Type of Ringing Denotes Cause?

Some 'new to me' things listed at this site (apologies if they have already all been posted somewhere):

http://www.randombio.com/tinnitus.html


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Continuous ringing
In this type of tinnitus, the patient hears a continuous, high-pitched ringing or hissing sound that is unaffected by body movement. Often, tinnitus is accompanied by a partial loss of hearing. Usually, only higher frequencies are lost.

Researchers believe it is no coincidence that tinnitus sufferers most often report hearing high-pitched sounds. High frequencies (around 4kHz) are usually the first to be lost after noise trauma (which is a major cause of sensorineural hearing loss), as well as in presbycusis (age-dependent hearing loss). As many as 80% of tinnitus sufferers also have some form of hearing impairment. It is believed that the nervous system adapts to this loss of acoustic stimuli by creating artificial phantom sounds. This is analogous to phantom limb syndrome, where constant pain is felt in a limb after it has been amputated. Thus, patients with a history of exposure to loud noise are most likely to report hearing high pitched ringing sounds.

The pitch of tinnitus often coincides with the frequency region in which the audiogram starts to show a steep decline. This suggests that tinnitus might result from an "edge effect" caused by the brain's attempts to equalize different parts of the acoustic spectrum [16].

There is some relationship between pitch and cause of tinnitus. In the ear, higher-pitched sounds are detected in the outermost portion of the cochlea. Thus, the frequency may depend on the exact part of the inner ear where the original injury occurred. Tinnitus caused by sensorineural hearing loss is usually high pitched. The tinnitus that occurs in Ménière's disease, a disease of the inner ear, is typically of a much lower pitch.

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Non-ringing
When the sound is not a ringing, but a rushing, clicking, thumping, or other atonal sound, it usually represents some mechanical process in or near the ear. Often these sounds can be heard by another person using a stethoscope, and therefore they are called "objective" tinnitus. A common example is a pulsatile bruit caused by turbulent flow through blood vessels in the neck.

Clicking sounds are often associated with temporomandibular joint (TMJ) syndrome. Clicking sounds can also be caused by intermittent contraction of various muscles in the middle ear, including the tensor tympani or stapedius muscles. This condition is called middle ear myoclonus. Although thought to be rare, it may actually just be widely undiagnosed. A related condition is palatal myoclonus. A physician may prescribe muscle relaxants such as orphenadrine, or in severe cases, may inject botulinum toxin to stop the muscle from contracting.


Tinnitus that becomes fainter over time
Dental problems Dental problems are another possible cause of tinnitus. Tooth abscesses or impacted wisdom teeth can cause tinnitus [34]. In such cases, further dental work will sometimes cure the problem. Other times, the tinnitus gradually becomes fainter over a period of months [35]. One way dental problems can cause tinnitus is by the prolonged neck bending that occurs during dental surgery. Another way is by aggravation of pre-existing TMD. Injury of the nerves during extraction of a wisdom tooth has also been known to cause tinnitus. Another possibility might be inflammation spreading from an infected tooth. There have been cases of bilateral sensorineural hearing loss (which usually causes tinnitus) following dental surgery


Noise is made better or worse by changes in bodily posture, or arm or neck movements
Muscle spasm Some researchers believe that muscle spasm in head or neck is the most common cause of tinnitus, accounting for as many as 80% of patients [8, 47]. When the noise is made better or worse by changes in bodily posture, or arm or neck movements, the patient has "somatic tinnitus." Somatic tinnitus is usually unilateral. In its earliest stages, it may be caused by hearing trauma, an injury, or a muscle contraction (such as by grinding one's teeth) that compresses some part of the auditory system. Later, cross-talk occurs between the signals the muscles send to the brain and the signals from the ear. For these patients, relaxation therapy and biofeedback, which help the patient establish voluntary control over the muscle, can be helpful. Once alerted to the possibility that stretching and muscle relaxing exercises may be able to alleviate their tinnitus, patients may be able to devise an effective treatment on their own. In extreme cases, botulinum toxin to temporarily paralyze the muscle, or even surgery, can be performed

 

Thanks Jane. Mine doesnt seem to be on this list

 

well my right ear does go 'click click click click' every so often since getting T - never used to! - so I think I'll have a bit of botox

 

When mine's at relatively low levels or starting to rise, I can accentuate the pitch and intensity by craning my neck (which I try to avoid). Hence, somatic, mostly on one side. However, when acutely at high levels for days on end, it's obviously in the "continuous ringing catagory." At that point, it matters little whether it's somatic or not, although sometimes I crick my neck and hold my ears closed for a while in an attempt to make it worse, so that releasing such gives me a few minutes at lower levels (try anything stage!). Contrary to the theory above, though, I suffer from no related hearing loss or iniability to detect the higer frequencies, so neither can be attributed to my brain's attempt to compensate.

 

Markku you really sound like a good candidate for the treatment I have tried - I mean upper "cervical kinesistherapy". I don't know if this is the same as chiropractor, I don't think so. If I remember right you are not sure of the cause of your tinnitus and your hearing test turned out fine?

 

I just wanted to share an experience that happened a few months ago that hopefully someone may find useful.

One day when I came home over break, I noticed a faint buzzing in just my left ear that grew in loudness and level of annoyance within the next few days. It was odd, but I also noticed that it was a relatively low-pitched buzzing, and when I heard someone's voice or music that was around the same pitch range, I wouldn't notice the sound. I tried several tactics to mask the noise -- wearing ear plugs, playing white noise in the background, etc. -- hoping that the buzzing would just go away with time. But it didn't.

So I went to my doctor who claimed it was just earwax and cleaned out my ears, but that didn't help. Then I went to an ENT specialist who couldn't detect anything wrong with my inner ear or hearing ability and said that I must be stressed/overexerted at school, but that seemed more like an excuse to me and didn't make sense because nothing was particularly different about this semester at school.

About a week later, I got a toothache on the same side of my ear buzzing and noticed my gums starting to swell. Frustrated with all these problems arising when I was an otherwise very healthy/active person, I went to my dentist, whose x-ray determined that all four of my wisdom teeth were growing in impacted. Immediately after I got my wisdom teeth extracted, the buzzing didn't really subside, and even grew in loudness from time to time due to the swelling. But right after my mouth healed, the buzzing did indeed go away! It's amazing how interconnected our bodies are.

If anyone else finds that they're experiencing similar symptoms, it might be something to look into, especially if you're a teenager around the age of getting your wisdom teeth out. Hopefully someone can find this useful!

 

I always suspected neck muscles spasms to be the cause of my tinnitus(started after a head trauma). Recently I had XRAY cervical and it showed "loss of cervical lordosis(curvature) due to muscle spasm probably" I don't know what to make out of it but I will go to a physiotherapist probably and ask him if spasms are causing my tinnitus. Also sometime back I had ultrasound therapy on my neck and after the physiotherapist relaxed my neck muscles my tinnitus went away 100% for like 2 days before creeping back again! I expect it as i am anxious and worrying personality so maybe it affects my muscles and make them stiff and tight. Will look into this again soon

 

ALERT- Don't use foamrubber earplugs. I cleaned earplugs with alcohol, put them in my ears til morning (8 hrs). The earplugs disintegrated in my ears! Now I have T. in both ears! Can't prove its the cause, just don't use earplugs!
-Barrett Haynes, Inventor

 

Barrett, I'm very sorry for your problems, and I sincerely hope you’ll get better in the next weeks.

Foam ear plugs are normally for single time use. Never clean them with alcohol (or even water) or they lose their properties anyway. Wash your hands before touching them.

I'm not sure if it's a good idea to tell people to not use them, as they can act as sound protection under loud levels, don't you think? I use them a lot since a few years in musical concerts. Are my Ts higher because of them? It’s a good question. But I doubt they are the initial cause of my problems…

 

Botox only helps middle ear twitches for up to 3 months or so then has to be repeated if there are stilltwiches. Some have recomended cyclobenzaprine or flexaril although UK doctors seem not to have heard of this. Some sufferers have the tensor tympani and stapedius muscles cut and have reported the problem ceases. There are risks with this procedure though as with all ear surgery. I suffer from this problem and am giving it a year or so (if I can stand it) before going the surgical route.

 

Old post, but just to say there can be multiple tinnitus symptoms present in the same person.

I never had any TMJ related somatic tinnitus till after I got my noise induced T at age 54, even though I've had TMJ and bruxism all my life.

It's my belief that one form of tinnitus can trigger another, given the appropriate conditions.

Doctors should avoid an either-or mentality but keep an open mind as to multiple possible causes, even though the expected tinnitus symptoms may not have immediately arisen but been triggered at a later date.