What is Tinnitus?
Tinnitus (pronounced “tin-it-us”) is a noise heard by the patient which is not caused by any sound in the environment.
Tinnitus is common — nearly 36 million Americans have tinnitus and more than half of the normal population has intermittent tinnitus.
Tinnitus can come and go, or be continuous.
It can sound like a low roar, or a high pitched ring.
Tinnitus may be in both ears or just in one ear. Seven million Americans are so severely affected that they cannot lead normal lives.
What Causes Tinnitus?
Tinnitus is usually static noise in the auditory system that is associated with lots of sound from the external environment.
Therefore, tinnitus is common and in most, but not all, cases it is associated with some degree of hearing loss.
The most common causes of tinnitus are damage to the high-frequency hearing by exposure to loud noise or elevated levels of common drugs that can be toxic to the inner ear in high doses.
How is Tinnitus Diagnosed?
Because tinnitus is a symptom rather than a disease, it is important to evaluate the underlying cause. Persons who experience tinnitus should be seen by a physician expert in ear disease, typically an otolaryngologist.
In addition, several blood tests may be performed:
- fluorescent treponemal antigen (FTA)
- erythrocyte sedimentation rate (ESR)
- hemoglobin AIC (HbAIC)
- fasting glucose
- antinuclear antibody (ANA)
- sequential multiple analyzer (SMA-24)
- anti-microsomal antibodies
- thyroid stimulating hormone (TSH)
Drugs that Commonly Cause or Increase Tinnitus
Many medications can cause tinnitus. Normally this is thought to arise from their effect on the cochlea (ear). The following is a list of some common medications that may contribute to tinnitus:
- nonsteroidal anti-inflammatory drugs (NSAIDS), such as Motrin and naproxen
- antibiotics ending in -mycin (such as erythromycin)
- quinine and related drugs
- Lasix and other “loop” diuretics
- aspirin and other salicylates
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Medicine may occasionally help lessen the noise even though no cause can be found. In general, we are not very enthused about medication treatment as the side effects can be substantial and the results are often unimpressive.
The following medications are used in treatment of tinnitus:
- lorazepam or clonazepam (in low doses). These are benzodiazepines
- Amitriptyline or nortriptyline (again in low doses). These are tricyclics
- Mysoline or carbamazepine in doses used for epilepsy
- furosemide (Lasix)
- furosemide (Lasix)
- Verapamil or nimodipine etc.