Tinnitus

 

Tinnitus is feeling or hearing ringing, swishing, clicking, buzzing whistling, etc types of noise in the ear.

Tinnitus is a non-auditory, internal sound that can be intermittent or continuous, in one or both ears, and either a low- or high-pitch squeal.

Symptoms

Tinnitus involves the annoying sensation of hearing sound when no external sound is present.

Tinnitus may be present all the time, or it may be at irregular intervals.

• Ringing
• Buzzing
• Roaring
• Clicking
• Hissing

Types of Tinnitus

• Subjective tinnitus: In this type of Tinnitus only patient can hear. This is the most common type of tinnitus.
• Objective tinnitus: In this type of Tinnitus, doctor can hear when he or she does an examination of the patient. This rare type of tinnitus may be caused by a blood vessel problem, a middle ear bone condition or muscle contractions.

Why Tinnitus happens?

A common cause of Tinnitus is inner ear cell damage. Tiny, delicate hairs in your inner ear move in relation to the pressure of sound waves.

This triggers ear cells to release an electrical signal through a nerve from your ear (auditory nerve) to your brain. Your brain interprets these signals as sound.

If the hairs inside your inner ear are bent or broken, they can “leak” random electrical impulses to your brain, causing tinnitus.

Causes

• Exposure to loud noise

1. Loud noises, such as those from heavy equipment, chain saws and firearms, are common sources of noise-related hearing loss.
2. Portable music devices with head phones also can cause noise-related hearing loss if played loudly for long periods.
3. Attending a loud concert continuously for long periods. 

• Age-related hearing loss: For many people, hearing worsens with age, usually starting around age 60. This type of hearing loss can cause tinnitus.

• Blockage in the Ear: When too much earwax accumulates, it becomes too hard to wash away naturally, causing hearing loss or irritation of the eardrum, which can lead to tinnitus. 

• Ear bone changes: Stiffening of the bones in your middle ear (Otosclerosis) may affect your hearing and cause tinnitus.

Other causes of tinnitus

Some of the rare causes of tinnitus are:

• Meniere’s disease.Tinnitus can be an early indicator of Meniere’s disease, an inner ear disorder that may be caused by abnormal inner ear fluid pressure.
• TMJ disorders.Problems with the temporomandibular joint, the joint on each side of your head in front of your ears, where your lower jawbone meets your skull, can cause tinnitus.
• Head injuries or neck injuries.Head or neck trauma can affect the inner ear, hearing nerves or brain function linked to hearing. Such injuries generally cause tinnitus in only one ear.
• Acoustic neuroma.This noncancerous (benign) tumor develops on the cranial nerve that runs from your brain to your inner ear and controls balance and hearing. Also called vestibular schwannoma, this condition generally causes tinnitus in only one ear.

 Blood vessel disorders linked to tinnitus (Pulsatile tinnitus)

• Head and neck tumors: A tumor that presses on blood vessels in your head or neck (vascular neoplasm) can cause tinnitus and other symptoms.
• High blood pressure: Hypertension and factors that increase blood pressure, such as stress, alcohol and caffeine, can make tinnitus more noticeable.
• Atherosclerosis: With age and buildup of cholesterol and other deposits, major blood vessels close to your middle and inner ear lose some of their elasticity — the ability to flex or expand slightly with each heartbeat. That causes blood flow to become more forceful, making it easier for your ear to detect the beats. You can generally hear this type of tinnitus in both ears.
• Turbulent blood flow: Narrowing or kinking in a neck artery (carotid artery) or vein in your neck (jugular vein) can cause turbulent, irregular blood flow, leading to tinnitus.
• Malformation of capillaries: A condition called Arteriovenous malformation (AVM), abnormal connections between arteries and veins, can result in tinnitus. This type of tinnitus generally occurs in only one ear.

Medications that can cause tinnitus or worsen the condition

• Antibiotics including Polymyxin B, Erythromycin, Vancomycin and neomycin
• Diuretics– such as Bumetanide, Ethacrynic acid or Furosemide
• Quinine medications
• Certain antidepressants
• Aspirin

Diagnosis

• Hearing examination:As part of the test, you’ll sit in a soundproof room wearing earphones through which will be played specific sounds into one ear at a time. You’ll indicate when you can hear the sound, and your results are compared with results considered normal for your age. This can help rule out or identify possible causes of tinnitus.
• Movement:Your doctor may ask you to move your eyes, clench your jaw, or move your neck, arms and legs. If your tinnitus changes or worsens, it may help identify an underlying disorder that needs treatment.
• Imaging tests:Depending on the suspected cause of your tinnitus, you may need imaging tests such as CT or MRI scans.

Treatment for tinnitus

Sound therapy

Sound therapy is a broad term that incorporates using external noise to mask the individual’s perception of tinnitus.

Tinnitus Retraining Therapy or Tinnitus Feedback Retraining

Tinnitus retraining therapy (TRT) involves retraining the auditory system to accept the abnormal sounds of tinnitus as natural rather than disruptive.

 

Healthy lifestyle

• Exercise
• Healthy eating
• Regular sleeping Habit
• Smoking cessation
• Recreational
• Social activities
• Stress management and relaxation techniques
• Avoid noisy environment

Ayurvedic views about Tinnitus

In Ayurveda Tinnitus is correlated with condition Karnanada and Karnakshweda.

According to Ayurveda, Tinnitus in not a disease but a symptom of Prana vayu disturbance.

Karna= ear

Nada= sound

Karnakshweda person listens the sound similar to the noise of flute. If we analyze these two ear conditions, it appears that the Karnanada is the condition of conductive deafness. Here there will be obstruction in the pathway of the conduction of sound.
Karnakshweda is originated due to the debility or fatigue. Otherwise, it is a direct result of diminished strength of the auditory nerves.

Causes of Tinnitus according Ayurveda

• Excess cold water head bath – For a long period of time, especially in old age, causes Vata dosha imbalance.
• Vata dosha increasing food and habits – such as excess travelling, being awake at night, excessive intake of bitter, spicy and astringent foods.
• Stress and strain
• Loss of sleep
• Debility and exhaustion
• Constant headache or the diseases of the scalp etc.
• Diseases where tinnitus occurs as a symptom: Pandu (reference: C S Ch. S 16)

Treatment for Tinnitus as per Ayurveda

• Ghrita Pana – Administration of cow ghee, in a dose of 1 – 2 teaspoon per day, pacifies Vata and improves the strength of the nerves.
• Rasayana – Anti aging therapies. Especially in elderly patients, Herbs with anti aging properties and high nutrition value are administered – Amalaki (Gooseberry), Paribhadra (Erythrina varigata), Bala (Sida cordifolia) are helpful in this regard.
• Snehana- Applying oil, around the ear and to the scalp pacifies Vata dosha and strengthens the nerves and muscles. Hence the improvement is observed. Bilva taila, Kshara taila, Ksheerabala taila etc are administered.
• Shamana oushadha- Medicines which pacify Vata are helpful to relieve the complaint of Tinnitus.

Formulations useful in Tinnitus

• Sarivadi Vati – used in Tinnitus, hearing loss, ear infection etc.
• Amalaki Rasayana
• Saptamrita Loha – used in the treatment of eye, ear disorders, gastritis, abdominal colic, etc.
• Bilva Taila – used in the treatment of ear pain, hearing loss / difficulties and tinnitus.
• Ashwagandharishta
• Balarishta
• Shatapaka bala Taila
• Mashabaladi Kashaya
• Shadbindu Tail and Anu tail

 

Ekamuliya – Single herbs useful in Tinnitus

Paribhadra, Bala, Sariva,  Amalaki (Amla), Bilva, Gokshura and  Yashtimadhu

Useful diet and tips

• Snehana – Oleation (Application of oil to the scalp)
• Ghrita pana – Intake of ghee along with food
• Ksheera paka – Medicated milk
• Kavala and Gandoosha – Oil pulling in the mouth and Herbal decoction gargling in the oral cavity.

Lifestyle tips for tinnitus:

• Ati Vyayama- Heavy exercise.
• Sheeta jala snana – Cold water head bath.
• Bhashana- Prolonged speech.
• Vatala Ahara- Vata dosha aggravating food and habits.
• Ratri jagarana – Night awakening.
• Kashaya Tikta rasatisevana- Food and beverages possessing bitter and astringent taste etc.
• Avoid hearing to loud music, loud noises, and headphones. When you are surrounded by loud noise, as in a sport event, club etc, wear hearing protection or some cloth band covering ears, to protect your ears from the noises.
• Follow relaxation techniques such as deep breathing, drinking a cup of water, talking to your friend etc, while under stress.
• Stress management in patients often results in decrease or cure of tinnitus.
• Avoid Caffeine it may worsen the condition.
• For those who experience tinnitus while asleep, sound of fan or radio may act as counter noise, helping to relieve the buzzing sound.
• Smokers and alcoholics have high risk of Tinnitus, it is advisable to avoid.

Author:

Dr. Raghavendra Shetty

Ayurveda doctor &

Panchakarma Expert