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Tinnitus

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ringing or roaring in one or both ears, that does not come from the surroundings and does not go away. Can feel like cricket chirps, buzzing, whistling or high-pitched ringing, low-pitched venous hum, soft sounds like rustling grass or loud noises,  roaring, clicking, hissing and heartbeat pulsating. Tinnitus is sometimes accompanied by hyperacusis (when moderately loud sounds are perceived as very loud). Could be accompanied by pressure in the head and gets worse with ear infection, excess wax, prior traumas, stress, anxiety, poor sleep, exposure to loud noises and certain drugs such as aminoglycoside antibiotics that kill the sensory "hair" cells.
Causes of tinnitus include:
  • Hearing loss in older people
  • Exposure to loud noises
  • Ear and sinus infections
  • Heart or blood vessel problems
  • Meniere's disease
  • Brain tumors
  • Hormonal changes in women
  • Thyroid problems
  • Certain medicines
Because of the complex pathophysiology of tinnitus, definitive treatment is yet to be developed. There are multiple nonpharmacological treatment options available, such as tinnitus retraining therapy (TRT), masking, amplification, and limiting inducing agents and environmental factors  such as stress, caffeine, aspirin, and nicotine intake. A cochlear implant eliminates tinnitus in up to 86% of patients with profound hearing loss, although in 9% symptoms worsen. Acupuncture, herbal remedies such as Ginkgo biloba, ear candling, low-power lasers, and electromagnetic stimulation all have been used to treat tinnitus but with little evidence of benefit.  Currently, patients show improvement with counseling, cognitive behavioral therapy, and additional use of different sound therapy; however, many prefer drug therapy. Several drugs are now undergoing clinical trials.

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