I hear a hiss or hum in my ears. What is tinnitus?

Written by Francis L’Africain,
Audiologist

Tinnitus is the perception of a noise that is not produced by the environment. It can be perceived in the ears (or only one ear), in the head or even sometimes out of the head. It is often described as a whistling or humming sound, but it can present itself in other forms of noise.

Therefore, some people can hear a radio that while they are in their room completely silent or a continuous whistle while no cicada is nearby.

Tinnitus is sometimes accompanied by sound intolerance (1), a condition called hyperacusis. Hyperacusis is present when we find sounds to be too loud, while they have a strong volume but tolerable according to our surroundings.

What are the possible causes?

Tinnitus is not a disease per se, but rather a symptom. In comparison, cough is also a symptom. It can be a manifestation of several diseases such as flu, pneumonia, but also asthma or gastric reflux.

Tinnitus can be caused by several causes. Here is a short list:

1. Hearing loss (2)

Tinnitus is often consistent with hearing loss. Thus, hearing loss in high frequencies (acute sounds) usually corresponds to tinnitus resembling a whistle (an acute sound). Tinnitus therefore often corresponds to sounds that are not well heard by the person.

2. Exposition to loud noises (3) →

Exposure to loud noise causes temporary or permanent hearing damage. Thus, after a concert, it is possible to hear a tinnitus that will disappear the next morning. However, if noise exposure is too high, tinnitus may become permanent.

3. Concussion or head injury

Can be the cause of tinnitus.

4. Vascular problem

A tinnitus that would be in rhythm with the heart rate is called a pulsatile tinnitus. This may be a hint of a vascular problem. In this case, it is important to see a physician.

5. Neck or jaw problem

This is called somatosensory tinnitus (4) since it is generated by another part of the body than the auditory system. Generally, the intensity or type of the perceived sound changes with movements.

6. Impacted earwax

Sometimes, impacted earwax can be the cause of tinnitus.

7. Medication intake

Some medications have the perception of tinnitus as a side effect.

8. Presence of a pathology

Some pathologies like Meniere’s disease, tumour on the auditory nerve or high blood pressure can be the cause of tinnitus.

9. Other factors

Other factors such as stress, fatigue, excessive caffeine, alcohol and tobacco consumption can influence the perception of tinnitus.

However, the cause of tinnitus is often unknown.

How does tinnitus occur?

Tinnitus often accompanies hearing loss or hearing damage. However, this is not always the case. There is still no consensus in the scientific literature on the mechanisms of tinnitus, but a popular theory at present is that of central gain.

This theory indicates that under-stimulation of the brain and auditory nerve, due to damage, would result in ill-adapted compensation. The brain in response to decreased stimulation would increase its activity, which would be the cause of tinnitus (C).

What proportion of the population is affected?

According to Statistics Canada, 37% of Canadian adults have never had tinnitus during a year. Tinnitus would be bothersome for 7% of them with impacts on sleep, concentration and moods (A).

Indeed, hearing a sound continuously when you would like to be able to enjoy the silence can become very inconvenient for some people.

What are the solutions?

Consult health professional

Solutions according to the type of tinnitus

Support from people in similar situations

There is no magic pill that can eliminate tinnitus. However, several solutions (5) exist to reduce the disturbance it can cause.

1. Consult health professional

First, it is important to consult a health professional (family doctor, ENT doctor, audiologist) to identify the cause of tinnitus and determine which solutions are suitable for your situation

2. Solutions according to the type of tinnitus

In the case of somatosensory tinnitus, an audiologist can refer you to the professional who will be able to help you.

In the case of tinnitus of auditory origin, there are some possible solutions. Wearing hearing aids, sound therapy or sound enrichment, cognitive behavioural therapy, relaxation technique and good sleep hygiene can reduce disturbance.

3. Support from people in similar situations

Some people find great comfort in talking to other people who have the same problem. Organizations such as Tinnitus Quebec (B) allow this type of encounter.

Do you have tinnitus? Do not hesitate to contact the ODYO team! An audiologist can help you.