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Tinnitus – Ringing in the EarsWhat is tinnitus?46767752749550Tinnitus is usually described as a ringing in the ears.0Tinnitus is usually described as a ringing in the ears.467677510160000Tinnitus is a condition usually described as ringing in the ears that can only be heard by the individual experiencing the condition. Tinnitus is not associated with any psychological disorders, i.e. patients are not imagining the sound. Other sounds associated with tinnitus include buzzing, hissing, whistling, whooshing, roaring, clicking, chirping, screeching, static, pulsing, or even a musical sound. The noise can be low- or high-pitched, intermittent or continuous, heard indeterminately within the head or in one or both ears, and the volume can fluctuate during the day, often becoming most intense at night or in times of relative quiet. Some cases of tinnitus are temporary, while others are permanent. Some cases are so severe as to be debilitating, causing difficulty hearing, concentrating, sleeping, and working. There are two general types of tinnitus, subjective and objective: Subjective tinnitus is the most common, accounting for over 99% of cases. In this type of tinnitus, only the sufferer can hear the noises.50222152142490Tinnitus can cause adverse psychological and emotional side effects.0Tinnitus can cause adverse psychological and emotional side effects.520446031369000Objective tinnitus, on the other hand, is very rare. In this type of tinnitus, the patient’s circulatory or somatic systems create the noises and they can be heard by others. Tinnitus is one of the most common health problems in the United States, affecting almost 50 million people, or nearly 15% of the population. Of those, approximately 2 million experience debilitating tinnitus. In Germany, about 19 million people have tinnitus, about 2.7 million of those cases are chronic, and 1 million are very severe. About 10% of the United Kingdom’s population suffers from this condition. While tinnitus is irritating on its own, it can carry several side effects, including psychological, emotional, physical, and social problems, such as stress, fatigue, irritability, anxiety, and depression.What causes tinnitus?464820029571950046482004043045Tinnitus can be caused by playing headphones too loud.0Tinnitus can be caused by playing headphones too loud.01793875Tinnitus is usually caused by damage to the inner ear.0Tinnitus is usually caused by damage to the inner ear.042227500There are many causes for tinnitus, as it is a symptom of around 200 different medical conditions, but the most common is damage to the inner ear, associated with either age-related or noise-induced hearing loss. When tinnitus is a symptom of age-related hearing loss, it is generally heard in both ears and the loss is usually of high-frequency sounds. When it is due to damage caused by prolonged exposure to intense noise, tinnitus often affects only one ear and the hearing loss is often near the frequency of the catalyst sound. In the case of hearing loss, one hypothesis is that tinnitus is the brain filling in missing frequencies as they are lost. Some risk factors for tinnitus include noise exposure, smoking, gender (men are affected more often than women), and age (older people are affected more often than younger people). Despite this last fact, tinnitus is becoming more common in young people due to indiscriminate use of personal music devices, leading to inner ear damage.Other causes of tinnitus include:Obstructions in the middle ear, which can cause pressure to build up in the inner ear and have an impact on the ear drum, leading to tinnitus. The ear drum is very sensitive and can become irritated if touched. Obstructions having an impact on the ear drum can include excessive ear wax, loose hair, dirt or other foreign objects, or can be caused by head colds. Head and neck trauma, which can lead to nerve, circulatory, and muscle problems. Tinnitus caused by trauma to the head and neck is often louder and more irritating than other types. In addition, type and frequency of sound, as well as from where in the head it is heard, can be more variable.Temporomandibular joint (TMJ) disorder, or damage to the muscles, ligaments, or cartilage of the TMJ (where the lower jaw connects to the skull) can result in the perception of tinnitus. Because the TMJ shares some ligaments and nerve connections with structures in the middle ear, the auditory system can be affected by such damage.43815088392000Sinus pressure and barometric trauma, which can affect normal hearing and cause symptoms of tinnitus. Rapid or intense changes in air or water pressure from diving, flying, or explosions can damage the middle and inner ear. 45720097155Rapid pressure changes when diving can lead to tinnitus.0Rapid pressure changes when diving can lead to tinnitus.Traumatic brain injury, which is caused by a concussive shock, can damage the brain’s sound processing system. Some medications, called “ototoxic” because they harm the inner ear, usually cause temporary tinnitus. Once patients stop taking the medications, the symptoms of tinnitus go away. However, some cases can be more permanent, such as those caused by non-steroidal anti-inflammatory drugs (NSAIDs such as aspirin and ibuprofen), some antibiotics and cancer medications, water pills and diuretics, and quinine-based medications. Other medical conditions, such as diabetes and cardiovascular disease, as well as metabolic, autoimmune, blood vessel, psychiatric, vestibular, and tumor-related disorders, can lead to tinnitus symptoms. How can tinnitus be treated?While there is as-yet no scientifically-proven cure for tinnitus, there are several existing ways to manage the condition. These treatments generally address the underlying cause (which can eliminate tinnitus perception) or reduce the perception of tinnitus by distracting the patient or training the brain to ignore the sound. Some ways to manage underlying causes include removing obstructions in the ear (although some obstructions can cause permanent damage), caring for ear and sinus infections, discontinuing use of ototoxic medications, and treating TMJ disorders. 365760041021000For chronic tinnitus, there are several treatments:38862001818640Improving health and wellbeing through diet and exercise can help reduce tinnitus perception.00Improving health and wellbeing through diet and exercise can help reduce tinnitus perception.Improving general health and wellbeing can lessen the perceived intensity of tinnitus. Some ways to improve health include eating a healthful diet, regular exercise, social activity, recreation, hobbies, stress management, relaxation, hypnotherapy, wearing ear protection, and practicing common sense when using personal music devices. Hearing aids can improve the reception of external sounds and mask tinnitus or otherwise stimulate the auditory pathways damaged through hearing loss.37719005480050037719002353310Sound therapy, including playing nature sounds, can help mask the perception of tinnitus.00Sound therapy, including playing nature sounds, can help mask the perception of tinnitus.Sound therapies use external noise to counteract the symptoms of tinnitus. Hearing aids can act as a form of sound therapy through sound masking. Other sound therapies can act as a distraction, train the brain to ignore tinnitus sounds, or minimize perception of tinnitus. Several devices are used in sound therapy, including masking devices (provide white noise, nature sounds, or other pleasant background noise; often tabletop or bedside devices, but can be any sound-producing instrument), modified-sound or notched-music devices (medical-grade sound machines customized to individual patients on which certain tones or frequencies are emphasized), and combination devices (often hearing aids with white noise or customized sound generators). Behavioral therapies help patients control tinnitus-related anxiety, depression, and anger.Drug therapies can help patients manage stress, anxiety, and depression.Experimental therapies are ongoing, and include various forms of electromagnetic stimulation to reduce the brain’s perception of tinnitus. Reading Comprehension Questions:What is tinnitus? What are the two types of tinnitus and which one is the most common? What is the most common cause of tinnitus? What are some examples of ways this can come about?What is one hypothesis about hearing-loss-related tinnitus?List four other causes of tinnitus and their associated treatments.Extension Questions:Explain why improved health and wellbeing, including social activity and recreation, might lessen the perception of tinnitus.Tabletop devices for sound therapy are only temporary solutions. Why is this? If you were a sound therapy engineer, what would you create to give patients lasting relief?Research one experimental tinnitus therapy. Explain its goal and how researchers believe it can accomplish that goal. Have any trials been successful? Are you convinced by the explanation? ................
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