Tinnitus is the perception of sound when there is no external sound source present. Tinnitus is commonly related to loud noise exposure and age-related hearing loss.
While tinnitus can sometimes coincide with normal hearing, studies suggest that up to 90% of people with tinnitus also have hearing loss. It’s no coincidence that hearing loss is linked to ringing in the ears. While the specific cause of tinnitus has yet to be found, it’s likely that damage to the special sensory cells (hair cells) of the inner ear (cochlea) is directly related to tinnitus. This damage is known as ‘sensorineural hearing loss’.
When a person has sensorineural hearing loss, the ear has less ability to detect sound. This causes a lack of stimulation to the brain. It is thought that changes occur in the brain and auditory nerve due to the lack of stimulation, creating phantom noises (tinnitus).
The pitch of a person’s tinnitus is usually related to the same range of frequencies where there is a loss of hearing. For example, damage to the inner ear in the region of the high frequencies gives rise to high pitched tinnitus. This damage is typical of age-related hearing loss and noise-induced hearing loss, which is why high-pitched tinnitus is so common.
Tinnitus can also be linked to another type of hearing loss called ‘conductive hearing loss’. Conductive hearing loss can be caused by impacted earwax in the ear canal, otosclerosis, and ear infections. This type of tinnitus can sometimes be resolved with treatment of the underlying medical condition.
Dealing with chronic tinnitus alone can be difficult enough by itself, without having to cope with the effects of hearing loss too. It can be cognitively demanding to tune out the tinnitus in order to hear. Hearing loss causes us to become more aware of our tinnitus as environmental sounds don’t block out the sound well.
You may experience fatigue because you need to put in extra efforts to be in conversations every day. When you find yourself in an environment with background noise, it is even more challenging because both the noise in the background and tinnitus start to compete with each other.
Unfortunately most hearing loss caused by damage to the inner ear (cochlea) is permanent, and there is no cure for tinnitus. While it is discouraging to hear that there is no ‘magic bullet’ to fix these problems with the auditory system, there are many treatment options available that can improve the situation vastly. See our blog on management strategies for a broad review.
See An Audiologist
If you suffer from tinnitus and suspect that you have hearing loss, see a clinical audiologist for a hearing test. Following an assessment, an audiologist will provide you with different options to manage your tinnitus and hearing difficulties, if you have them.
Hearing aids are an effective form of tinnitus treatment. If you do have a hearing loss, hearing aids may be beneficial for you. Hearing aids provide amplification to important sounds so you are able to hear them. Most hearing aids have in-built noise cancellation programs that help you to hear better in background noise, by selectively amplifying the sounds you want to hear. Many hearing aids also have a tinnitus masking program, which uses different sounds to mask or distract you from your tinnitus to make it more manageable.
Some individuals with hearing loss and tinnitus find themselves withdrawing from their social life as it becomes overwhelming. Communication strategies are simple and effective ways of easing communication. Here are some tips for effective communication that you can use:
1. Encourage your communication partners to speak face to face with you and in the same room. This is because visual information, such as seeing a person’s lips and facial expression gives lots of information. A well-lit room is best.
2. If you have a better ear, try to position yourself so the communication partner is on your better side.
3. Ask your communication partner to speak slowly and clearly.
4. Try to have conversations in a room where there is little to no background noise.
5. When in a noisy environment such as a cafe, position yourself so the noise source is behind you.
6. If important information is being shared on, e.g. date, time, location, try repeating back the information to confirm what was said.