My Ears are Ringing! Tinnitus

1. My Ears are Ringing! Tinnitus Kelly C. Waldvogel, Au.D. Doctor of Audiology Northwestern Medicine

2. Tinnitus What is tinnitus? What causes tinnitus? Factors that influence tinnitus. How do we manage tinnitus?

3. What is tinnitus? /’tinitəs,ti’nī-/ Sounds heard in the ear(s) that are not present in the environment; “ringing in the ears”; phantom perceptions Hissing, roaring, static, crickets, screeching, sirens, whooshing, pulsing, ocean waves, buzzing, clicking, etc.

4. Classifying tinnitus • “normal tinnitus” having occasional tinnitus that lasts a short time and goes away on its own • Significant tinnitus-having constant tinnitus, but it may fluctuate from day to day • Subjective tinnitus: meaning only the person can hear it • 95% • Objective tinnitus: an examiner can hear it using a stethoscope • 5%

5. How common is tinnitus? Approximately 15% of the world population has tinnitus 10-20% of people seek medical help 70-90% of individuals with tinnitus show some hearing deficit when tested The incidence and prevalence of tinnitus increases with age and severity of hearing loss

6. What causes tinnitus? • Outer ear disorders • Inner ear disorders • Cardiovascular disease • High blood pressure • Multiple sclerosis • Kidney transplant/renal disease • Lyme disease • Zinc deficiency • Poor circulation • Hypothyroid/hyperthyroid disorders • High cholesterol • Vascular disorders • Jaw joint disorders • Cervical or neck disorders • Certain medications *If an individual has one of the above, it does not mean that they will have tinnitus

7. Most common condition associated with Tinnitus • Hearing loss • Outer/Middle Ear: ear wax, allergies, middle ear infection, etc • Inner Ear: hearing loss, noise exposure, etc

8. However the specific cause of tinnitus is still unknown in many cases: • Difficulties arise when individuals experience the following as a result of tinnitus: • Difficulty sleeping and/or concentrating • Focusing/concentrating on speech • Anxiety • Frustration, depression • Annoyance, irritation • Stress

9. Where is the tinnitus coming from? • Regardless of the initial cause of the tinnitus it is perceived and processed in the brain • Because most people with tinnitus also show some hearing loss it is thought that it is related to auditory deprivation • Similar to phantom limb syndrome • Additionally, activation of the limbic or emotional system also contributes to tinnitus

10. Auditory or Hearing Area Limbic or Emotional Area

11. Assessment of Tinnitus • Visit an Audiologist • Discussion of the time frame of tinnitus symptoms and other associated symptoms • Hearing evaluation is completed • Recommendations of treatment and management for tinnitus and/or hearing loss • Referral to other medical providers as needed

12. Tinnitus treatment/management • There are currently no proven medications that treat tinnitus • HOWEVER, there are MANY ways to help manage tinnitus and an individuals reaction to tinnitus • Hearing Devices with or without hearing loss • Use of sound in quiet environments • Relaxation techniques

13. Questions? Audiology Services-Department of Otolaryngology 675 North Saint Clair Street, Galter 15-200 Chicago, IL 60611

14. Sources: Coles, R.R. (1984) Epidemiology of tinnitus. J LaryngolOtol Suppl. 9, 7-15 Dobie, R.A. (2004). Overview: suffering from tinnitus. In: Snow JB, editor. Tinnitus:Theory and Management. Lewiston, NY: BC Deker Inc. 1-7 National Institute on Deafness and Other Communication Disorders (2001, February) The noise in your ears: Facts about tinnitus (NIH Pub No 00-4896). Bethesda, MD Sweetow, R.W. (2000) Cognitive-behavior modifiction In: Tyler RS. Editor. Tinnitus Handbook. San Diego: Singular Publishing Group, 297-311 Sweetow, R.W. and Widex A/S(2012) Widex Zen Therapy: Managing the effects of tinnitus. All Images were obtained from Google Images