Tinnitus is the medical term for "ringing in the ears" although some people hear other sounds. It is the subjective complaint of hearing a noise in the absence of any external sound. This noise may be heard in one ear, both ears, the middle of the head – or it may be difficult to pinpoint its location. The noise may be low, medium or high-pitched; there may be a single noise or two or more components to the sound; the noise may be continuous or it may come and go. Experiences of tinnitus are very common in all age groups, especially following exposure to loud noise, but it is unusual for it to become a major problem unless the exposure becomes chronic.
Approximately 10 to 20% of Americans suffer from mild tinnitus and 80% of those hear ringing constantly. Of the elderly, 30% experience tinnitus.
Besides loud noises, other causes include severe head trauma, sinus and respiratory infections, ear infections, wax build-up, high blood cholesterol, TMJ problems, food allergies, certain types of tumors and a long list of other conditions. In one database of 1,687 tinnitus patients, noise exposure was the cause of 24% of cases and no known cause was identifiable in 43%.
Sometimes a tinnitus noise beats in time with your pulse. This is called pulsatile or vascular tinnitus. Approximately 3% of tinnitus patients experience this kind of tinnitus; people with pulsatile tinnitus typically hear a rhythmic pulsing, often in time with a heartbeat. The most common cause of pulsatile tinnitus is arterial turbulence, a noisy blood flow caused by plaques or kinks in the arteries in the head or neck. It can be made worse if there is also hypertension. Many forms of pulsatile tinnitus are treatable.
Here is a list of the possible causes of pulsatile tinnitus:
Many patients recover spontaneously – with or without treatment – during the first 6 months of suffering. Chronic tinnitus results when the disturbing symptom is present for more than 6 months.
People with pulsatile tinnitus typically hear a regular sound that occurs in time with their heartbeat.
A study of twenty patients with tinnitus found that ten tested positive for TMJ dysfunction in all diagnostic tests used, and nine more tested positive to one or more of the diagnostic procedures. Only one patient of the twenty had no positive evidence of any jaw joint dysfunction. Dr. Morgan's findings were published in The Journal of Craniomandibular Practice. ["Tinnitus of TMJ Origin: A Preliminary Report," Vol.10, No.2]
Another research project was headed by Richard L. Goode, MD, professor of ENT and Head and Neck surgery at Stanford University's School of Medicine. Drs. Morgan and Goode were able to establish the mechanical connection between the ossicles in the middle ear and the capsule and disk of the TMJ. ["The TMJ-Ear Connection", Journal of Craniomandibular Practice, Vol. 13, No.1).]
You may get an idea if the tinnitus is connected to your TMJ in some way, by:
As many as 50% of people using these techniques find a change in their tinnitus and a TMJ correlation they had not known about.
In one report, 47% of people with tinnitus and related disorders were found to have vitamin B12 deficiencies. Supplementation may therefore be of benefit. [Vitamin B12 deficiency in patients with chronic-tinnitus and noise-induced hearing loss. Am J Otolaryngol 1993;14: pp.94-9]
High concentrations of zinc are found in the inner ear. A Japanese study tested the theory that insufficient levels of zinc may therefore contribute to tinnitus. Researchers found that tinnitus sufferers with low zinc levels in their blood experienced an improvement in their symptoms when, after two weeks of zinc supplementation, their zinc levels rose significantly.
Another study found that 25% of those with tinnitus and low serum zinc reported improvement after 3 to 6 months of supplementation. [Am J Otol 1985;6: pp.116-7]
Many tinnitus sufferers become depressed simply from having to deal with the constant noise. Treating the depression may make the tinnitus seem less severe. Certain anti-depressants may worsen tinnitus, while others may improve it. SRI anti-depressants may temporarily worsen tinnitus for the first few weeks.
Alprazolam (Xanax) in a double-blind study showed 76% of the subjects benefited with tinnitus reductions of at least 40%, whereas only 5% of the placebo subjects had an improvement. [Arch Otolaryngol Head Neck Surg. 1993:119: pp.842-5]
Studies have shown a range of responses from nothing more than a placebo to an effectiveness rate of 50%. Gingko must be administered long term (many months) to achieve benefit. Amongst patients suffering from cerebrovascular insufficiency, a common problem associated with normal aging, a gingko extract produced a significant improvement in the symptoms of vertigo, tinnitus, headache and forgetfulness.
The effects of tinnitus can be magnified by at least 200 different drugs. This list includes some commonplace drugs such as aspirin, alcohol, caffeine, quinine, birth control pills and antibiotics such as gentamicin. It should be noted, however, that special gentamicin applications have cured tinnitus also.
Regular exercise may help increase blood circulation to the head and thus reduce the symptoms of tinnitus if it is caused by poor circulation.
300 young healthy male military recruits undergoing two months of basic training were studied. The trainees were repeatedly exposed to high levels of impulse noises, with ringing of the ears as a consequence. Each recruit received daily either 167mg of magnesium aspartate or a placebo. Permanent hearing loss was significantly more frequent and more severe in the placebo group than in the magnesium group. [Am J Otolaryngol 1994;15: pp.26-32]
Patients suffering from tinnitus were given 2ml of a medicated DMSO solution every 4 days. The medication contained anti-inflammatory and vasodilatory compounds and was applied locally to the external ear canal. They were also given an intramuscular injection of DMSO at the same time. After one month, 9 of the 15 subjects had a complete cessation of the tinnitus which didn't return during the one year observation period. It diminished in two others and in the remaining four occurred occasionally instead of permanently. Cold temperatures seemed to be the main factor causing it to return. [Annals of the New York Academy of Sciences 75:243:468: p.74]
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