What is tinnitus?
Tinnitus is the perception of sound without the presence of an external auditory stimulus. The perceived sound may be described in different tones and characteristics, such as ringing, buzzing, the sound of wind, or the sound of a machine operating. Regardless of its characteristics, all such sounds are referred to as “ringing” or “tinnitus.”
Tinnitus is not a disease but a symptom (a complaint); in other words, it is a finding that can be seen in many different diseases. Therefore, many people may present with this symptom. Its causes can range from very simple to significant. Among the most common causes is something as simple as earwax accumulation in the external ear canal (cerumen = earwax plug), while in very rare cases it may be due to a serious cause such as a tumor. For this reason, all cases of tinnitus should be taken seriously, and basic examinations and evaluations should be performed. Although tinnitus can occur at any age, it is more commonly seen in older adults.
Our tinnitus blog is for informational purposes only:
In order to provide you with better service and work in a more focused manner, we have chosen to concentrate solely on rhinoplasty procedures. Therefore, Prof. Dr. Seçkin Ulusoy has been providing services as a rhinoplasty clinic since 2017, performing only nose aesthetic surgery. Apart from this, we do not provide general Ear, Nose, and Throat examination or treatment services. This blog is intended for general informational purposes only, and we have shared our theoretical recommendations and advice regarding tinnitus. For tinnitus follow-up and treatment, we recommend consulting our colleagues who specialize in this field.
What are the types of tinnitus?
The sensation of hearing sounds from the ear is basically divided into two groups:
- Objective tinnitus: Although it may not be clearly heard by others, there is an actual sound originating from the ear region or neighboring organs and tissues. This sound may also be detected during examination with careful listening. It is usually caused by turbulence of blood flowing through vessels in highly vascular tumors or vascular anomalies. Involuntary rhythmic contractions (myoclonus) of the muscles around the middle ear or Eustachian tube may also cause objective tinnitus. It is a relatively rare cause of tinnitus.
- Subjective tinnitus: This is by far the largest group of tinnitus cases. These are perceived sounds despite the absence of any sound originating from the environment or the body.
What are the most common causes of tinnitus?
- Aging of the hearing organ (cochlea) in the inner ear (Presbycusis = age-related hearing loss)
- Hearing loss due to various causes
- Narrowing of the blood vessels supplying the ear and circulatory disorders
- Exposure to noisy environments (acoustic trauma)
- Middle ear infections
- Diseases of the external ear canal
- High cholesterol and other blood lipids
- Hypertension
- Psychological factors (depression, stress)
- Medications used (aspirin, some antibiotics, chemotherapy drugs)
Which doctor should I see for tinnitus?
After seeing your family physician for tinnitus, the first specialty you should consult is an Ear, Nose, and Throat (ENT) specialist. A comprehensive ENT examination and evaluation should definitely be performed. Afterwards, based on the test and imaging results, the ENT specialist may refer you to other specialties. These are generally Internal Medicine, Neurology, Physical Medicine and Rehabilitation, or Psychiatry.
For effective treatment, a multidisciplinary (coordinated between specialties) approach and treatment plan will increase the likelihood of success.
What tests should be performed for tinnitus?
Considering that tinnitus is not a disease in itself but a symptom of another pathology, an attempt should be made to determine the diagnosis. However, since the actual cause of tinnitus cannot be identified in most cases, the goal of treatment is to reduce tinnitus or help the patient adapt to living with it. The evaluations that should be performed in patients presenting with tinnitus include:
- A detailed medical history and a complete physical examination
- Audiological tests (for the middle and inner ear)
- Blood pressure measurement
- Blood tests (complete blood count, blood glucose, cholesterol, liver function, thyroid hormone tests)
- Radiological examinations (plain X-rays, computed tomography, or magnetic resonance imaging depending on the suspected pathology).
What are the treatment options for tinnitus?
If the examinations reveal a disease that may be causing tinnitus, treatment is directed toward that disease. However, even successful treatment of the underlying condition may not completely eliminate tinnitus. Surgery is the primary treatment option for benign and malignant tumors and vascular anomalies causing tinnitus.
Whether or not the cause is identified, the most commonly used method to reduce tinnitus is medication. For this purpose, drugs that increase blood flow to the inner ear and/or regulate the activity of the hearing cells in the inner ear are used (Magnesium, Vitamin B, various medications containing Ginkgo Biloba, corticosteroids).
In addition, various hearing aids are among the frequently used treatment methods for tinnitus associated with hearing loss.
If tinnitus is severe enough to affect the patient’s daily life, devices called tinnitus maskers, which are similar to hearing aids, may be beneficial. These devices deliver sounds at the same frequency as the tinnitus to the inner ear, aiming to reduce the sensitivity of the areas responsible for tinnitus.
For patients who have difficulty falling asleep because of tinnitus, listening to music before bedtime suppresses tinnitus for 4–6 hours. This is a practical method and is among the first recommendations we give to patients with mild to moderate tinnitus complaints.
Among the newer methods that have been introduced in recent years for tinnitus treatment, cognitive therapy, Tinnitus Retraining Therapy (TRT), and narrowband and broadband noise therapies can provide highly successful results in some patients.
In addition, since stress is a significant cause of tinnitus in the majority of individuals affected by tinnitus, psychological relaxation is important. For this purpose, supportive treatments such as meditation and relaxation techniques, exercise, and proper nutrition, as well as antidepressants, are among the supportive treatment options.
What is the cost of tinnitus treatment?
Following the diagnosis and evaluation of tinnitus, the condition is generally managed with recommendations and supportive treatments. All of these can be provided free of charge in public hospitals under the Social Security Institution (SGK). If second-line treatment options are required for patients who do not benefit from these initial treatments, additional costs may be involved. Methods such as cognitive therapy and TRT offered by some centers are available at quite reasonable fees. Since it would not be appropriate to state a specific price here, we recommend contacting the tinnitus treatment centers you are considering. These alternative treatments are generally provided in sessions. To give a general idea of the cost, treatment usually consists of approximately 15–20 sessions, with fees of around 100–150 Dollars per session.
In summary:
Tinnitus is not a disease but a symptom that may occur due to a wide variety of causes. Sometimes it is also a finding that significantly disturbs the individual and reduces quality of life. It should first be evaluated by an Ear, Nose, and Throat specialist, followed by appropriate diagnosis and treatment options. There is no single magical solution for this condition, but it is a benign finding for which many patients can be successfully treated with different treatment methods.
Frequently Asked Questions
What Is Tinnitus?
Tinnitus is the perception of ringing, buzzing, humming, hissing, or similar sounds in the ears or head despite the absence of any external sound source.
What Are the Most Common Causes of Tinnitus?
Tinnitus may result from many different causes, including exposure to loud noise, age-related hearing loss, earwax buildup, ear infections, certain medications, and circulatory system disorders.
Is Tinnitus Permanent?
Tinnitus may be temporary in some individuals, while in others it can persist for a long time. Depending on the underlying cause, appropriate treatment may reduce or help control the symptoms.
Can Tinnitus Be Treated?
Treatment varies according to the cause of the tinnitus. Once the underlying cause has been identified, medication, hearing aids, sound therapy, or lifestyle changes may be recommended.
Can Tinnitus Be a Sign of Hearing Loss?
Yes, tinnitus is frequently associated with hearing loss. Therefore, individuals experiencing tinnitus are advised to undergo a hearing test.
Can Stress Make Tinnitus Worse?
Yes, stress and anxiety can make tinnitus more noticeable. Stress management may help reduce symptoms in some individuals.
When Should I See a Doctor for Tinnitus?
If tinnitus begins suddenly, occurs in only one ear, or is accompanied by hearing loss, dizziness, or severe pain, you should consult an Ear, Nose, and Throat specialist without delay.
Is It Possible to Prevent Tinnitus?
Protecting yourself from loud noise, maintaining good ear health, limiting headphone use, and having regular health checkups may help reduce the risk of tinnitus.
Can Tinnitus Affect Daily Life?
Yes, persistent tinnitus can negatively affect sleep quality, concentration, work performance, and overall quality of life. Appropriate treatment and supportive methods may help reduce these effects.
Which Department Should I Visit for Tinnitus?
Individuals with tinnitus are advised to consult an Ear, Nose, and Throat (ENT) specialist for evaluation and treatment. Hearing tests and additional examinations may be performed if necessary.
