What is tinnitus, and does it go away?

Do you hear ringing, buzzing, hissing, or roaring in one or both of your ears? If so, it’s called tinnitus, and it’s something that many people experience. It can be annoying, but it usually isn’t anything to worry about.

This issue is most commonly caused by damage to cells in the inner ear. These damaged cells send signals to your brain that make you think you’re hearing sounds that aren’t really there.

Tinnitus can be reversible, and in most cases, it will go away. The duration varies from person to person, and can last from just a few hours to months, and even years.

If your tinnitus doesn’t start fading after a few days, it is possible that it will never disappear completely. This might sound like something that could drive a person crazy, but the truth is most people suffering from chronic tinnitus seem to get used to it and are not that bothered by it.

Let’s dive into it a little bit deeper and answer some of the most common questions regarding this bothersome condition.

What is tinnitus?

Tinnitus is the perception of sound in the absence of an apparent acoustic stimulus. It can be perceived as being within one or both ears, within or around the head, or as an outside distinct noise.

Tinnitus can be categorized as continuous or intermittent. Despite the fact that both could significantly affect the patient, the latter is frequently unrelated to a serious underlying medical condition.

The sound can additionally be categorized as pulsatile or non-pulsatile. Although non-pulsatile tinnitus may be related to underlying disease, pulsatile tinnitus raises more worry for underlying severe pathology.

The American Tinnitus Association estimates that 50 million Americans suffer from chronic tinnitus (with chronic tinnitus being defined as a case lasting more than six months).

This equates to about 20 percent of the entire US population!

It has a major influence on their quality of life and is severe enough to interfere with the daily activities of 12 million people. These people are effectively disabled by their tinnitus to varying degrees.

Tinnitus can also affect children, however, it is less common than in adults. It is also more prevalent in smokers (just another great reason to stop smoking!) and can occur at any age.

What causes tinnitus?

There are many different reasons and causes for tinnitus, but the most common tinnitus which is experienced by the population living in urban, noisy cities is damage to the hearing nerve.

Bear with me for a short anatomy lesson about the ear, or if you are more of a visual person, check out this video and then come back to the article.

The human ear is divided into 3 parts: external, middle, and inner ear. The external and middle ear serve as a conductor of the auditory wave to the inner ear, where the auditory nerve lies. In the inner ear, there is a snail-like bony structure (medically called the cochlea) in which there are delicate hair cells that move and generate impulses as the sound wave travels through them. Those impulses then are sent via the nerve to the brain. That’s enough anatomy.

Constant exposure to noise, or even short but intense exposure to very loud noise, can cause damage to these hair cells in the cochlea, which become excited and continue to fire impulses even without sound. This is, for example, the feeling we experience after a party when we lay down in a quiet room and just hear a high-pitched or buzzing sound. That is the most common tinnitus, which is thankfully short-lived.

However, if the exposure to loud sounds and noise becomes chronic, let’s say you work in a loud factory or airport and don’t use hearing protection for 20 years or more, that will cause the so-called sensorineural hearing loss which is the most common reason for long-lasting tinnitus.

As a matter of fact, a study shows that the presence of tinnitus indicates the presence of hearing loss in workers who have been exposed to noise in the workplace.

A similar condition where tinnitus is present is presbycusis, which is just a fancy way to refer to hearing loss due to aging. It is a normal process of aging, just like the refractive error of middle and older age when people can’t see well up close (needing reading glasses).

The hair cells accumulate damage through the years and the high-pitched tones can’t be heard as well. This can also turn into high-pitched tinnitus.

Another fairly common cause of tinnitus is medications – ototoxic medications. Tinnitus caused by these types of medications usually affects both ears. The list of drugs causing tinnitus is extensive, but some worth mentioning are the chemotherapeutic agents, aminoglycoside antibiotics and loop diuretics such as furosemide, and also some antidepressive and antiepileptic drugs.

Other causes of tinnitus which unlike the subjective ones mentioned above, are organic in nature, can be vascular, such as hums from the venous blood vessels, arterial bruits, vascular malformations, neurologic disorders, jaw joint dysfunction, and other conditions which are beyond the scope of this article.

Is tinnitus permanent?

Unfortunately, this is not a simple yes or no answer.

Generally speaking, if tinnitus appears after being exposed to an acute loud noise, it is reversible.

If it is from an organic cause, it may be amenable to medical interventions or surgery which can reverse the tinnitus.

However, tinnitus arising from the auditory system such as that from sensorineural hearing loss, presbycusis, or ototoxicity (explained above) tends to dwell for a long time (if not indefinitely).

Ear wax or cerumen does not cause tinnitus and removing the earwax will not relieve the tinnitus. Tinnitus can sometimes occur from fluid in the middle ear or barotrauma, so it can come and go if that process is cured.

If the tinnitus persists for 6 months or more, qualifying it as chronic, you should undergo a comprehensive audiological examination. It is very unlikely that long-standing tinnitus will go away, therefore it is important that measures be undertaken to alleviate the symptoms and make it easier to cope with.

Conclusion

Tinnitus is not a disease, it is a symptom. It may point to a disease, although it is rare that anything more serious may be hiding behind this symptom.

Many of us experience tinnitus after standing too close to a gunshot or leaving a lavishly amplified concert, but these cases are short-lived (gone in a matter of hours).

Most frequently chronic tinnitus will be from sensorineural hearing loss (which usually comes from chronic noise exposure), but pulsatile tinnitus, tinnitus with vertigo and unilateral tinnitus should be investigated in more depth by a medical professional.

If you happen to suffer from tinnitus, know that you are not alone. There are some models of treatment and support or prevention that might help you.