409-1031

Internet: http://www.coganssyndrome.info/



Hearing Loss Association of America

7910 Woodmont Avenue

Suite 1200

Bethesda, MD 20814

Tel: (301)657-2248

Fax: (301)913-9413

Email: info@hearingloss.org

Internet: http://www.hearingloss.org



For a Complete Report

This is an abstract of a report from the National Organization for Rare Disorders, Inc.® (NORD). Cigna members can access the complete report by logging into myCigna.com. For non-Cigna members, a copy of the complete report can be obtained for a small fee by visiting the NORD website. The complete report contains additional information including symptoms, causes, affected population, related disorders, standard and investigational treatments (if available), and references from medical literature. For a full-text version of this topic, see http://www.rarediseases.org/search/rdblist.html.

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