We’ve all experienced the discomfort of stubborn water remaining in the ear after a dip in the pool or a shower, a ringing sensation after attending a loud sporting event or a concert, or the sudden sensation of the room spinning, after standing up too quickly.
Our ears are made of tiny bones, passages and structures that not only control our hearing, but also our sense of balance and equilibrium. This delicate, intricate system can be thrown out of whack by many things: a cold, an infection, medication or an injury.
The three parts of the ear — outer, middle and inner ear — are all used in hearing. The outer and middle ear conduct sound waves, while the inner ear creates and sends the nerve impulses to the brain, where they are recognized as sounds. The inner ear also controls balance, which is why disorders of this part of the ear are particularly troublesome and can impact quality of life.
A common problem that affects more than 50 million Americans is tinnitus. With tinnitus, an abnormal ear noise such as roaring or ringing is heard in the ear. The noise has nothing to do with actual sound waves in the ear, but rather, is a “phantom” sound that’s heard either intermittently, or all the time. It can develop in the outer, middle or inner ear — and it can affect not only hearing, but balance too.
Tinnitus is challenging to diagnose and treat. It can be caused by many things and is generally a symptom of an underlying condition, such as damage to the inner ear by illness, injury or abnormal tissue growth.
Tinnitus can occur in one or both ears. The phantom sound can be constant or occur in episodes, and can be accompanied by vertigo — a spinning sensation or loss of balance. The condition can be caused by excess fluid, infection, disease of the middle ear bones or ear drum, advancing age, loud noise exposure, or medication. There are more than 200 medications — over-the-counter and prescription drugs — known to cause balance disorders. Sometimes, discontinuing the medication will reverse hearing and balance problems, but permanent damage is possible.
According to the American Speech-Language-Hearing Association, tinnitus can be brought on by a variety of conditions, including impacted wax in the outer ear, an ear infection, middle ear tumors, vascular problems (circulation disorders), noise-induced hearing loss, heart problems, TMJ (chronic inflammation of the jaw), auditory nerve tumors, epilepsy, or Meniere’s disease, a disorder of the inner ear in which inner ear fluid is not properly regulated.
Unfortunately, for many tinnitus cases, there is no known cause or cure. Often, tinnitus goes away on its own, but if it persists, untreated, it can cause permanent ear noise and disability. Balance issues, an associated symptom, are difficult to manage. While the human body can learn to adapt to reduced balance control, it’s important to see a doctor, since compromised balance can lead to other problems, particularly in seniors who are prone to falls and injuries.
The first step in treating tinnitus is a medical evaluation by your doctor, an ear, nose and throat (ENT) specialist, or an audiologist, if hearing loss is suspected. Other diagnostic tests may include an MRI or CT scan to rule out the small possibility of a tumor on the balance or hearing nerve. Your doctor can locate the cause and recommend medical or surgical treatment, or suggest methods to alleviate tinnitus symptoms, if no identifiable cause can be found.
By Dr. Stephen Tai
Pottstown Memorial Medical Center