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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Moving Forward Safely

One of the most frustrating and anxiety-producing traits of our COVID –19 pandemic is how much uncertainty is involved in all aspects of this disease. Symptoms caused by the Coronavirus, age groups affected, the usefulness of medications, anticipated death rate, and the timeline for development of a vaccine are examples of information that sometimes change on a weekly basis.

Vermonters have done a great job of limiting the spread of the virus and protecting our most vulnerable neighbors by following the Governor's "Stay Home, Stay Safe" order over the past few months. Now, we've all been directed to wear masks in public. Both Bennington and Wilmington's Select Boards have passed local mandates requiring masks in public places. Thanks to these efforts—along with distancing, handwashing, and other factors—Vermont is among the states with the fewest number of infections. Continuing each of these important infection-prevention strategies is crucial to returning to a more normal way of life.

As we open up and begin to re-connect, we fully expect to see a rise in COVID –19 cases in Vermont. Thankfully, we have had time to prepare for this increase. We also have adequate PPE, and increased testing will help us gather crucial information for stemming the spread with less disruption to our normal lives.

More than ever, I find it helpful to focus on what we have learned and how it can help us move forward safely. Here is some of what we have learned so far: Most large hospitals, often treating over 1000 COVID patients daily, effectively protected their workers by obsessively following the rules of screening, hygiene, distancing, and masking. Each of these components is designed to work together; Each alone has its inherent limits.

  • Absent quick testing at the workplace, the best screening is asking employees if they have COVID-like symptoms (fever, chills, new cough, shortness of breath, sore throat, loss of taste or smell) and to stay home if they do.
  • Washing our hands (or using sanitizer) after touching well-handled items or visiting populated areas. Washing your hands 10 times daily is not too often.
  • Though an uncovered sneeze or cough can travel farther, 6 feet distancing continues to be the sweet spot for safety.
  • Masks (double layer cotton and surgical) are effective to prevent spreading of large and some small droplets containing virus. They also seem to give some minimal protection to those wearing a mask. Since possibly 40 percent of transmission happens when we do not have symptoms, we wear our masks to protect others and to suppress overall infection rate. They also help many people (not all) to avoid touching their face. The downside is a warm chin; the upside is you may be protecting someone from a significant illness. Masks are not a symbol of government intrusion. Masks are simply a tool to protect others and show empathy.

It is difficult to predict how many COVID-19 infections will occur in our communities in the coming months. What I am certain of is that our choices, on where we go and what we do, often affect the safety of those around us. As we learn to live with this virus in our community, following the recommendation above will help us all.

Marie George, MD, is SVMC’s infectious disease specialist.

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