Tinnitus is perception of sound where there is none: what to do?

Tinnitus is perception of sound where there is none

Tinnitus, a common symptom, is defined as the perception of noise in the absence of an acoustic stimulus outside of the body.

In 2011, British newspapers reported that a rock fan committed suicide to relieve tinnitus that he had for 3 months after a supergroup's gig. Tinnitus is characterized as perception of sound where there is none.

The Cleveland Clinic Journal of Medicine published a review on Tinnitus: Patients do not have to ‘just live with it’ and Tinnitus relief: Suggestions for patients.

From NHS YouTube channel:



Causes of tinnitus

- idiopathic
- sensorineural hearing loss is the most common identified cause
- otologic, vascular, neoplastic, neurologic, pharmacologic, dental, and psychological factors

More serious causes, such as Meniere disease or vestibular schwannoma, can be excluded during the evaluation.

Tinnitus is a common medical symptom that can be debilitating.

Risk factors include:

- hearing loss
- ototoxic medication
- head injury
- depression

At presentation, the possibilities of otological disease, anxiety, and depression should be considered.

Diagnosis

Almost all patients with tinnitus should undergo audiometry with tympanometry, and some patients require neuroimaging or assessment of vestibular function with electronystagmography.

No effective drug treatments are available. Surgical intervention for any otological pathology associated with tinnitus might be effective for that condition, but the tinnitus can persist.

Available treatments include:

- hearing aids when hearing loss is identified (even mild or unilateral)
- wide-band sound therapy
- counselling

Cognitive behavioural therapy (CBT) is indicated for some patients. The evidence base is strongest for a combination of sound therapy and CBT-based counselling.

Metallica drummer struggles with tinnitus: "Once your hearing is gone, it's gone"

From CNN: "I've been playing loud rock music for the better part of 35 years," said Ulrich, 46, drummer for the heavy metal band Metallica. "I never used to play with any kind of protection." Early in his career, without protection for his ears, the loud noise began to follow Ulrich off-stage. "It's this constant ringing in the ears," Ulrich said. "It never sort of goes away. It never just stops." It is a condition called tinnitus, a perception of sound where there is none. "I try to point out to younger kids ... once your hearing is gone, it's gone, and there's no real remedy." The military is generating a tremendous number of tinnitus patients."

References:

Tinnitus : The Lancet http://bit.ly/1aAsa9E Diagnostic approach to patients with tinnitus. [Am Fam Physician. 2014] http://buff.ly/1ggzRox Tinnitus - 2014 Clinical Practice Guideline http://buff.ly/1s5RdN5

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