Every new patient who comes to see me in the clinic is asked to fill out a health questionnaire about various symptoms they may be experiencing. A high percentage of patients here in Kodiak have answered in the affirmative that they hear ringing in their ears. Due to this high prevalence, I thought it would be useful to further explore this symptom and its causes, and possible ways to prevent it or improve the condition.
Ringing in the ears is called “tinnitus” and is defined as perception of sound in proximity to the head in the absence of an external source. It can occur in one or both ears, and can sound like ringing, buzzing or hissing. Intermittent tinnitus is not usually related to serious problems, but continuous tinnitus can be more concerning.
Pulsatile tinnitus occurs when the sound comes and goes with the heartbeat, and should be evaluated further to exclude a vascular abnormality or tumor. It is estimated that 50 million people in our country have tinnitus for over six months, and up to 12 million have symptoms severe enough to interfere with normal activities. The incidence of tinnitus is higher in smokers and in men.
Tinnitus most commonly is caused by hearing loss and auditory system dysfunction. It is often an early indicator of cochlear hair cell dysfunction or loss, which can occur from prolonged noise exposure. Presbycusis is the natural hearing loss that occurs with aging and is also commonly associated with tinnitus.
Many medications can be toxic to the sense of hearing, including some blood pressure medications (ACE inhibitors, calcium channel blockers, loop diuretics), NSAIDs, some antibiotics (fluoroquinolones, aminoglycosides and clarithromycin), proton pump inhibitors, antimalarial drugs and chemotherapy. Other causes include infections, bone disease, vascular disease, tumors, diabetes, thyroid disorders, chronic kidney failure or trauma to the ear.
Hearing loss prevention is best accomplished by noise reduction. Everyday noises compounded over time can cause hearing loss. Noises greater than 120 decibels (rock concert, jet engine) in short blasts can cause profound hearing loss. A lawnmower creates about 90 decibels of sound, and OSHA recommends hearing protection for any worker exposed to 85 decibels or more time-weighted average.
About 43 percent of adults between the ages of 65 and 84 have hearing loss. If you are experiencing hearing loss with or without tinnitus, and would like further testing, Kodiak does have audiology appointments available through the Providence Kodiak Island Specialty Clinic or through KANA.
When I asked my coworker, Ilva Fox, about her experience with hearing aids, she said that they changed her life. She had no idea how much she could not hear until she got hearing aids, and now the difference is amazing, both for her and for her friends and family.
While we may accuse our spouse or significant other of “selective hearing” unrelated to medical causes, we all are prone to “tune out” things we don’t want to hear. It sometimes takes a good friend or family member to tell us that we are unaware of our deafness, and to spur us on to get help. Being willing to hear from others requires humility, and I find great comfort in knowing that God does not suffer from deafness as we do, but is hearing us and speaking to us all the time. I pray that all of us will have open ears to hear from each other and from God. “So faith comes from hearing, and hearing through the word of Christ” (Romans 10:17).