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Tinnitus

What is tinnitus?

Tinnitus is the perception of sound heard in one or both ears or the head, without an external source.

The most common causes are age-related hearing loss (presbycusis) and noise exposure [2],
particularly with increasing years of work-related noise exposure [3].

In Australia, around 14-20% of people are estimated to experience tinnitus at some point in their life, and 25% of the Australian workforce experience tinnitus: 15% occasional, 5% intermittent and 6% constant) [1].

Watch a 2 minute video on our tinnitus research

The most common causes are age-related hearing loss (presbycusis) and noise exposure [2], particularly with increasing years of work-related noise exposure [3].

The myriad other possible causes include [1,2,4]:

  • Impacted ear wax
  • Chronic middle ear infection or ear drum perforation
  • Ear trauma
  • Otosclerosis (abnormal bone changes in middle ear)
  • Tumour of the auditory nerve
  • Medications e.g. aspirin, certain antibiotics
  • High blood pressure
  • Ménière’s disease
  • Temporomandibular joint dysfunction
  • Tumour/malformation of blood vessel
  • Exposure to certain solvents or carbon monoxide
  • Insufficient sleep
  • Excessive caffeine or alcohol

Tinnitus is diagnosed and assessed by:

  • Taking a history – such as presence in one or both ears, pulsing or not, hearing loss
  • Questionnaires
  • An examination – including visualisation of ears with an otoscope, neurological examination, and referral for audiological testing (summarised in Table 1) [5]
  • Sometimes other tests such as scans

TABLE 1

Summary of audiological testing

Pure-tone audiometry
  • Hearing tests at a range of frequencies and volumes
  • Performed in special test booth/room or with
  • Sound-attenuating headset
Tympanometry
  • Assesses middle ear and eustachian tube function
  • Test uses a probe-like device that alters ear pressure
Specific tinnitus tests
  • Test recreates tinnitus as a way of measurement
  • Test finds sounds that mask tinnitus

The 80-to-90 rule (volume 80% of maximum for < 90 minutes daily) is advised to reduce noise exposure as well as wearing ear protection. Employers can also ensure workers do not exceed occupational health limits, and are monitored with regular audiometry [2].

Research at the Bionics Institute into a new diagnostic tool for tinnitus

The Bionics Institute are developing an objective test of tinnitus, to aid diagnosis; facilitate more accurate symptom monitoring, and accelerate development of new treatments.

• The test uses technology called functional near-infrared spectroscopy (fNIRS) to track changes in brain activity

• A special cap is used to shine near-infrared light over the head while listening to sounds

• Measurements of the light reflected back into sensors in the cap indicate variations in blood oxygen which are analysed using software

• The results of research studies have shown measurable differences between people with and without tinnitus, and distinguishing between subjective severities.

With your help, we can accelerate the evolution of this device, improving the diagnosis of tinnitus.

Read more

With your help, we can accelerate the evolution of this device, improving the diagnosis of tinnitus.

Your support today could turn the seed of an idea into a new treatment in the future.

Support this research

Medical disclaimer

This article contains general information relating to a medical condition. Such information is provided for informational purposes only and does not replace medical advice given by your healthcare professional.

References

1. Lewkowski K, Heyworth J, Ytterstad E, Williams W, Goulios H, Fritschi L. The prevalence of tinnitus in the Australian working population. Med J Aust [Internet]. 2021 Feb 7 [cited 2022 Feb 14];216(4):1–5. Available from: https://www.mja.com.au/journal/2022/216/4/prevalence-tinnitus-australian-working-population

2. Wu V, Cooke B, Aud M, Eitutis S, Matthew M, Simpson TW, et al. Approach to tinnitus management. Can Fam Physician [Internet]. 2018 [cited 2022 Feb 14];64:491–5. Available from: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC6042678/pdf/0640491.pdf

3. Bhatt JM, Lin HW, Bhattacharyya N. Tinnitus Epidemiology: Prevalence, Severity, Exposures And Treatment Patterns In The United States. JAMA Otolaryngol Head Neck Surg [Internet]. 2016 [cited 2022 Feb 14];142(10):959–65. Available from: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC5812683/pdf/nihms940519.pdf

4. NIDCD. What Is Tinnitus? — Causes and Treatment [Internet]. 2014 [cited 2022 Feb 14]. p. 1–4. Available from: https://www.nidcd.nih.gov/sites/default/files/Documents/health/hearing/NIDCD-Tinnitus.pdf

5. Esmaili AA, Renton J. A review of tinnitus. AJGP [Internet]. 2018 [cited 2022 Feb 14];47(4):205–8. Available from: https://www1.racgp.org.au/getattachment/778ff020-ed5b-488a-9785-ce4e7918e4b9/Tinnitus.aspx

6. Tunkel DE, Bauer CA, Sun GH, Rosenfeld RM, Chandrasekhar SS, Cunningham ER, et al. Clinical practice guideline: Tinnitus. Otolaryngol – Head Neck Surg (United States) [Internet]. 2014 Oct 1 [cited 2022 Feb 14];151(25):S1–40. Available from: https://journals.sagepub.com/doi/pdf/10.1177/0194599814545325

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