Your Health by Dr. Rallie McAllister

Silence is golden, especially for people who suffer from a condition known as tinnitus.

Also known as ringing in the ears, tinnitus is the perception of sound that cannot be attributed to an external source. People with the condition may hear ringing or other noises, such as clicking, hissing, buzzing, or whining in one or both ears.

The sounds are often described as having a mechanical or musical quality, ranging from a deep roar to a high-pitched squeal. They may be as quiet as a whisper or as loud as the blast of a jet engine.

The sounds may be relentless and unchanging, or they may come and go throughout the day and night. For some, the internal racket is merely annoying: For others, it is emotionally devastating.

Many patients with severe tinnitus suffer from depression and anxiety, insomnia and trouble concentrating. A small percentage of these individuals are driven to contemplate suicide.

According to the American Tinnitus Association, the condition currently affects as many as 50 million Americans. In spite of being one of the most common hearing-related disorders in the U.S. and worldwide, tinnitus remains rather poorly understood.

It may be caused by problems in the outer, middle or inner structures of the ear, or by damage to the auditory nerves or regions of the brain that interpret nerve signals as sound. In some cases, the cause of the problem may be reversible, such as a buildup of wax in the ear canal or a symptom of seasonal allergies.

The condition may be a side effect of medications, including certain antibiotics, anti-inflammatory agents, sedatives and drugs used in the treatment of cancer. People who take high doses of aspirin may experience ringing in the ears temporarily.

Tinnitus is often associated with hearing loss following repeated exposure to loud noises, such as music at rock concerts, the roar of machinery in occupational settings or the thunder of weapons and explosives in combat situations. The disorder is a common war-related injury and a significant source of disability among U.S. soldiers serving in Afghanistan and Iraq.

Even in the absence of hearing loss, tinnitus may be associated with other medical conditions, including diabetes, thyroid disease, hardening of the arteries and head or neck injuries.

In some patients, the cause is never discovered.

For some individuals, a simple change of medication may eliminate, or at least alleviate, ringing in the ears. For others, the use of hearing aids can help by amplifying external sounds sufficiently to mask the internal noises.

In some cases, surgery may be indicated. But even when medical treatment can't completely eliminate ringing in the ears, a few simple strategies may help diminish the severity of symptoms.

Avoiding stimulants, such as caffeine and nicotine, is a good place to start, since these substances often worsen tinnitus. It's also wise to steer clear of over-the-counter medicines, such as aspirin and nasal decongestants, that are likely to aggravate the condition.

Adding background noise may be beneficial. Turning on a fan or playing soft, soothing music can distract the brain's attention from the internal noise.

Since stress can worsen symptoms, using relaxation therapy often provides some relief. When tinnitus leads to insomnia, excessive anxiety or depression, prescription medications may be helpful.

Several small studies indicate that extracts of the popular herb, ginkgo biloba, may be beneficial. Ginkgo is believed to help reduce ringing in the ears by improving circulation, stabilizing cell membranes and exerting neuro-protective effects.

In the past decade, scientists and physicians have made significant strides toward developing new treatments for tinnitus. Recently, researchers at the University of Arkansas tested a noninvasive therapy called transcranial magnetic stimulation, or TMS for short.

The treatment involves placing a coil on the patient's scalp that creates a magnetic field over the brain's surface. The magnetic field induces an electrical current that either activates or inhibits the activity of nerves believed to be responsible for tinnitus.

Researchers at University of California developed a treatment that involves using a low-pitched sound, delivered to the patient by an ordinary MP3 player. Preliminary studies with this approach suggest that it may provide temporary relief for some tinnitus sufferers.

Although there's still no definitive cure, there's always reason for hope. Virtually every individual with the disorder can benefit from a treatment program designed to diminish not only the symptoms of tinnitus, but also the suffering it causes.

Rallie McAllister, M.D. is a family physician, speaker, and co-founder of www.MommyMDGuides.com, a website featuring child-raising tips from trusted doctors who are also moms. To find out more about Rallie McAllister, M.D., and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com.

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