What is Tinnitus?
Tinnitus can be defined as a sound that a patient can hear and relates it to the ear, head or both the ear and the head, while there is no such sound outside the head. The sound is simple and has no meaning of language. In that aspect these sounds are different from auditory hallucinations. When the sound can be heard or recorded by someone else (usually pulsatile sound) it is called objective tinnitus. When the Tinnitus exists more then 6 months it is considered Chronic Tinnitus.
Features of Subjective Tinnitus
The patient may tell about sounds of sea waves, high voltage cables, electric engine such as the engine of a refrigerator, discharge of air under pressure, sounds of birds or insects. The spectrum of sound can be from weak and non-disturbing to severe and intractable. For more details – see associated symptoms.
Features of Objective Tinnitus
The objective tinnitus can be heard by another person with or without instruments for amplification of the sound. In most cases the objective tinnitus is pulsatile. The pulsations can have the same rate as the heart beats or with no synchronization at all.
The main Associated Symptoms
Insomnia (disturbance to sleep), irritability, inability to concentrate, fatigue, exhaustion, deterioration in ability to work, disturbance to family life, detachment from social life, anhedonia (inability to derive pleasure from life), anxiety, depression, hyperacusis (sensitivity to noise), palpitations, hypertension and hearing loss. It is impossible to distinguish between cause and effect.
The main Associated Factors
The causes of tinnitus are not known. Some of the main associated factors are: all types of noise exposure, accidents, medications and pathology of the auditory system. In most of the patients the cause of the tinnitus is not known.
Statistics
I do not know of any statistical research about Tinnitus in Israel. In the USA the estimation is that 40 million Americans report of tinnitus, and 10 to 12 millions suffer from severe Tinnitus. If we apply it to Israel, most probably 80000 Israelis are suffering from Tinnitus. About 30% of the Tinnitus patients are also suffering from vertigo.
Approach to treatment of Tinnitus
Treatments can be classified to 3 categories:
(1) Paliative Treatments - Psychotropic medications, H2-Blockers, Psychotherapy (hypnosis, cognitive behavioral therapy, bio-feedback, relaxation exercises), sound therapy (Tinnitus Maskers, TRT, hearing aids).
(2) Curative Treatments - Surgery for tumors, surgery for blood vessels abnormality, Drainage of infection, antibiotic therapy for infection, removal of Otto-Toxic medication and metabolic intervention.
(3) Treatments with unknown mechanism - Homeopathic treatments, herbal treatments.
