Hearing Loss and Central Auditory Processing

59 Tinnitus

Learning Objectives

Be able to describe what it is and why it may happen.

Be able to discuss the possible long-term impact of it.

Tinnitus is phantom noise (“ringing”) in the ears. It is characterized by the perception of sound when there is no external sound. It can present itself as ringing, buzzing, clicking, or hissing. The word tinnitus comes from the Latin “tinnire” which means “to ring”. (5) When sensorineural loss occurs, the brain is missing sensory input and imagines it is hearing noise, just like a phantom limb. Sensorineural loss happens when there is damage in the inner ear or nerve pathways that are in charge of transmitting signals of sound to the brain. Tinnitus is generally a sign of sensorineural damage, although it is not necessarily accompanied by hearing loss.

Tinnitus is not a disease but a symptom resulting from a range of underlying causes that can include ear infections, foreign objects or wax in the ear, nose allergies that prevent (or induce) fluid drain and cause wax build-up. Tinnitus can also be caused by natural hearing impairment (as in aging), as a side-effect of some medications, and as a side-effect of genetic (congenital) hearing loss. Injuries to the head and neck can also result in tinnitus, usually just in one ear. (14) However, the most common cause for tinnitus is noise-induced hearing loss.

Tinnitus can be perceived in one or both ears or in the head. It is usually described as a ringing noise, but in some patients it takes the form of a high pitched whining, buzzing, hissing, screaming, humming, tinging, or whistling sound, or as ticking, clicking, roaring, “crickets” or “tree frogs” or “locusts,” tunes, songs, beeping, or even a pure steady tone like heard in a hearing test. (1) It has also been described as a “wooshing” sound, as of wind or waves. (2) Tinnitus can be intermittent or it can be continuous, in which case it can be the cause of great distress. In some individuals, the intensity of tinnitus can be changed by shoulder, head, tongue, jaw, or eye movements. (3) Click on this link to try out a simulation of what one with tinnitus may experience hearing. Scroll down to the “Sounds of Tinnitus” section, and be sure to keep your volume low/medium.

 

Fig.6.4.1. Tinnitus can be experienced as ticking, clicking, beeping, buzzing screaming, whining and tinging. It can be very distressing. (Credit: Alexander Krivitskiy, Thomas Bormans, and Anh Nguyen. Edited by: Jarod Davis. Provided by Unspash. License: CC-BY)

Prevention involves avoiding exposure to loud noise for longer periods. (4) If there is an underlying cause, treating it may lead to improvements. (5) Otherwise, typically, management involves psychoeducation or counseling such as talk therapy. (6) Sound generators or hearing aids may help some. (4) As of 2013, there were no effective medications. (5) It is common, affecting about 10–15% of people. (6) Most tolerate it well, and it is a significant problem in only 1–2% of people. (6)

Besides being an annoying condition to which most people adapt, persistent tinnitus may cause anxiety and depression in some people. (7)(8) Tinnitus annoyance is more strongly associated with the psychological condition of the person than the loudness or frequency range. (9)(10) Psychological problems such as depression, anxiety, sleep disturbances, and concentration difficulties are common in those with strongly annoying tinnitus. (11)(12) 45% of people with tinnitus have an anxiety disorder at some time in their life. (13)

 

Exercises

  1. Although tinnitus is not a disease, it is a symptom resulting from a range of causes, such as ear infections, foreign objects in the ear, genetic hearing loss, noise-induced hearing loss, etc., and there are methods used to prevent it. Which of the following is the most common preventative measure to take in avoiding tinnitus?
    A. Hearing aids
    B. Attend psychoeducation and/or talk therapy.
    C. Limiting exposure to loud noise for long periods of time
    D. Avoid taking aspirin and Tylenol.
  2. As of 2013, there are no effective medications for Tinnitus, but what does end up occurring with most people who have Tinnitus?
    A. Most people experience anxiety disorders.
    B. Most people experience depression.
    C. Most people have a significant problem with handing it.
    D. Most people tolerate it well.
  3. One who experiences tinnitus may notice a phantom noise in a quiet environment daily. Although a phantom noise can be ignored, what is a common sound that people typically hear when they are living with tinnitus?
    A. Ringing
    B. Heart beat
    C. Rhythmic drums
    D. Tree frogs
  4. Tinnitus can be perceived in ____ ears and is usually described as a  ____ noise.
    A. One ear only, dinging
    B. One or both ears, chirping
    C. One or both ears, ringing
    D. Both ears, beeping
  5. Tinnitus annoyance is more strongly associated with the ____ condition of the person than the loudness or frequency range. 45% of people with tinnitus have a(n) ____ disorder at some time in their life.
    A. Sensorineural, sleeping
    B. Sensorineural, anxiety
    C. Psychological, sleeping
    D. Psychological, anxiety
  6. A youthful individual listens to music quite loud in their car on their thirty minute drives to work, five days a week, without ear protection. They have recently noticed that throughout their daily life, they hear a phantom ringing noise. This particular individual also has several relatives who wear hearing aids, due to their old age. Worried about their potential hearing damage, the individual goes to the doctor to get their hearing checked out, and they are told that they are experiencing tinnitus. The source of their tinnitus is most likely due to which of the following?
    A. Age-related hearing loss
    B. Genetic predisposition to hearing loss
    C. Ear-wax buildup
    D. Exposure to loud noise for long periods of time
  7. One who has tinnitus may experience phantom noises, such as ringing, whining, buzzing, tinging, whistling, etc. Moreover, the intensity of tinnitus can be changed by what type of movements of the body?
    A. Head movements only
    B. Shoulder, head, jaw, tongue, and/or eye movement
    C. Eye, head, tongue, and jaw movements
    D. Head and jaw movements only
  8. Below is a list of some types of hearing damage. Which of the following forms of hearing damage listed can stem from a side-effect of some medications?
    A. Age-related hearing loss
    B. Tinnitus
    C. Hidden hearing loss
  9. One gets psychological testing done, and their results come back with depression, anxiety, and concentration difficulties. They have also complained about hearing a ringing noise constantly throughout the day, irritating them greatly, and they cannot ignore it. It turns out that they have a form of tinnitus that affects what percent of people?
    A. 1-2%
    B. 45-50%
    C. 10-15%
  10. Tinnitus, which is phantom noise or “ringing” in the ears, is a common symptom of underlying causes that can include ear infections, foreign objects or wax in the ear, nose allergies that prevent fluid drain, natural hearing impairment with aging, noise-induced hearing loss, or a side-effect of medication or of genetic hearing loss. That being said, what is happening in the brain, on a neurological level, when one experiences Tinnitus?
    A. The brain is missing sensory input, i.e. the brain imagines hearing noise.
    B. The hair cells in the ear are moving, even when there is not a sound wave to be heard, causing one to believe that they are hearing noise.
    C. The nerves in the ear, such as the vestibulocochlear nerve, are damaged, and they are retrieving sound from the last source that they remember prior to injury, creating a phantom noise.

Answer Key:

  1.  C
  2.  D
  3.  A
  4.  C
  5.  D
  6.  D
  7.  B
  8.  B
  9.  A
  10.  A

 

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Cheryl Olman PSY 3031 Detailed Outline
Provided by: University of Minnesota
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Wikipedia, Psychology Wiki, Tinnitus
URL: https://psychology.wikia.org/wiki/Tinnitus
License: CC BY SA 3.0

Wikipedia, Tinnitus
URL: https://en.wikipedia.org/wiki/Tinnitus
License: CC BY SA 3.0

References

  1. ↑ RNID.org.uk: Information and resources: Tinnitus: About tinnitus: What is tinnitus
  2. ↑ MedlinePlus Encyclopedia 003043
  3. ↑ Simmons R, Dambra C, Lobarinas E, Stocking C, Salvi R. (2008). Head, Neck, and Eye Movements That Modulate Tinnitus. Semin Hear. 29(4):361-370. PMID 19183705
  4.  “Tinnitus”. NIH – National Institute on Deafness and Other Communication Disorders (NIDCD). 6 March 2017. Archived from the original on 3 April 2019. Retrieved 20 September 2019.
  5. Baguley, D; McFerran, D; Hall, D (Nov 9, 2013). “Tinnitus” (PDF). The Lancet. 382(9904): 1600–07. doi:10.1016/S0140-6736(13)60142-7. PMID 23827090. Archived (PDF) from the original on 2018-04-11.
  6.  Langguth, B; Kreuzer, PM; Kleinjung, T; De Ridder, D (Sep 2013). “Tinnitus: causes and clinical management”. The Lancet Neurology. 12 (9): 920–30. doi:10.1016/S1474-4422(13)70160-1. PMID 23948178.
  7. Andersson G (2002). “Psychological aspects of tinnitus and the application of cognitive-behavioral therapy”. Clinical Psychology Review. 22 (7): 977–90. doi:10.1016/s0272-7358(01)00124-6. PMID 12238249.
  8.  Reiss M, Reiss G (1999). “Some psychological aspects of tinnitus”. Perceptual and Motor Skills. 88 (3 Pt 1): 790–92. doi:10.2466/pms.1999.88.3.790. PMID 10407886.
  9.  Baguley DM (2002). “Mechanisms of tinnitus”. British Medical Bulletin. 63: 195–212. doi:10.1093/bmb/63.1.195. PMID 12324394.
  10. Henry JA, Meikele MB (1999). “Pulsed versus continuous tones for evaluating the loudness of tinnitus”. Journal of the American Academy of Audiology. 10 (5): 261–72. PMID 10331618.
  11.  Henry JA, Dennis KC, Schechter MA (2005). “General review of tinnitus: Prevalence, mechanisms, effects, and management”. Journal of Speech, Language, and Hearing Research. 48 (5): 1204–35. doi:10.1044/1092-4388(2005/084). PMID 16411806.
  12.  Davies A, Rafie EA (2000). “Epidemiology of Tinnitus”. In Tyler, RS (ed.). Tinnitus Handbook. San Diego: Singular. pp. 1–23. OCLC 42771695.
  13. Pattyn T, Van Den Eede F, Vanneste S, Cassiers L, Veltman DJ, Van De Heyning P, Sabbe BC (2015). “Tinnitus and anxiety disorders: A review”. Hearing Research. 333: 255–65. doi:10.1016/j.heares.2015.08.014. PMID 26342399.
  14. Mayo Foundation for Medical Education and Research. (2022, November 30). Tinnitus. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/tinnitus/symptoms-causes/syc-20350156

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Introduction to Sensation and Perception Copyright © 2022 by Students of PSY 3031 and Edited by Dr. Cheryl Olman is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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