What’s the Buzz About?

imagestinnitusAn estimated 37 million Americans suffer from ringing, buzzing, humming or hissing in the ear known as tinnitus. Tinnitus, by definition is the conscious perception of sound in the absence of an externally generated sound source. Tinnitus can be a combination of sounds and for many people may vary in tone, character and loudness. It may remain consistent and persist or may subside or at times seem to disappear. For some, stress and diet exacerbate it. Others have difficulty determining what makes it better or worse.

And while tinnitus is perceived in the ear, and may, in some cases be generated in the middle ear space, most scientists will agree that in most cases, the sound perceived in the ear is occurring in the brain. Yes, that’s right, tinnitus is perceived in the ear, but occurs in the brain. This explains why many patients with severed auditory nerves will lose all ability to hear from the severed nerve ear, but will still experience tinnitus.

Scientists disagree over the causes, origins and models for how tinnitus originates and becomes weaved into the neural pattern, but what they do agree about is the fact that many different types of tinnitus exist. A popular theory suggests that damage to the peripheral auditory structures send disrupted, abnormal neural signals to the brain which subsequently causes persistent abnormal activity in the central auditory pathway (Nageris, et al., 2010; Jastreboff & Hazell, 1993).

While tinnitus can occur for individuals with normal hearing, 85% of those with tinnitus do have some degree of hearing loss. (Simpson & Davies, 2000). This makes sense when we think about how damage to the ear can result in disrupted and abnormal signals to the brain.

For many patients, simply acknowledging the presence of the tinnitus and understanding that it is a result of damage to the auditory mechanism is enough for them to accept the noise intrusion. Others find their tinnitus more debilitating and seek other avenues for help.

For many tinnitus sufferers with hearing loss, a properly fit hearing aid will help to reduce the perception of tinnitus in over 60% of cases. Some find that use of amplification can suppress tinnitus. But for most, decreased awareness of tinnitus is either a result of a complete or partial masking of the sounds or a reduced contrast between silence and the tinnitus, or because of a more structured neural pattern, among other possible occurrences that contribute to diminished awareness of the presence of tinnitus.

For others, amplification alone will be insufficient to help deal with the effects of tinnitus. Stress management and counseling or cognitive behavioral therapy is often extremely useful when used alone or in conjunction with amplification therapies.

Certainly, one with tinnitus should know that there is help. An appointment with an audiologist can help identify whether there is hearing loss, need for medical referral and design an approach for dealing with tinnitus.

Hears to Healthy Living!

Stefanie Wolf, Au.D.

Doctor of Audiology
Audiology of Nassau County
165 North Village Avenue
Suite #114
Rockville Centre, NY 11570
(516) 764-2094

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Jastreboff, P., & Hazell, J. (1993). A neurophysiological approach to tinnitus:
clinical implications. British Journal of Audiology, 27, 7-l7.

Nageris, B., Attias, J., & Raveh, E. (2010). Test-retest tinnitus characteristics in patients with noise-induced hearing loss. American Journal of Otolaryngology–Head and Neck Medicine and Surgery, 31, 181-184.

Simpson, J., & Davies, E. (2000) A review of evidence in support of a role for 5-HT in theperception of tinnitus. Hearing Research, 145, 1-7.

In Case your Doctor Forgot to Mention…

Often patients express surprise when I share some very basic information about hearing and ear health and hygiene. Either some of these topics are neglected at a physical exam or they are forgotten by the patient. Keeping our ears safe and healthy is an essential aspect of overall health. Hopefully, for most, the information below will serve as a friendly reminder and not new information.
Here are a few basics when it comes to taking care of your ears:

1) DO NOT USE Q-TIPS IN YOUR EARS! The best thing you can do with your Q-tips is to break them in half and toss them in the trash! Ear wax is a good thing. EAR WAX IS NOT DIRT! Ear wax is anti-bacterial, anti-fungal, a natural bug repellent and it is there for a reason! Q-tip users who complain about itchy ears have itchy ears BECAUSE of Q-tip use. Scrubbing the natural oils from the ears depletes the canals of essential moisture causing itching and dryness. Stop the Q-tips, stop the itch. Remember nothing smaller than your elbow should ever go in the ear canal!

2) Protect your ears from noise ALL THE TIME! Both young and old should take care to protect the delicate hearing mechanism. Noise exposure damages the fragile hair cells that reside in the cochlea that are responsible for detecting sound. Damage to the hair cells can result in hearing loss. This can happen after one encounter with something extremely loud or over time with repeated exposures. Consider ear protection for home, on the job or for concerts or loud events.

3) Tinnitus or ringing in the ear should always be evaluated. If you or someone you know reports that they experience tinnitus, an audiometric evaluation should be performed by an audiologist. Often tinnitus is caused by damage to the auditory mechanism. An audiologist can also recommend different treatments to help manage tinnitus annoyance and when indicated can refer to the appropriate otologist.

4) Changes in hearing should receive prompt attention. Sudden changes in hearing such as ‘sudden deafness’ is considered a medical emergency and should receive immediate attention.

5) Dizziness or a sense of disequilibrium should be discussed with your physician or audiologist.

6) Hearing loss should be addressed as an important health issue. Untreated hearing loss has been linked to depression and social isolation. Recent studies have also linked untreated hearing loss to dementia.

7) There IS help for the hearing impaired. Speak with your audiologist and learn about your options for better hearing and hearing protection.


Stefanie Wolf, Au.D.