Tinnitus

What do Jeff Beck, Bono, Pete Townsend, Eric Clapton, Phil Collins, and David Letterman have in common?  Unfortunately they all suffer from tinnitus.  Often described as "ringing in the ear", tinnitus is common to most musicians. 

What is tinnitus?
Subjective tinnitus is the perception of an acoustic like sensation for which no external generation exists. Sounds reported range from buzzing, whistling, ringing, static, crickets, music, and pulsing.  Majority report a single tone type sound. Location of tinnitus is usually "at both ears" but may be unilateral, or located somewhere else in the head. It can be intermittent or constant. It can fluctuate in volume. The word tinnitus derives from the latin meaning "to tinkle or ring like a bell" and can be pronounced 'TIN-a-tis" or "tin-EYE-tus".
Historical review – thousands of years ago the Phoenicians wrote about it, Egyptians hieroglyphics depict it, Aristotle noted it 350B.C., Martin Luther, Beethoven, Van Gogh, through to modern day celebrities David Letterman, Barbara Streisand, William Shatner, Tony Randall,  Pete Townsend.
Current estimates in USA are that 50 million have it and 12 million suffer severe forms of tinnitus (with 2 million having debilitating tinnitus).

Mechanisms of tinnitus:
Simply put we cannot state for sure where, within the complex auditory system, the sensation of tinnitus is generated.  Probably there are multiple causes and mechanisms (which include the peripheral and central systems) for the generation of tinnitus.  Outer hair cell damage in the cochlea is a logical point of interest due to the afferent and efferent nature and balance of the organ of Corti in the cochlea. 
IMPORTANT to note: tinnitus is not a manifestation of psychiatric disorder – a physical cause gives rise to all tinnitus.

Known Triggers include;

  • Noise Induced Hearing Loss – 90% of all tinnitus sufferers
  • Earwax impaction
  • Ototoxic medications – even aspirin
  • Ear/sinus infection
  • Jaw misalignment – *note PETscans can show areas in the brain where tinnitus activity occurs when patients can change or bring on their tinnitus through jaw position.
  • Cardiovascular disease – 3%, hypertension, heart murmur, hardening of arteries
  • Tumors of the auditory, vestibular, or facial nerves (these tumors are VERY rare)
  • Head and neck trauma

Tinnitus Treatments: (partial list)

  • Medical intervention – needed for sinus/ear infections, jaw misalignment, etc.
  • Psychological intervention -
  • Cognitive –Behavior Modification
  • Alternative therapies – biofeedback, hypnosis, relaxation therapies
  • Tinnitus Retraining Therapy – use of low level sound and a form of counseling called "directive counseling"
  • Masking – use of sound generating device called a masker worn at the ear to provide immediate relief from the perception of tinnitus.
  • Hearing Aids – when appropriately fit for common high frequency hearing loss hearing aids often have a pleasant "side effect" of reducing the awareness of tinnitus.

For musicians the key to tinnitus may be prevention.  Earplugs can prevent high levels of sound energy from damaging the delicate hearing hair cells.  Many musicians who use earplugs regularly note a decrease in tinnitus.  If you suffer from tinnitus visit your local audiologist or otolaryngologist (ear, nose, and throat specialist) for an evaluation.  See our links section for further information from the American Tinnitus Association.

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