Tinnitus: The bothersome perception of noise in older adults

May 29, 2019 @ 3.09pm

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Prolonged exposure to loud noises from heavy equipment, firearms, and portable music devices can cause hearing loss and tinnitus.

Tinnitus is the perception of noise or ringing in the ears. The noise can be ringing, buzzing, roaring, clicking or hissing. Although it is bothersome, it usually does not signify any underlying serious problem.

Dato’ Dr Rajbans Singh, consultant physician and geriatrician at Pantai Hospital Kuala Lumpur pointed to several causes of tinnitus, among which are age-related hearing loss as one gets older. This is called presbycusis.

Causes
“Long term exposure to loud noises like heavy equipment, chain saws, firearms and portable music devices can lead to hearing loss and tinnitus.

“Other contributing factors are earwax blockage and irritation of ear drum, ear bone changes called otosclerosis which runs in the family, Meniere’s disease – an inner ear disorder caused by abnormal inner ear fluid pressure - where tinnitus can be an early indicator of the disease.

“TMJ disorders, problems with the temporomandibular joint, head or neck injuries which can affect the inner ear, hearing nerves or brain function linked to hearing are also linked to tinnitus, but in only one ear.

Other causes include acoustic neuroma – a benign tumor that develops on the cranial nerve that runs from the brain to the inner ear that controls balance and hearing. This also causes tinnitus in one ear.

Blood vessel disorder - in rare cases pulsatile tinnitus is caused by atherosclerosis, head and neck tumors, high blood pressure, turbulent blood flow due to narrowing or kinking in neck artery or arteriovenous malformation.

Certain antibiotics like Polymyxin B, erythromycin, vancomycin and neomycin, cancer medications including mechlorethamine and vincristine, diuretics such as bumetanide and furosemide, quinine medications, certain antidepressants and high dose aspirin can cause or worsen tinnitus. The noise however disappears when the drug is stopped.

Due to the severity of the problem, the person affected may also experience fatigue, stress, sleep problems, trouble concentrating, memory problems, depression, anxiety and irritability.

Treatment
Having a change in medication, treating an underlying health condition such as removing the earwax or treating a blood vessel condition may help resolve tinnitus. A physician can also be consulted for an electronic device to suppress the noise.

However, Rajbans cautioned against using drugs as it is unable to cure tinnitus although it may reduce the severity.

“Possible drugs include tricyclic antidepressants and alprazolam but these have their side effects and are habit forming. It should only be used as a last resort. It is also advisable to avoid possible irritants like loud noises, caffeine, nicotine, reducing alcohol consumption which increases blood flow and managing stress levels which worsens tinnitus.

Gingko, acupuncture and hypnosis
Rajbans explained that gingko EGb 761 taken at a dose of 120mg for three months help in certain patients. So does zinc and B supplements. Alternative therapies such as acupuncture and hypnosis have been tried by several patients with varying results.

Coping and Support
Tinnitus does not always improve or go away with treatment. Some suggestions to help you cope include counseling, support groups and educating yourself.

However, if you experience a new onset tinnitus, do consult an ENT specialist.