The sounds of tinnitus rarely indicate a serious medical condition–though tinnitus symptoms can indicate a serious health issue–so one might wonder, “Should I seek professional assistance to diagnose tinnitus or can I do it myself?” While tinnitus sounds are easy to recognize once you’ve read the descriptions of the disorder, there is far more to tinnitus than an occasional or constant ringing sensation, and the diagnosis process tackles common underlying conditions.
Although tinnitus itself does not typically indicate the presence of a serious condition, it is important to speak with health and hearing professionals such as audiologists or ear, nose, and throat (ENT) doctors to make sure that there is not an underlying disorder triggering tinnitus symptoms and to begin treatment for the condition.
Symptoms And Causes Of Tinnitus
Tinnitus can seem like a simple condition involving the inner ear, but the actual definition and symptoms of tinnitus can vary, and unexpected factors can make tinnitus worse. When looking into the loud noises characteristic of tinnitus, it is important to truly understand what a tinnitus sound is, and how it develops.
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"Treble Health helped me reduce my tinnitus by about 80%, and now I can live my life again!"
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Tinnitus Definition And Symptoms
Tinnitus is a hearing condition that involves the sound of ringing, buzzing, hissing, clicking, etc without an identifiable external source. A ringing sound can be heard in one ear or both to qualify for a tinnitus diagnosis, and symptoms can be mild or severe, acute or chronic.
A more common condition than you might expect, between 10% and 25% of the population experiences symptoms, and of those, 20% find tinnitus to be bothersome. The remaining 80% may not be functionally impacted by their tinnitus symptoms.
Causes Of Tinnitus Include:
- Hearing Loss
- Sensorineural hearing loss. Although there are many different types of hearing loss, the most common type is sensorineural hearing loss, or hearing loss caused by loud noise, age-related loss (presbycusis), and acoustic neuroma. One subset of this type of hearing loss is sudden sensorineural hearing loss, which occurs as a result of idiopathic causes.
- Conductive hearing loss. This type of hearing loss occurs as a result of sound transmission loss through the outer or middle ear. This type is most frequently caused by conditions such as otitis externa (also called Swimmer’s Ear), otitis media, otosclerosis, and cholesteatoma. As its name suggests, this type of loss results when something obstructs or impairs the conduction of sound signals through the ear.
- Mixed hearing loss. Mixed hearing loss combines conductive and sensorineural hearing loss, and may be the result of age-related hearing loss, issues with the inner ear, congenital disorders, infection, and ongoing exposure to loud noise.
- Head Injury/ Neck Injury
- Head and neck injury can cause changes to the way fluid passes through the sinuses, impairing hearing, and can also negatively impact the inner ear.
- Medications/Ototoxic Exposures
- Some medication causes harm to the inner ear and other portions of the ear, leading to impaired hearing and other conditions like tinnitus.
- Hypertension can lead to tinnitus and the loss of hearing, because adequate blood flow is essential for ear function to retain its efficacy.
- Just as diabetes can negatively impact nerve impulses elsewhere in the body, nerve impulses within the auditory pathway can be negatively impacted by high blood sugar.
- Kidney Disease
- Kidney disease leads to nerve damage, systemic inflammation, and intense immune responses, all of which can damage hearing in one ear or both.
- Meniere’s Disease
- A disease of immunity, Meniere’s Disease is a common root of both the loss of hearing and tinnitus.
- Autoimmune Disorders
- The precise reason for autoimmunity’s effects on hearing health is not certain, but studies have shown that diagnosing tinnitus is more likely in those with an autoimmune disorder.
How Does A Doctor Diagnose Tinnitus?
Subjective tinnitus is a type of tinnitus that describes hearing a ringing or buzzing sound without a measurable cause. To receive a diagnosis of subjective tinnitus and begin tinnitus treatments, a doctor of audiology or ENT doctor will take a thorough medical and case history and discuss symptoms with the patient. It can be viewed as self-diagnosis that is then discussed with a health professional to get to the root. Audiologists and ENT doctors will complete additional tests to determine the type of tinnitus you have, the subjective sound level of your symptoms, the type of sound you are hearing, and more. Typical tests include:
- A small, magnified light is placed in the ear canal to visualize the ear canal and ear drum. Doing this means that health professionals can be sure that all structures are intact and healthy in appearance. It is often completed prior to fitting for hearing aids, as well.
- This immittance test evaluates the mobility of the middle ear system, including the ossicles (or the small middle ear bones) to rule out middle ear disorders that may lead to conductive hearing loss.
- Acoustic Reflex Testing
- This immittance test evaluates a person’s acoustic reflex to loud noises when they are presented to the auditory system. This is a helpful tool in ruling out retrocochlear pathologies, such as Acoustic Neuroma, because it helps hearing professionals determine whether the issue is reflex related, or might have another cause, like pulsatile tinnitus.
- Sound Booth Audiometry
- These hearing tests involve inserting earphones in or placing headphones on the patient’s ears. Pure tones are played at varying sound levels in short beeps. Patient responses are recorded though either pushing a button or raising a hand. During these hearing tests, the practitioner will identify the softest volume of pure tones the patient can hear (called their threshold). The threshold is then evaluated to determine if hearing has been lost or is considered normal.
- Pitch Matching
- During this test, a practitioner presents sounds and tones to identify the pitch most similar to the patient’s tinnitus. This is a useful piece of information to find, as it allows a hearing aid and other interventions like Tinnitus Retraining Therapy (TRT) to be calibrated to address your unique needs.
- Loudness Matching
- Once the pitch of a client’s tinnitus has been matched, a hearing professional can then play that sound at different volumes to determine the subjective loudness level of an individual’s phantom sounds. Patients then have quantifiable data for their symptoms, which can help inform the treatment of both severe and less noticeable tinnitus and help patients feel as though they have more control over their condition.
- Residual Inhibition Testing
- This particular test is conducted to help create a tinnitus treatment plan, most often using sound therapy or Tinnitus Retraining Therapy. TRT and sound therapy benefit from residual inhibition testing, because the test determines what is required for symptoms to successfully be repressed. A white noise machine or a masking device is played at a loud enough volume to overtake the sound of tinnitus, left on for 1 minute, then stopped. A timer then starts and the patient is asked to alert the test-giver when they begin to hear their tinnitus symptoms once more.
I Have Been Properly Diagnosed With Tinnitus: Now What? Treatment Options And Interventions
From high blood pressure to persistent exposure to loud external sounds, it is vital to undergo a hearing test and give a detailed medical history to rule out any underlying cause for tinnitus onset, and to determine what type of the condition might be present, such as objective tinnitus as a result of pulsatile tinnitus and related cardiovascular issues. Once that process has been completed, all underlying issues and root causes have been addressed, and you have been cleared for treatment, you can begin looking into the most common tinnitus treatment options. These include:
- Hearing Aids
- A hearing aid is one of the most common first-line interventions for tinnitus, because it can address multiple issues related to high pitched ringing. Hearing aids can help improve hearing ability, cutting through the sounds of tinnitus, and can also be used to implement sound therapy and TRT. They can also help restore the auditory pathway to the brain.
- Tinnitus Retraining Therapy (TRT)
- TRT is a valuable intervention, because it tackles tinnitus through both environmental sounds or masking devices, and the mental health aspects of hearing disorders. TRT uses a masking device or hearing aid to deliver sound therapy to tinnitus patients, while also teaching them how to develop a healthier coping response to symptoms.
- Cognitive Behavioral Therapy (CBT)
- CBT is a mental health intervention that helps address mental and emotional responses to experiences. For tinnitus specifically, CBT functions as tinnitus counselling, as it allows people with tinnitus to change their response to symptoms in order to feel anxious less frequently and experience improvements to everyday life.
- Sound Therapy
- Sound therapy can be completed in many different ways; some prefer to deliver sound therapy with a white noise machine, while others prefer the convenience and consistency of hearing aids or wearable tinnitus maskers. Sound therapy utilizes white noise and other background sounds to minimize the sounds of tinnitus and can be used no matter the underlying condition or underlying cause of symptoms.
While it may be tempting to self-diagnose tinnitus because tinnitus evaluation often relies heavily upon personal report, pulsatile tinnitus has the potential to be hazardous, and the underlying cause of the disorder must be addressed in order to prevent the repercussions of high blood pressure and other cardiovascular issues. Whether you visit a throat specialist like an ENT doctor, or speak to an audiologist first, it is essential to uncover the roots of your high or low pitched ringing to make sure that you address the issues at play, and do not worsen tinnitus symptoms. A hearing specialist will conduct imaging tests, hearing tests, and take a thorough medical history to develop the best treatment plan for persistent tinnitus and ensure the health of the inner, middle, and outer ear.