More than 360,000 Canadians suffer from tinnitus, and 150,000 of those are severely affected. The disorder can strike anyone, regardless of age or sex, and has affected men and women for ages. Vincent Van Gogh is said to have cut off his ear during an excruciating bout of tinnitus.
"The problem was hidden for a long time," says Marthyne Brazeau, an audiologist at Notre Dame Hospital in Montreal, "because people were afraid to tell their doctors they heard sounds that others did not."
The auditory system is complex: Sound waves stimulate hair cells in the inner ear, causing electrical impulses to travel along the auditory nerve to the brain. Once in the brain, these impulses are then perceived as sound.
Tinnitus can take different forms—buzzing, whistling, humming, ringing, hissing, even the sound of a waterfall. The sound may be heard in one ear or in both, or it may seem to come from somewhere inside the head. It may appear suddenly or progressively, remain permanent or be intermittent, and can vary in intensity. It may also simply disappear.
Tinnitus is often an indication that there is a problem affecting the auditory system. It can be caused by a head injury, muscular contractions or a dysfunction related to the joints involving the jaw, head or neck.
All in Your Head
In the vast majority of cases, doctors deal with subjective tinnitus: Only the patient can hear the noise.
"After taking a thorough medical history, we examine the patient for any treatable causes of this form of tinnitus, such as wax lying against the eardrum," says Dr. Phillip Wade, an ENT specialist at the Toronto General Hospital and chief ear consultant at the Canadian Hearing Society.
In high doses, some medications such as acetylsalicylic acid (ASA) or nonsteroidal anti-inflammatory drugs (NSAIDs) may also cause tinnitus. Other causes include hearing loss due to noise exposure or age. Other possible causes: high blood pressure, diabetes or high cholesterol.
When the doctor cannot find an organic or mechanical reason for the sound, he may be unable to eliminate it. The treatment for tinnitus may then require the services of not only an ENT specialist but also an audiologist and sometimes a psychologist or psychiatrist.
Retraining the Brain
One way to bring tinnitus under control is to mask the noise with another. A masker is a device that looks like a hearing aid and produces a static hiss-like sound that may be easier to tolerate than the tinnitus.
Masking has been the treatment of choice for years, but Tinnitus Retraining Therapy (TRT) is now being offered in Canada.
TRT consists of training the brain through counselling to be either unaware of or untroubled by the tinnitus. Frequently, patients will be fitted with a noise generator that is worn about eight hours a day and set at a very low sound level. Positive results of the combined therapy may appear within just a few months, and most patients report significant improvement after 18 to 24 months.
Most experts agree that tinnitus sufferers should practise relaxation methods to help them cope. Relaxation CDs with sounds of waves or the jungle can help induce sleep. Antidepressants can improve the well-being of some patients, but all drugs have side effects.