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Tinnitus (Ringing in the Ears) in Seniors

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Tinnitus is one of the common hearing problems that arises with age, although it can also affect younger people. It is a condition where there is a sound of ringing or roaring in the ears even though there is no actual sound from the environment. It is not a disease in itself but usually a symptom of an underlying condition such as ear deformity or a vascular disorder. Tinnitus is a common problem and the symptom is experienced by almost 1 among 5 people some time or other. The condition tends to worsen with age.

Types of Tinnitus

Tinnitus can be classified into two types.

  • Subjective tinnitus: Only heard by the patient. This is the most common type of tinnitus. The cause could be a deformity in the ear or in the nerve supplying the ear (auditory nerve) or in the region of brain responsible for hearing.
  • Objective tinnitus: This type of tinnitus can be audible by the doctor as well. It is a rare type caused due to blood vessel problems or muscle contractions or problems in the bones of ear which are responsible for conduction of the sound.

Tinnitus Symptoms

Tinnitus is a symptom and the nature and volume of the sound can vary. It could appear in one or both ears and may be loud enough to interfere with the daily activities. The sound could be continuous or intermittent. Ringing, clicking, whistling, buzzing, roaring or hissing type of sounds are commonly reported. Tinnitus could also be associated with the following symptoms:

  • Hearing loss.
  • Dizziness.
  • Fatigue.
  • Problems with sleep.
  • Irritability.

Causes of Tinnitus

Tinnitus can be caused due to deformities of the ear, the auditory nerves or due to deformities in the part of the brain responsible for hearing. Tinnitus can result due to prolonged exposure to loud sounds such as those from chain saw, firearms, music systems or a prolonged use of audio players with earphones. Temporary tinnitus can result from a brief period of exposure to loud sounds. Irritation of the eardrum due to earwax or foreign body can cause tinnitus. Tinnitus is seen in the following medical conditions:

  • Are related hearing loss (presbycusis).
  • Meniere disease.
  • Excessive psychological stress or depression.
  • Deformity of the jaw joint.
  • Head or neck trauma or tumors.
  • Acoustic neuroma.
  • Atherosclerosis.
  • Hypertension.
  • Vascular diseases.

Certain medications such as erythromycin, vancomycin, chemotherapy, furosemide, quinine or chloroquine can cause tinnitus. Older people are at a greater risk of tinnitus. A significant number of cases of tinnitus are due to unknown reasons.

Tinnitus Treatment

Hearing tests and imaging studies help in the diagnosis of tinnitus. The treatment mainly involves addressing the underlying cause of tinnitus when it can be identified. The following types of treatment thus can be helpful if they are the cause of tinnitus:

  • Earwax removal.
  • Correction of vascular deformities through surgery or medication.
  • Changing of medications if this is the cause.
  • Use of white noise machines which suppress the sound of tinnitus.

Counseling and retraining to distract a person from the sound can be helpful. Common medications used are tricyclic antidepressants such as amitriptyline or nortriptyline, and alprazolam. The side effects of these drugs need to be taken into consideration before commencing with it.


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