Tinnitus

Understanding Tinnitus

You’re not alone. At least one in every ten adults experiences tinnitus.
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Tinnitus is a common problem, 10-15% of the population. In simple terms, it is the
perception of sound when there is no external source.
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The experience of tinnitus varies greatly from person to person; what it sounds like, how unpleasant it can be and how much it intrudes on daily life - inhibiting ability to sleep, concentrate and perform day-to-day tasks.
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There are many possible causes and types of tinnitus, which makes treating it difficult. For some, tinnitus is an issue that builds gradually. For others, it can present itself quite suddenly.
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It can be a temporary condition or one that, unfortunately for some, becomes an ongoing issue. Whether your tinnitus is persistent or new, we can help.

What are the common signs of hearing loss?

Some of the most common signs include:
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- Frequently asking others to repeat themselves
- Turning up the TV or radio louder than others prefer
- Difficulty following conversations, especially in noisy environments
- Feeling like people are mumbling
- Avoiding social situations due to hearing difficulties

If you notice any of these signs, it's a good idea to schedule a hearing assessment.

What causes hearing loss?

Hearing loss can result from a variety of factors, including:

- Age-related hearing degeneration (presbycusis)
- Prolonged exposure to loud noise
- Ear infections or blockages like earwax buildup
- Certain medications that can damage hearing (ototoxic drugs)
- Head injuries or genetic conditions
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An audiologist can help determine the specific cause in your case.

How is hearing loss diagnosed?

An audiologist will perform a comprehensive hearing evaluation, which may include:

- A review of your medical and hearing history
- Physical examination of the ears
- Pure-tone testing to measure what sounds you can hear
- Speech testing to assess how well you understand words
- Tympanometry to evaluate middle ear function

This assessment helps us tailor a treatment plan specific to your needs.

Are hearing aids the only treatment for hearing loss?

Not always. Treatment depends on the type and severity of hearing loss. In some cases, medical treatment or surgery can address the issue.

However, for most forms of sensorineural hearing loss (the most common type), hearing aids are the most effective solution.

Modern hearing aids are discreet, highly customizable, and designed to improve quality of life. Your audiologist will guide you through the best options.

Why do I have tinnitus?

There are multiple possible causes for tinnitus. There’s loud noises and exposure to noise, illness, head or ear injuries or infections, medication side effects, disease and general hearing loss.

Why does it make that sound?

Tinnitus changes the communication signals going from the ear to the part of the brain where sound is processed, known as the auditory cortex. This means that some parts of the brain do not receive signals the way they should. The noise causes permanent damage to the sound-sensitive cells of the cochlea, a spiral-shaped organ in the inner ear.

What are the symptoms of tinnitus?

People’s experience of tinnitus differs greatly. Most commonly, you will hear it described as an annoying ringing in the ears. You will also hear it described as a buzzing, humming, hissing, or whistling sensation. It can be perceived as being in one or both ears, in the head or even outside the head in certain cases. For many, it’s a constant or fluctuating sound that they will hear all day long – even more so when it’s quiet (such as at night, when there is less external sound to dull it down) – but for others it may be something that comes and goes
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Some sufferers will report hearing one single sound whilst others can hear a multitude of sounds. On top of all of these common variations, the sound itself can also vary in both pitch and loudness.

What are the causes?

Hearing loss, as a result of ageing, is by far the most common cause of tinnitus. Other common causes of tinnitus can include middle ear infection, Ménière’s disease, acoustic trauma caused by sudden exposure to loud noise, certain medications, head injury, temporomandibular joint disorder (TMJ) and stress.

Tinnitus is also linked to hearing loss caused by a blockage or ear condition that affects the outer or middle ear which stops sound waves from passing into the inner ear.

Is tinnitus a problem?

The majority of people who have tinnitus are not particularly bothered by it; they may find it only mildly annoying and ultimately learn to live with it. For some people, however, living with tinnitus can have a serious impact on their quality of life, triggering anxiety, stress, depression and interfering with hearing, sleep and concentration.

Whether it’s mild or severe, the good news is that tinnitus is not a life-threatening condition. Fortunately, the majority of people find that their tinnitus gets better over time. This is because the brain gradually learns to ‘filter it out’ and not pay attention to it. This process is called ‘habituation’. Habituation is one of the main goals of tinnitus treatment and management therapies.

How do I manage tinnitus?

There is currently no cure for tinnitus. That being said, treatment and management therapies are available that can help reduce the impact of tinnitus so that people can live a normal active life. The aim of treatments, such as sound therapy, relaxation therapy and cognitive behavioural therapy (CBT), is to help people effectively ignore or manage their tinnitus to the point where it is no longer a problem. Some treatments also aim to reduce the stress that can be associated with tinnitus. Of course, if there is an underlying cause of tinnitus that can be easily treated, such as an ear-wax blockage or an ear infection, treating this may get rid of the tinnitus.

Audiologists may recommend one or more of the following options: sound therapy, including sound generators and hearing aids, relaxation exercises such as yoga, Cognitive Behavioural Therapy, or Neuromodulation Treatment. Whichever treatment path is recommended to you, it is important to understand that it can take time for things to improve, be it the stress associated with tinnitus or the tinnitus symptoms themselves. What’s recommended for each patient will depend on the nature of their tinnitus, how it impacts them and whether they have any other underlying problems, like hearing loss, or stress. It may also depend on what is comfortable or acceptable for each patient.

Who is affected?

Though not as widely discussed as some other health concerns, the reality is that around 10-15% of a population will experience bothersome tinnitus. To put that into context, if you take the latest population figures from the US (which, in 2019, was just over 328 million), that’s 32-49 million people who will live with tinnitus symptoms. People of all ages can get it; even children.

Statistically though, it’s more common in adults as it is associated with hearing loss which is believed to increase with age. Many people get tinnitus for a short period of time (‘acute tinnitus’ is tinnitus that lasts for a maximum of three months). It can manifest after being exposed to loud music, perhaps at a concert or via headphones, but it can also arise due to an excess in ear wax, or as a result of a cold or a flu. In a lot of these cases, it will pass, but for some, it doesn’t go away, and can be a chronic and bothersome issue.

What are the types of tinnitus?

Generally speaking, there are two types of tinnitus: Subjective Tinnitus and Objective Tinnitus.

Subjective Tinnitus is tinnitus that only the person themselves can hear. This is the most common type of tinnitus, encompassing any and all of the aforementioned symptoms.

Objective tinnitus is tinnitus that your healthcare professional can hear when they do an examination and put a stethoscope to the ear.

What do I do if I have tinnitus?

For a lot of people, identifying the specific cause of their tinnitus symptoms proves difficult. For this reason, it’s important that patients experiencing tinnitus go and see their GP for a full examination in order to diagnose the underlying cause. In some cases, resolving the cause may alleviate the perception of tinnitus, such as an ear infection.

If the GP cannot find an underlying cause, patients may be referred to an ENT Consultant for further investigation or to an audiologist to have their hearing assessed.

Hamilton Audiology specialise in treating tinnitus and will tailor a treatment plan to you, following a comprehensive tinnitus assessment, using the latest evidence-based treatments.

What is sound intolerance?

Sound intolerance refers to an abnormal sensitivity or emotional reaction to everyday sounds that most people find tolerable. The two most common types are:

‍Hyperacusis: heightened sensitivity to sound, causing discomfort or pain.

‍Misophonia: strong emotional reactions like anger or anxiety to specific trigger sounds (e.g., chewing, tapping).
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If you find normal sounds overwhelming or distressing, a professional evaluation can help determine the cause and best course of action.

What causes sound intolerance?

There are several potential causes, including:

- Noise-induced hearing damage
- Neurological conditions or brain injury
- Temporomandibular joint (TMJ) disordersAnxiety, PTSD, or other emotional health factors
- Ear infections or other ear disorders

‍In some cases, sound intolerance is linked to other hearing issues, so a full hearing evaluation is essential

How is sound intolerance diagnosed?

Diagnosis typically involves:

- A thorough case history and symptom discussion
- Hearing tests to rule out hearing loss or damage
- Sound tolerance testing (such as Loudness Discomfort Level testing)
- Assessment of psychological or emotional responses to sound

Our clinic uses a multidisciplinary approach to ensure an accurate diagnosis and personalized care plan.

Can sound intolerance be treated?

Yes, sound intolerance can often be managed with the right strategies, such as:

- Sound therapy to gradually desensitize the ears
- Counseling or cognitive behavioral therapy (CBT) to address emotional reactions
- Use of hearing devices with sound generators
- Lifestyle adjustments and coping techniques

Treatment is highly individualized and may involve both audiological and psychological support.