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If you are reading this, you probably already known by your own experience what tinnitus is! Medicine differentiates between acute tinnitus, which is a first-time event, usually of sudden onset, and chronic tinnitus. If a tinnitus which has newly occurred doss not disappear, but rather persists for more than 6 months, we call it chronic.
There are certain very forms of tinnitus based on vascular anomalies, where tinnitus can be picked up with a microphone and actually can be made audible for others. This answer will surprise you – tinnitus is always a very silent sound, comparable to the sound of the leaves of a tree at almost calm. Because tinnitus loudness cannot be measured objectively, it is difficult to make a comparison. Part of the answer may be already in the question; to some extent tinnitus is a mental experience. Scholars today assume that ‘tinnitus-experience “is-at least partially – the result of a learning process by the brain, perhaps comparable to a vicious circles.
You can easily imagine that every second the brain will receive an abundance of information from all ours senses. Typical examples are the ticking of a clock on the wall, the soft humming of a refrigerator, or the scratching of a new pullover when they first occur, but thereafter the brain will usually make a judgement as to whether “important” or unimportant”. To summarize the above, the brain has to evaluate information as part of a ‘Darwinian struggle”. Its one set is usually sudden and typically in a particular stress- or strain Situation (almost 80% of people report that this is how their tinnitus, started). Consequently, as a plain sensory and usually harmless impression, tinnitus already has stamped negative.
There are many hints that in most cases tinnitus does actually begin in the inner ear, i.e. In this context it may be of interest that, after a while, all of us without exception will experience tinnitus when locked up in a sound-tight chamber.
Most of us will have difficulty to develop an understanding of phantom pain, but we all have an idea about what arachnophobia might be like. As part of the diagnostic procedure for acute tinnitus, your doctor will check for acoustic neuroma, a rare and benign tumor affecting the acoustic nerve. It tries to answer every day questions, which typically come to people’s mind and are often posed in medical clinics. Acute tinnitus, in particular when accompanied by acute hearing loss, needs to be attended by a doctor quickly to exclude any underlying and possibly serious condition. A typical example is caused by excessive noise (explosion, gum shot).Very often one can find some damage of the inner and outer hair in the inner ear. If tinnitus is accompanied by some form of hearing loss, them the individual tinnitus frequency is very often localized where hearing loss begins.
Many tinnitus-sufferers have some from of accompanying hearing loss, usually affecting the higher frequencies. With the help of an audiogram one can measure how loud an individual will experience a certain sounds by playing with a distinct loudness for comparison. Individual experiences will diverge very much, measurement (as described above) show tinnitus to be a very silent sound, in the range of 10 to 15 dB at the most.
Many people report that yawning or chewing will calm it, while after physical strain such as sports or after long car rides, it will become louder. It is not a sound signal being sent from the ear to the brain, rather it seems to be some kind of perceptual irritation, some form of over-interpretation by the brain. Sounds with no “information value” receive no attention by the brain and are consequently banned form our consciousness.
If we do not know a signal and, in particular, if a new signal comes suddenly, we usually react with fear and tension – in physiological preparation for flight.
Your brain dies not know how to value this sound; your environment cannot perceive it and reacts with disbelief. You start to consciously listen for your tinnitus, whether it is still there” or whether it has become louder”. We may thus conclude that tinnitus is a actually the manifestation of some from of basic activity of our auditory system, which we normally don’t notice, because its level its level is too low. Because of the implications, in the view of many (but not all) doctors, this necessitates quick medical action with the goal to raise tissue oxygen supply.
When selecting a particular type of aid, it may make sense to choose a combination device (hearing aid + tinnitus control instrument TCI). Treatment of acute tinnitus and hearing loss may vary from country to country- in Europe it is probably given more attention than in the US.
In other words, we assume that your tinnitus has already been subject to various diagnostic regiments, which have produced no specific identifiable and treatable cause. Even though very often some degree of hearing loss marks the beginning of tinnitus, tinnitus seems to be a process, which gains momentum on its own. Incidentally, the initial fitting of a hearing aid for testing purpose is usually free of charge and without obligation. 80% of all people with tinnitus, even though they may describe it as ‘’fairly Loud’’,are well adjusted to it and report no negative experiences at all, while the other 20% will give all sorts of descriptions from ‘’irritating to ‘’unbearable’’. Your ear does pick up the clock, but you will not hear” it – unless you wish to and actually concentrate on it, i.e.
A typical reaction of yours is fear and apprehension “whether something serious is happening”, soon in combination with an element of range, because tinnitus is taking away your “right of silence”. Indeed, with the excess of sound impressions that reach our ear every minute, there must be some occasional mal-information, which is carried via the auditory pathway to the brain and triggers a loop as above. Only when it manages to get hold of our “auditory awarenss:, does tinnitus become a problem. Diagnostic procedures for tinnitus might typically involve an ENT specialist, neurologist and orthopedist.
When tinnitus is accompanied by partial hearing loss, then many patients will localize their individual tinnitus frequency in the vicinity of their hearing loss, i.e.
As outline above, one can often suspect from the audiogram where someone’s tinnitus frequency is, but not if someone actually has tinnitus or not. Rather, this type of ‘’measurement’’ is based on the somewhat based judgement of the individual itself.
An unfortunate few are dominated by their tinnitus, are unable to sleep, concentrate or find any more joy in life. Whether it becomes louder in your own individual reception will partially depend on the personal strategy you choose in coping with it. Perhaps you get answer like “there’s nothing you can do about it”, this may be the coming of a heart attack or stroke “and the like.
If the mal-information was only brief, this loop should quickly terminate or-as we say - “run dead”. Remember that 80% of people with tinnitus are very well habituated to it and report no reduction in their quality of life.
Very often, this will make the tinnitus disappear.Today, we know many causes for acute tinnitus and listing them all would consume more space. The audiologist can also advise you, whether a combination aid (hearing aid + noise) might make sense. Nevertheless, if the individual is cooperative, then measurement can be reproduced within a very narrow range of deviation, and do give a good picture of the loudness a test person does actually experience. Hearing is a deeply emotional process, even anatomically: parts of the auditory neural chain communicate with the so-called “Limbic System”, an anatomical structure within the brain which “houses” our feelings.
Such answer are typical, unfortunately,- and they can be devastating, They leave you rather hopeless and with no problem solving strategy. If some mal-information with a high level of alertness perpetuates, it will constantly re- trigger the sensorineural loop as above, until by way of internal feed back mechanisms, it will become a phenomenon solely located within the brain. Only for a few unfortunate, it goes as far as to dominate their life and keep them from going places and doing things they would have otherwise done. This procedure has been performed on some unfortunate people in deep distress, and has of course left them completely deaf, but has failed to terminate their tinnitus.
Such measurement have revealed that, interestingly, many tinnitus sufferers do actually record even minute changes in the loudness of their tinnitus, typically after sports or some from of physical strain. The sound of swallowing, which is very well audible when one pays attention, has approximately 30 dB and is thus 10 times louder! It seems that after a while the brain itself causes you to play increasing attention to and concentrate on your tinnitus. Sadly enough, this leads to a lack of understanding of the environment and very often puts extra strain on partner relationships. Nevertheless, you will usually not hear yourself swallow because you don’t actively listen for it.

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