Tinnitus is a symptom of an underlying disease rather than being a disease itself. It is characterized by various soft or loud sounds in the ears of the patient when there is no such sound in the environment.

Around 15 per cent of people experience tinnitus at some stage of life and it's more likely to occur beyond the age of 60.

Some people are mildly affected by the condition while some are severely affected.

Types of Tinnitus

There are two types of Tinnitus: objective and subjective:-

• Objective tinnitus is present in less than 5 percent of overall tinnitus cases. Here the examining physician may hear sounds in the patient’s ear canal.

  This is usually associated with a blood vessel or muscle related condition. The tinnitus may be pulsatile or in rhythm with the heartbeat.

• Subjective tinnitus is seen in 95 percent of tinnitus cases. Here the patient alone can hear the sound.

Common Symptoms of Tinnitus

Symptoms of tinnitus include (1, 2, 3, 4) :–

• Sounds like ringing, buzzing, humming, hissing, whistling, sizzling, clicking, knocking, roaring or blowing.

  Patients complain of sounds similar to calling of crickets or cicadas or blowing winds, falling or gushing water, grinding steel, escaping steam, running engines, chain saws, fluorescent lights, etc.

• Some patients may hear high pitched loud sounds while others may hear soft whispering noises. Most patients describe the sounds over 3KiloHertz in frequency.

  In Meniere’s disease the frequency of the tinnitus may be as high as 125-250 KHz.

• Some patients may hear musical hallucinations. These are common with long term sufferers who also have hearing loss. They hear musical refrains continuously.
• The sounds may be heard in one or both ears. When heard from both ears the sound is described to come from the “middle or the head”.

  If it is heard in the ears it is called tinnitus aurium and if it is heard in the head it is called tinnitus cranii.

• Tinnitus may be short episodes of the sounds, waxing and waning courses of the sounds or constant and continuous sounds.
• Sometimes tinnitus may be pulsatile. The sounds beat a rhythm with the heart or blood flow to a vessel within the ear.

Aggravation of the symptoms of Tinnitus

Tinnitus may be aggravated with certain postures like lying or sitting down or on turning the head.

The movements cause pressure changes in the nerves and fluids within the inner ear leading to this aggravation.

Some may also find increased sensitivity to other sounds. For example, those with tinnitus find radio or television painfully loud even at normal volumes. This is called hyperacusis.

Problems caused by the symptoms of Tinnitus

Prolonged sounds may cause sleep problems and lack of ability to concentrate.

They may lead to anxiety disorders and depression. If it persists for more than 2 years, it is considered permanent and irreversible. This type of tinnitus is difficult to treat.