Photo credit: Tembela Bohle

by Daniel Fink, MD, Chair, The Quiet Coalition

Fox News reporter Melissa Rudy wrote an excellent piece on tinnitus. However, I have a few minor quibbles with what she wrote, and what audiologist Donald Troast said. But the main thrust of the article — tinnitus is caused by exposure to loud noise and can be avoided — is spot on.  

The common definition of tinnitus is: “ringing in the ears.” Troast’s definition, “persistent ringing, buzzing,” or “whooshing sound in the ears that the patient can hear but no one else,” is more descriptive. The technical definition of tinnitus is: “the perception of sound without an external sound source.”

Troast answers the question, “is it [tinnitus] a sign of something serious?” by stating that “most of us have experienced ringing in our ears after going to a concert, but if it lasts for less than a day, it’s very often not a cause for concern.” That’s a statement I vigorously disagree with. Tinnitus is a serious indicator that major auditory damage has occurred, and an important warning sign that one’s auditory health is at risk. That warning sign shouldn’t be ignored, but should spur those with tinnitus to take better care of their ears by reducing noise exposure.

I call tinnitus the “poor researcher’s audiogram” because the researcher doesn’t need a sound-insulated quiet booth, calibrated audiometry equipment and a trained audiologist to determine that auditory damage has occurred. All the doctor or researcher has to do is ask if one has ever had ringing in the ears. Does it go away or is it there all the time? A study of almost 4,000 high school juniors in Belgium, with a mean age of 16.5 years, found that about 75% had temporary tinnitus and 18% had permanent tinnitus. There is no such thing as temporary auditory damage, and extended range audiometry would have found noise-induced hearing loss in those young people. Unfortunately, early hearing loss is an early warning sign for future hearing loss.

Tinnitus is now thought to be a brain disorder, caused by a rewiring of brain auditory pathways by noise exposure. Troast discusses treatment of hearing loss, including hearing aids and cognitive behavioral therapy, but doesn’t mention the only FDA-approved treatment, neuromoducation.

Of course, prevention of disease is still better than treatment, and noise-induced tinnitus is entirely preventable. Avoid loud noise, turn down the volume, use hearing protection or leave the noisy environment and one won’t get noise-induced tinnitus or noise-induced hearing loss.

That’s sound advice (pun intended) that everyone should heed.

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