American Medical Association Family Medical Guide - American Medical Association [718]
Alerting devices
Alerting devices can make a person aware of sounds and help him or her communicate. Some alerting devices use light or vibrations to make a person aware of sounds. For example, the light on a lamp may flash to indicate that a doorbell is ringing, or a telephone may vibrate to indicate that it is ringing. Communication devices such as closed captioning on televisions allow a person to read what is being said, while devices such as text telephones allow conversations to be read rather than heard.
Tinnitus
Tinnitus is hearing ringing or other noises in the ear when there is no external source of sound. Tinnitus is a symptom, not a disease. It often results from an underlying condition such as an earwax blockage (see page 1025). The most common cause of tinnitus is hearing loss as a result of damage to the hair cells in the cochlea (which conveys sound information to the brain), usually caused by aging or exposure to loud noise (see page 1015). Taking some medications—such as aspirin or other nonsteroidal anti-inflammatory drugs, antidepressants, or some antibiotics—can also cause tinnitus. Some conditions—such as allergies, tumors that affect the auditory or facial nerves, or diabetes—can increase a person’s risk of tinnitus.
Symptoms and Diagnosis
Tinnitus is characterized by hearing noises such as ringing, buzzing, or humming in one or both ears. The noise may vary in frequency and volume from high to low.
To evaluate tinnitus, your doctor will probably take a detailed health history, examine your ears, and ask you about any prescription or over-the-counter medications you are taking. He or she will probably refer you to an otolaryngologist (a doctor who specializes in disorders of the ear, nose, and throat) for an evaluation. You may have hearing tests (see page 1016), a CT scan (see page 112), X-rays (see page 109), or an MRI (see page 113) to rule out possible causes other than damage to your ear.
Treatment
The treatment of tinnitus depends on the cause. For example, if tinnitus is caused by a medication you are taking, your doctor will ask you to stop taking the medication or will recommend or prescribe a different one. Tinnitus caused by a medical condition can be corrected by treating the condition. Tinnitus that occurs as the result of aging or noise damage is difficult to treat. If a person has significant hearing loss, a hearing aid often can help. For people whose tinnitus causes insomnia, doctors may recommend supplements of melatonin (a hormone that regulates the body’s sleep cycle) or sleep medication. Because tinnitus is usually worse when it’s quiet, some people try devices called tinnitus maskers, which produce a variety of soft sounds—such as white noise—to help mask or cover up the noise heard in tinnitus.
Disorders of the Middle Ear
The most common disorders of the middle ear are infections and damage to the eardrum. Infections of the middle ear are often caused by bacteria or viruses, which enter the middle ear via the bloodstream, through a perforated eardrum, or along the eustachian tube from the back of the nasal cavity. A buildup of fluid in the middle ear is a frequent cause of hearing loss in middle ear disorders, especially in children.
Middle ear
Barotrauma
Normally, because of air passing through the eustachian tube, the air pressure in the middle ear is the same as the air pressure in the outer ear. But if the eustachian tube becomes blocked—such as from a cold, sinus infection, or nasal allergies—an imbalance between the pressure in the middle ear and the pressure in the outer ear can result. This imbalance in pressure, called barotrauma, can stretch the eardrum, causing pain.
Barotrauma often occurs when a person who has a nose or throat infection travels in an airplane. The ascent of the plane lowers the air pressure in the cabin. If the eustachian tube does not open normally, air pressure in the middle ear becomes greater than