Tinnitus: The Sound of Silence
Grace Weatherby
/ Categories: WELLNESS, 2024

Tinnitus: The Sound of Silence

Whether you pronounce it tin-a-tus or tin-eye-tus (both are correct, by the way), one thing people living with this condition can agree on is that it’s annoying. An audiological and neurological condition experienced by more than 25 million American adults; tinnitus is the perception of sound when no actual external noise is present. 

For some people, the sound is perceived as a ringing, buzzing, or hissing noise while others hear a roaring, whistling, or whooshing sound in one or both ears. The volume of tinnitus can vary from soft to loud and may vary throughout the day. In addition, the pitch of the noise may also change. While many people learn to live/cope with the condition, 2 million Americans experience a range of debilitating reactions to the often-perpetual noise. For those individuals, tinnitus can lead to:

- Fatigue

- Stress

- Problems sleeping

- Trouble concentrating

- Memory problems

- Depression

- Anxiety and irritability

- Headaches

- Problems with work and family life

The causes of tinnitus are not well understood. However, it is understood to be not a disease, but rather a symptom of some other underlying health condition.

Recent research out of Harvard Medical School suggests that damage to the cochlear nerve may be behind some cases of tinnitus. The findings suggests that with less sound coming in, the brain compensates by generating phantom noise.

While frequently linked to hearing loss (90 percent of tinnitus cases occur with an underlying hearing loss), there are roughly 200 different health disorders that can generate tinnitus as a symptom. Some common ones include:

- Age-related hearing loss

- Noise-induced hearing loss

- Obstructions in the middle ear (earwax, hair, dirt, foreign objects)

- Sinus pressure (from a severe cold, flu, or infection)

- Temporomandibular joint (TMJ) disorder

- Injury to the head or neck

- Traumatic brain injury

- Ménière’s disease

- Blood vessel problems (high blood pressure, atherosclerosis, etc.)

Chronic conditions (diabetes, migraines, thyroid disorders, anemia, and certain autoimmune disorders)

- Side effect of prescription medication*

*For a list of medications linked to tinnitus click here.

Given the range of potential causes, treating tinnitus is difficult if not impossible. There is currently no scientifically validated cure for most types of tinnitus. If an underlying cause, such as high blood pressure, TMJ, or injury is identified, you may be able to treat that and find some relief from tinnitus.

Other therapy and treatment options for tinnitus include:

- Hearing aids used for sound amplification

- Hearing aids used to mask the sound of tinnitus

- Cochlear implants

- Behavioral therapy

If you have tinnitus, set up an appointment with your primary care doctor, who can check for earwax or fluid from an ear infection that could be blocking your ear canal. You may be referred to and otolaryngologist (commonly called an ENT—an ear, nose, and throat doctor). An ENT can perform additional exams intended to the determine the source of your issue. They may also perform imaging or refer you to an audiologist, who can measure your hearing and evaluate your tinnitus.

To learn more about tinnitus or to connect with a volunteer peer support network, visit the American Tinnitus Association.

 

Allison Niemi, MD, is a member of the care team at SVMC’s Pownal Campus.

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The Latest Testing Information

The world of COVID-19 testing is very complex and changing rapidly. But gratefully, unlike early on in the pandemic, tests are available for everyone who wants one, whether they have symptoms or not. Below is a list of common questions, along with answers from SVMC’s Laboratory Services Director Karen Bond and SVMC’s Director of Perioperative Services Tanya Cowder, MSN, RN, CNOR.

What are the reasons someone may get tested for COVID-19, even if they don't have symptoms? People without symptoms of COVID-19 are being tested when they are admitted to SVMC, before being discharged to other facilities, before scheduled surgeries, or because they may have been exposed to the virus. Primary care providers are also able to order a test for those who need to return to work or school or to end quarantine or isolation. And anyone can be tested through the Vermont Department of Health's Pop-Up Clinics.

What types of tests are available for detecting active cases of COVID-19? SVMC offers Polymerase Chain Reaction (PCR) testing that is processed at both outside labs and our own lab, depending on how quickly results are needed. PCR, which was pioneered by American biochemist Kary Mullis in 1983, actually amplifies and detects the presence or absence of small gene sections. In this case, it determines whether or not COVID-19 is present.

The specimen is most often taken from deep in the nose-throat passageway (nasalpharyngeal). Patients experience eye watering and a burning sensation for 30 seconds or less. The test can also be taken from inside the nose (anterior nares), depending on the patient population. The most common type of test, like those administered both at SVMC’s drive-up testing station and at the Vermont Department of Health’s Pop-Up Clinics, is greater than 90% sensitive (meaning that the test picks up the virus, if it is present) and greater than 90% specific (meaning the test detects the COVID-19 virus, as opposed to other viruses).

How do I get my results and what should I do? Results are usually provided by a primary care provider within 48 hours. Your primary care provider will share specific directions regarding what you should do next. The Centers for Disease Control and Prevention is sharing this table, which provides a synopsis of tests, what results mean, and guidance for what to do. If the test is positive, the Vermont Department of Health may call before the primary care provider to initiate contact tracing.

Are all of the tests sufficiently available? Yes. Anyone with an order from their primary care provider can be tested at the drive-up testing site at SVMC. Anyone can be tested at the Vermont Department of Health's Pop-Up Clinics. Visit https://humanresources.vermont.gov/popups for times, dates, and locations. Tests for inpatients at the hospital are also in adequate supply.

Important Note: Remember test results offer a snap shot of the current active viral load. A negative test result doesn’t reveal whether you have been exposed in the past or predict whether you will be infected in the future. Whether or not the result is positive, we should all continue to wash our hands frequently, wear masks when in public and in proximity to those outside of our household, and stay 6 feet from others.

What about antibody tests? Antibody tests (serology) are also available. It does not tell you if you have active disease. Antibody tests check for antibodies that appear in the blood between about 1 – 3 weeks after symptom onset and may remain as long as a lifetime. Antibody tests may be positive while a person is infected. It is not yet known whether these antibodies protect against reinfection with the COVID-19 virus. For many other similar viruses, antibodies are protective for years or longer, but we do not yet have adequate data to know for COVID-19. Patients who would like the test would get a referral from their primary care provider and come to the SVMC Lab to have blood drawn. Results are delivered by the primary care provider.

Those who receive a positive antibody test or who have recovered from COVID-19 may qualify to donate plasma with the American Red Cross. The plasma, which includes antibodies, may help those fighting the disease. Learn more at https://www.redcrossblood.org/donate-blood/dlp/plasma-donations-from-recovered-covid-19-patients.html.

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