I wanted to become a surgeon from a very young age and eventually chose ENT surgery for various reasons. Firstly, I had a great mentor when I was a student who was an ENT surgeon. He engaged with me and encouraged me to do research with him which was eventually published. Secondly, ENT surgery is one of only a handful of surgical specialties who see and treat patients of all ages from very small babies to the elderly so the work is very varied.
The other fluid-filled chambers of the inner ear include three tubes called the semicircular canals (vestibular labyrinth). Hair cells in the semicircular canals detect the motion of the fluids when you move in any direction. They convert the motion into electrical signals that are transmitted along the vestibular nerve to the brain. This sensory information enables you to maintain your sense of balance.
Tinnitus (pronounced ti-ni-tis), or ringing in the ears, is the sensation of hearing ringing, buzzing, hissing, chirping, whistling, or other sounds. The noise can be intermittent or continuous, and can vary in loudness. It is often worse when background noise is low, so you may be most aware of it at night when you're trying to fall asleep in a quiet room. In rare cases, the sound beats in sync with your heart (pulsatile tinnitus).

When we hear, sound travels into the ear and then the hearing nerves take the signals to the brain. The brain is then responsible for putting it all together and making sense of the sound. Because the ears don’t know what’s important and what’s not, they send a lot of information to the brain. This is too much information for us to process, so the brain filters out a lot of unnecessary ‘activity’ and background sound, such as clocks ticking or traffic noise.


Subjective tinnitus is the most frequent type of tinnitus. It may have many possible causes, but most commonly it results from hearing loss. When the tinnitus is caused by disorders of the inner ear or auditory nerve it is called otic (from the Greek word for ear).[23] These otological or neurological conditions include those triggered by infections, drugs, or trauma.[24] A frequent cause is traumatic noise exposure that damages hair cells in the inner ear.

As ASD symptoms are subjective, they are easily misunderstood, misdiagnosed or not believed. An inadequate understanding of the symptoms often exacerbates anxiety, and can lead to confusion and distress. The long term symptoms of severe ASD are consistent with severe hyperacusis, or category 4 according to the Tinnitus Retraining Therapy (TRT) system of classification. Some of the most severe cases of hyperacusis seen in my clinic are those with ASD.

Post-lingual deafness is hearing loss that is sustained after the acquisition of language, which can occur due to disease, trauma, or as a side-effect of a medicine. Typically, hearing loss is gradual and often detected by family and friends of affected individuals long before the patients themselves will acknowledge the disability.[41] Post-lingual deafness is far more common than pre-lingual deafness. Those who lose their hearing later in life, such as in late adolescence or adulthood, face their own challenges, living with the adaptations that allow them to live independently.
According to Ramirez et al, at a peripheral level TTTS appears to trigger a series of physiological reactions in and around the ear from tympanic membrane tension and alterations in middle ear ventilation. The tensor tympani muscle is innervated by the motor portion of the mandibular branch of the trigeminal nerve, and the authors consider that TTTS can lead to, and in an efferent pathway be caused by, an abnormal stimulation of the trigeminal nerve. This can lead to a chronic irritation of the trigeminal nerve, as well as other cranial and cervical sensory nerves of the ear and periauricular region. Central sensitisation can develop from the resultant chronic pain, leading to an expansion of the perceived peripheral pain and resulting in the typical symptoms of severe TMD.
Consider education and motivation. Set up training sessions for EU Noise Directive and Acoustic Shocks safety needs – something that can be done by bringing the appropriate and independent expertise from the Health and Safety Executive (HSE) or the Acoustic Safety Programme. Remember: educational methods and materials should be tailored to the specific audience. The goal of education and training is not just to inform, but also to motivate. Dynamic, relevant training will imbue workers with a sense of personal control over their hearing health, lead to the development of intrinsic motivation to adopt positive hearing health.
When the sound waves reach the inner ear, they travel through the fluids of the cochlea. The cochlea is a snail-shaped structure in the inner ear. In the cochlea, there are nerve cells with thousands of miniature hairs attached to them. These hairs help convert the sound wave vibrations into electrical signals that then travel to your brain. Your brain interprets these electrical signals as sound. Different sound vibrations create different reactions in these tiny hairs, signaling different sounds to your brain.

Often interventions to prevent noise-induced hearing loss have many components. A 2017 Cochrane review found that stricter legislation might reduce noise levels.[97] Providing workers with information on their noise exposure levels was not shown to decrease exposure to noise. Ear protection, if used correctly, can reduce noise to safer levels, but often, providing them is not sufficient to prevent hearing loss. Engineering noise out and other solutions such as proper maintenance of equipment can lead to noise reduction, but further field studies on resulting noise exposures following such interventions are needed. Other possible solutions include improved enforcement of existing legislation and better implementation of well-designed prevention programmes, which have not yet been proven conclusively to be effective. The conclusion of the Cochrane Review was that further research could modify what is now regarding the effectiveness of the evaluated interventions.[97]

Besides research studies seeking to improve hearing, such as the ones listed above, research studies on the deaf have also been carried out in order to understand more about audition. Pijil and Shwarz (2005) conducted their study on the deaf who lost their hearing later in life and, hence, used cochlear implants to hear. They discovered further evidence for rate coding of pitch, a system that codes for information for frequencies by the rate that neurons fire in the auditory system, especially for lower frequencies as they are coded by the frequencies that neurons fire from the basilar membrane in a synchronous manner. Their results showed that the subjects could identify different pitches that were proportional to the frequency stimulated by a single electrode. The lower frequencies were detected when the basilar membrane was stimulated, providing even further evidence for rate coding.[130]
A 2017 report by the World Health Organization estimated the costs of unaddressed hearing loss and the cost-effectiveness of interventions, for the health-care sector, for the education sector and as broad societal costs.[103] Globally, the annual cost of unaddressed hearing loss was estimated to be in the range of $750–790 billion international dollars.
Pure tone audiometry, a standardized hearing test over a set of frequencies from 250 Hz to 8000 Hz, may be conducted by a medical doctor, audiologist or audiometrist, with the result plotted separately for each ear on an audiogram. The shape of the plot reveals the degree and nature of hearing loss, distinguishing conductive hearing loss from other kinds of hearing loss. A conductive hearing loss is characterized by a difference of at least 15 decibels between the air conduction threshold and bone conduction threshold at the same frequency. On an audiogram, the "x" represents responses in the left ear at each frequency, while the "o" represents responses in right ear at each frequency.
i am currently studying acoustic shock for a course i am taking. i do also work in a headset environment in a large office. I would be interested to hear of anyones experiences of acoustic shock, temporary real or perceived. i myself suffer from the confused hearing loss, unable to clearly know which direction noises are coming from. especially dangerous when you have police, ambulance or fire engine sirens coming close to you. not knowing the direction they are coming from makes it difficult to remove yourself from their way eg at a roundabout… my sleep is also disturbed on occassion, by low drumming noises. this has only happened over the past 5yrs whilst working a lot on the telephone section of my department. a lot of customers answer the phone whilst holding a screaming baby or have a parrot screeching behind them, some shout down the phone suddenly, the noise seems intensified when it is held in a headpiece….
The initial physiological symptoms of acoustic shock are considered to be a direct consequence of excessive, involuntary middle ear muscle contractions. While the stapedial reflex is an acoustic reflex triggered by high volume levels, the tensor tympani reflex is a startle reflex (6, 7) which is exaggerated by high stress levels. The tensor tympani muscle contracts immediately preceding the sounds produced during self-vocalisation, suggesting it has an established protective function to loud sounds (1), assists in the discrimination of low frequency sounds (8), and is involved in velopharyngeal movements (8).
If there is a change in the system, for example, a hearing loss or ear infection, the amount of information being sent to the brain changes. The brain then responds to this change in levels by trying to get more information from the ear, and the extra information you may get is the sound we call tinnitus. The tinnitus is therefore actually brain activity and not the ear itself! It is generally accepted that it isn’t only a change in the ear that can result in tinnitus, but it could be due to a change in our stress levels, for example, with tinnitus being noticed after periods of significant stress, a change in life circumstances or general wellbeing.

Tinnitus is very common and is reported in all age groups, even young children. About 30% of people will experience tinnitus at some point in their lives but the number of people who live with persistent tinnitus is approximately 13% (over 1 in 8). Tinnitus is more common in people who have hearing loss or other ear problems, but it can also be found in people with normal hearing.
Some people experience a sound that beats in time with their pulse, known as pulsatile tinnitus or vascular tinnitus.[39] Pulsatile tinnitus is usually objective in nature, resulting from altered blood flow, increased blood turbulence near the ear, such as from atherosclerosis or venous hum,[40] but it can also arise as a subjective phenomenon from an increased awareness of blood flow in the ear.[39] Rarely, pulsatile tinnitus may be a symptom of potentially life-threatening conditions such as carotid artery aneurysm[41] or carotid artery dissection.[42] Pulsatile tinnitus may also indicate vasculitis, or more specifically, giant cell arteritis. Pulsatile tinnitus may also be an indication of idiopathic intracranial hypertension.[43] Pulsatile tinnitus can be a symptom of intracranial vascular abnormalities and should be evaluated for irregular noises of blood flow (bruits).[44]
Very regularly we see people who, after exposure to sudden and loud noise, are bothered by tinnitus, hyperacusis, hearing loss, pressure in the ear, aversion and fear of sounds, depression, etc.. However, a hearing test does not show signs of hearing damage or a noise trauma. This is characteristic of an "Acoustic Shock". Usually the symptoms disappear quite quickly, but when the symptoms persist, they speak of an Acoustic Shock Disorder (ASD).
The sound perceived may range from a quiet background noise to one that even is heard over loud external sounds. The specific type of tinnitus called pulsatile tinnitus is characterized by hearing the sounds of one's own pulse or muscle contractions, which is typically a result of sounds that have been created by the movement of muscles near to one's ear, or the sounds are related to blood flow in the neck or face.[8]
^ Global Burden of Disease Study 2013 Collaborators (August 2015). "Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 386 (9995): 743–800. doi:10.1016/s0140-6736(15)60692-4. PMC 4561509. PMID 26063472.
It is estimated that half of cases of hearing loss are preventable.[85] About 60% of hearing loss in children under the age of 15 can be avoided.[2] A number of preventive strategies are effective including: immunization against rubella to prevent congenital rubella syndrome, immunization against H. influenza and S. pneumoniae to reduce cases of meningitis, and avoiding or protecting against excessive noise exposure.[15] The World Health Organization also recommends immunization against measles, mumps, and meningitis, efforts to prevent premature birth, and avoidance of certain medication as prevention.[86] World Hearing Day is a yearly event to promote actions to prevent hearing damage.
^ Global Burden of Disease Study 2013 Collaborators (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.

^ Langguth B, Goodey R, Azevedo A, et al. (2007). "Consensus for tinnitus patient assessment and treatment outcome measurement: Tinnitus Research Initiative meeting, Regensburg, July 2006". Tinnitus: Pathophysiology and Treatment. Progress in Brain Research. 166. pp. 525–36. doi:10.1016/S0079-6123(07)66050-6. ISBN 978-0444531674. PMC 4283806. PMID 17956816.
Ringing/buzzing/humming/ringing are all called tinnitus. The best things you can do are A) avoid loud noise exposure, as noise exposure can make it worse, B) limit your salt and caffeine intake, as both of these have been linked with tinnitus, C) avoid silent environments (i.e. sleep with a fan/radio/podcast on, do homework while listening to music, etc). While there is no cure for tinnitus and no way to make it vanish completely, avoiding loud noise exposure and using gentle background noise are the recommended "treatments."

Repeated loud noise exposure can be a cause of tinnitus as well as hearing loss. Loud music may cause short term symptoms, but repeated occupational exposure (for example, musicians, factory and construction workers) requires less intense sound levels to cause potential hearing damage leading to tinnitus. Minimizing sound exposure, therefore, decreases the risk of developing tinnitus. Sound protection equipment, like acoustic ear-muffs, may be appropriate at work and at home when exposed to loud noises.

Boosting your immune system may also stop ringing in your ears. This will help to protect you from infections and diseases that may increase the level of unwanted sound. Also, an improvement in your health can mean an improvement in your tinnitus. Have a healthy lifestyle, which especially includes a healthy diet, proper and regular exercise, and enough sleep at night.
High-pitched ringing. Exposure to a very loud noise or a blow to the ear can cause a high-pitched ringing or buzzing that usually goes away after a few hours. However, if there's hearing loss as well, tinnitus may be permanent. Long-term noise exposure, age-related hearing loss or medications can cause a continuous, high-pitched ringing in both ears. Acoustic neuroma can cause continuous, high-pitched ringing in one ear.

Hearing loss is a partial or total inability to hear.[5] Hearing loss may be present at birth or acquired at any time afterwards.[6][7] Hearing loss may occur in one or both ears.[2] In children, hearing problems can affect the ability to learn spoken language, and in adults it can create difficulties with social interaction and at work.[8] Hearing loss can be temporary or permanent. Hearing loss related to age usually affects both ears and is due to cochlear hair cell loss.[9] In some people, particularly older people, hearing loss can result in loneliness.[2] Deaf people usually have little to no hearing.[6]
Post-lingual deafness is hearing loss that is sustained after the acquisition of language, which can occur due to disease, trauma, or as a side-effect of a medicine. Typically, hearing loss is gradual and often detected by family and friends of affected individuals long before the patients themselves will acknowledge the disability.[41] Post-lingual deafness is far more common than pre-lingual deafness. Those who lose their hearing later in life, such as in late adolescence or adulthood, face their own challenges, living with the adaptations that allow them to live independently.
This is one psychological approach that can be useful in managing tinnitus. The idea is that when you became aware of your tinnitus, you responded to it negatively. For example, you may have thought there was something seriously wrong with your hearing (a belief) and this led to you being anxious (an emotion), and you then tried to feel better, for example by avoiding silence (a behaviour). Some beliefs and behaviours are helpful and that’s great – keep doing them! But some beliefs and/or behaviours are unhelpful and CBT helps you to recognise them, and then you work together with the clinician (usually a psychologist, audiologist or hearing therapist) to find different ways of responding to the tinnitus so it becomes less bothersome.
Your ear consists of three major areas: outer ear, middle ear and inner ear. Sound waves pass through the outer ear and cause vibrations at the eardrum. The eardrum and three small bones of the middle ear amplify the vibrations as they travel to the inner ear. There, the vibrations pass through fluid in a snail-shaped structure in the inner ear (cochlea).
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If your child has not been born with hearing problems, it is most likely that their hearing loss is temporary. However, some children are born deaf. Each year in the UK, around 840 babies are born with permanent hearing loss. Your child will have a hearing test soon after they’re born (the Newborn Hearing Screening Programme ), so any problems with their hearing can be picked up early on.
Plagued by an unidentified ringing, buzzing, whooshing or other mysterious noise in your ears? It sounds like you may be suffering from tinnitus. Tinnitus is the name for hearing noises that are not caused by an outside source and while it can be extremely frustrating, the good news is it's extremely rare that tinnitus is related to anything more serious.
Itching (pruritis) of the ear due to otitis externa is caused primarily by irritation with foreign objects like a cotton ear swabs, hair pins, pens/pencils and matchsticks. The accumulation of water, dust or dirt, sand and other foreign particles that can enter the ear may also be responsible. An allergic reaction may occur or an infection may arise. Certain itchy skin conditions like psoriasis and eczema may also be responsible for itching of the ear canal.
Tinnitus retraining therapy (TRT). This technique is based on the assumption that tinnitus results from abnormal neuronal activity (see "What's going on?"). The aim is to habituate the auditory system to the tinnitus signals, making them less noticeable or less bothersome. The main components of TRT are individual counseling (to explain the auditory system, how tinnitus develops, and how TRT can help) and sound therapy. A device is inserted in the ear to generate low-level noise and environmental sounds that match the pitch, volume, and quality of the patient's tinnitus. Depending on the severity of the symptoms, treatment may last one to two years.
No. The worst case scenario is that the ringing in your ears may suggest you have permanent tinnitus and this may have a negative impact on your day to day life affecting your concentration, sleep and work performance which may lead to insomnia or depression for example. However, this can be controlled through certain therapies such as sound therapy and other self-help methods, which helps a person cope with tinnitus if it happens to be permanent.
Acoustic shock disorder (ASD) is an involuntary response to a sound perceived as traumatic (usually a sudden, unexpected loud sound heard near the ear), which causes a specific and consistent pattern of neurophysiological and psychological symptoms. These include aural pain/fullness, tinnitus, hyperacusis, muffled hearing, vertigo and other unusual symptoms such as numbness or burning sensations around the ear. Typically, people describe acoustic shock as feeling like they have been stabbed or electrocuted in the ear. If symptoms persist, a range of emotional reactions including post traumatic stress disorder, anxiety and depression can develop.
Globally, hearing loss affects about 10% of the population to some degree.[50] It caused moderate to severe disability in 124.2 million people as of 2004 (107.9 million of whom are in low and middle income countries).[13] Of these 65 million acquired the condition during childhood.[15] At birth ~3 per 1000 in developed countries and more than 6 per 1000 in developing countries have hearing problems.[15]

Fetal alcohol spectrum disorders are reported to cause hearing loss in up to 64% of infants born to alcoholic mothers, from the ototoxic effect on the developing fetus plus malnutrition during pregnancy from the excess alcohol intake. Premature birth can be associated with sensorineural hearing loss because of an increased risk of hypoxia, hyperbilirubinaemia, ototoxic medication and infection as well as noise exposure in the neonatal units. Also, hearing loss in premature babies is often discovered far later than a similar hearing loss would be in a full-term baby because normally babies are given a hearing test within 48 hours of birth, but doctors must wait until the premature baby is medically stable before testing hearing, which can be months after birth. [56]The risk of hearing loss is greatest for those weighing less than 1500 g at birth.


With the identification of ASD, output limiters in headset equipment have been developed to restrict maximum volume levels transmitted down a telephone line. However, ASD continues to occur despite their use. In my opinion, they are of benefit primarily to help reduce the probability of an initial acoustic incident exposure. The dominant factors of an acoustic incident leading to ASD appear related to the sudden onset, unexpectedness and impact quality of loudish sounds outside the person's control near to the ear(s), rather than to high volume levels alone. If TTTS develops, because of the vulnerability of further escalation to acoustic incidents at lower volume levels, it is impossible to give a 100% guarantee of protection.
Children may be less likely to say they have tinnitus unless they’re questioned about it. It's important that you talk to your child to get an idea of how they are coping and their feelings towards tinnitus. In fact, most children with tinnitus are not bothered by it. If your child does find it upsetting, always be supportive and reassure your child that they are not alone.
If you have good hearing, your doctor may suggest a sound generator. These used to be called masking devices. There are two main types. One is a portable machine that produces calming sounds. The other fits to your ear like a hearing aid and produces a constant low-level noise or tone, sometimes called white noise, masking (covering up) the tinnitus. This may also help your brain get used to the tinnitus. Some people find that sound generators interfere with their hearing while they’re using them.
^ Flamme GA, Deiters K, Needham T (March 2011). "Distributions of pure-tone hearing threshold levels among adolescents and adults in the United States by gender, ethnicity, and age: Results from the US National Health and Nutrition Examination Survey". International Journal of Audiology. 50 Suppl 1: S11-20. doi:10.3109/14992027.2010.540582. PMID 21288063.

^ Global Burden of Disease Study 2013 Collaborators (August 2015). "Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 386 (9995): 743–800. doi:10.1016/s0140-6736(15)60692-4. PMC 4561509. PMID 26063472.
Some people also experience a lot of pressure and pain in the ears. There can also be headache, muscle and joint pain along the neck, and stiffness of the limbs along with a tingling sensation on the top of the head, arms, and legs. In rare cases, there may be some emotional or psychological problems such as anxiety and panic attacks. The person may feel depressed, tired and frustrated. He/she may lose interest in routine activities. These, however, are common psychological side effects of general ill-health.

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This article was medically reviewed by Luba Lee, FNP-BC, MS. Luba Lee, FNP-BC is a board certified Family Nurse Practitioner (FNP) and educator in Tennessee with over a decade of clinical experience. Luba has certifications in Pediatric Advanced Life Support (PALS), Emergency Medicine, Advanced Cardiac Life Support (ACLS), Team Building, and Critical Care Nursing. She received her Master of Science in Nursing (MSN) from the University of Tennessee in 2006. This article has been viewed 3,276,631 times.

This article was medically reviewed by Luba Lee, FNP-BC, MS. Luba Lee, FNP-BC is a board certified Family Nurse Practitioner (FNP) and educator in Tennessee with over a decade of clinical experience. Luba has certifications in Pediatric Advanced Life Support (PALS), Emergency Medicine, Advanced Cardiac Life Support (ACLS), Team Building, and Critical Care Nursing. She received her Master of Science in Nursing (MSN) from the University of Tennessee in 2006. This article has been viewed 3,276,631 times.


This is a meditation technique that is used frequently for pain management, and more recently for tinnitus. The idea is that we tend to resist unpleasant sensations (eg hearing tinnitus). If we stop resisting and allow the unpleasant sensation, this alters our awareness to include more sensations. We start to notice that sensations become less dominant once our attention moves away from them and focuses on a different part of the body. All of this can change in a moment, simply by changing our awareness. If we use mindfulness effectively, we can create some space from the tinnitus and in that space, we can decide how we’re going to respond to it. It’s a wonderful way of achieving ‘peace and quiet’.
Hearing loss in both ears can be either conductive, sensorineural, or a mixture of both. It’s best to see an audiologist whenever you think there is a noticeable change in both your ears. They’ll fully assess your ears and perform a number of tests to determine the type of hearing loss you may have, and they’ll be able to recommend the best treatment option to help.
Tinnitus may be perceived in one or both ears. The noise can be described in many different ways but is reported as a noise inside a person's head in the absence of auditory stimulation. It often is described as a ringing noise, but in some people, it takes the form of a high-pitched whining, electric buzzing, hissing, humming, tinging, whistling, ticking, clicking, roaring, beeping, sizzling, a pure steady tone such as that heard during a hearing test, or sounds that slightly resemble human voices, tunes, songs, or animal sounds such as "crickets", "tree frogs", or "locusts (cicadas)".[4] Tinnitus may be intermittent or continuous: in the latter case, it may be the cause of great distress. In some individuals, the intensity may be changed by shoulder, head, tongue, jaw, or eye movements.[7]
Identification of a hearing loss is usually conducted by a general practitioner medical doctor, otolaryngologist, certified and licensed audiologist, school or industrial audiometrist, or other audiometric technician. Diagnosis of the cause of a hearing loss is carried out by a specialist physician (audiovestibular physician) or otorhinolaryngologist.

Tinnitus is the term for the sensation of hearing a sound in the absence of any external sound. Symptoms of tinnitus are you may hear different types of sound, for example, ringing, whooshing or humming or buzzing in the ear. These can be continuous or they can come and go. The tinnitus might seem like it’s in one ear or both, in the middle of the head or even be difficult to pinpoint. Some people may think the noise is coming from outside and hunt for it until they discover it’s actually inside them!

Conductive hearing loss results when there is any problem in delivering sound energy to your cochlea, the hearing part in the inner ear. Common reasons for conductive hearing loss include blockage of your ear canal, a hole in your ear drum, problems with three small bones in your ear, or fluid in the space between your ear drum and cochlea. Fortunately, most cases of conductive hearing loss can be improved.


Sound waves reach the outer ear and are conducted down the ear canal to the eardrum, causing it to vibrate. The vibrations are transferred by the 3 tiny ear bones of the middle ear to the fluid in the inner ear. The fluid moves hair cells (stereocilia), and their movement generates nerve impulses which are then taken to the brain by the cochlear nerve.[75][76] The auditory nerve takes the impulses to the brainstem, which sends the impulses to the midbrain. Finally, the signal goes to the auditory cortex of the temporal lobe to be interpreted as sound.[77]
▶ If inner ear disorders is due to an infection, then medications are prescribed to control or manage the symptoms of the infection. In case the infection is due to a bacterial infection, antibiotics are prescribed to clear it up. For people who are suffering from vertigo due to inner ear disorders, vestibular therapy is often recommended, and is highly effective.

Most tinnitus is subjective, meaning that only you can hear the noise. But sometimes it's objective, meaning that someone else can hear it, too. For example, if you have a heart murmur, you may hear a whooshing sound with every heartbeat; your clinician can also hear that sound through a stethoscope. Some people hear their heartbeat inside the ear — a phenomenon called pulsatile tinnitus. It's more likely to happen in older people, because blood flow tends to be more turbulent in arteries whose walls have stiffened with age. Pulsatile tinnitus may be more noticeable at night, when you're lying in bed and there are fewer external sounds to mask the tinnitus. If you notice any new pulsatile tinnitus, you should consult a clinician, because in rare cases it is a sign of a tumor or blood vessel damage.
A 2005 study achieved successful regrowth of cochlea cells in guinea pigs.[119] However, the regrowth of cochlear hair cells does not imply the restoration of hearing sensitivity, as the sensory cells may or may not make connections with neurons that carry the signals from hair cells to the brain. A 2008 study has shown that gene therapy targeting Atoh1 can cause hair cell growth and attract neuronal processes in embryonic mice. Some hope that a similar treatment will one day ameliorate hearing loss in humans.[120]

Hearing loss can be inherited. Around 75–80% of all these cases are inherited by recessive genes, 20–25% are inherited by dominant genes, 1–2% are inherited by X-linked patterns, and fewer than 1% are inherited by mitochondrial inheritance.[55] Syndromic deafness occurs when there are other signs or medical problems aside from deafness in an individual,[55] such as Usher syndrome, Stickler syndrome, Waardenburg syndrome, Alport's syndrome, and neurofibromatosis type 2. Nonsyndromic deafness occurs when there are no other signs or medical problems associated with an individual other than deafness.[55]

It is not a disease or illness; it is a symptom generated within the auditory system and usually caused by an underlying condition. The noise may be in one or both ears, or it may feel like it is in the head. It is difficult to pinpoint its exact location. It may be low, medium or high pitched and can be heard as a single noise or as multiple components.
Tinnitus is usually more noticeable in a quiet environment. It’s a bit like candles on a birthday cake – in the lights, the candles aren’t very bright but if you turn the lights off, the candles seem much brighter. With tinnitus, when there is other sound, it doesn’t seem that loud, but when you turn all the other sound off, the tinnitus seems much more noticeable.
The diagnosis of tinnitus is based on the patient’s history. Questionnaires also help assess how much the tinnitus is impacting the patient’s quality of life. The diagnosis can be supported with a neurological examination, an audiogram, and medical imaging if necessary. In rare cases, the clinician can hear the ringing sound using a stethoscope. (This is known as objective tinnitus.) Prevention of tinnitus involves avoiding loud noises and seeking appropriate treatment to prevent the condition from worsening.
Tinnitus may be perceived in one or both ears. The noise can be described in many different ways but is reported as a noise inside a person's head in the absence of auditory stimulation. It often is described as a ringing noise, but in some people, it takes the form of a high-pitched whining, electric buzzing, hissing, humming, tinging, whistling, ticking, clicking, roaring, beeping, sizzling, a pure steady tone such as that heard during a hearing test, or sounds that slightly resemble human voices, tunes, songs, or animal sounds such as "crickets", "tree frogs", or "locusts (cicadas)".[4] Tinnitus may be intermittent or continuous: in the latter case, it may be the cause of great distress. In some individuals, the intensity may be changed by shoulder, head, tongue, jaw, or eye movements.[7]

▶ For most inner ear problems, a sodium-restricted, caffeine-free diet is recommended. Caffeine is a central nervous system stimulant and its intake makes the symptoms of inner ear disorder (especially headache and dizziness) appear more pronounced. Hence, it is advisable to reduce the intake of caffeine as much as possible till the condition is completely treated. Excess sugar in the diet also triggers dizziness.
^ Global Burden of Disease Study 2013 Collaborators (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
The potential severity and persistence of ASD symptoms have significant clinical and medico-legal implications. With the rapid growth of call centres around the world, professionals providing tinnitus and hyperacusis therapy, as well as general practitioners, ENT specialists, occupational physicians, TMD specialists, neurologists and trauma psychologists/psychiatrists, are increasingly likely to encounter some or all of the cluster of ASD symptoms in their clients.
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There is a progressive loss of ability to hear high frequencies with aging known as presbycusis. For men, this can start as early as 25 and women at 30. Although genetically variable it is a normal concomitant of ageing and is distinct from hearing losses caused by noise exposure, toxins or disease agents.[46] Common conditions that can increase the risk of hearing loss in elderly people are high blood pressure, diabetes, or the use of certain medications harmful to the ear.[47][48] While everyone loses hearing with age, the amount and type of hearing loss is variable.[49]

Besides research studies seeking to improve hearing, such as the ones listed above, research studies on the deaf have also been carried out in order to understand more about audition. Pijil and Shwarz (2005) conducted their study on the deaf who lost their hearing later in life and, hence, used cochlear implants to hear. They discovered further evidence for rate coding of pitch, a system that codes for information for frequencies by the rate that neurons fire in the auditory system, especially for lower frequencies as they are coded by the frequencies that neurons fire from the basilar membrane in a synchronous manner. Their results showed that the subjects could identify different pitches that were proportional to the frequency stimulated by a single electrode. The lower frequencies were detected when the basilar membrane was stimulated, providing even further evidence for rate coding.[130]

Noise is widely recognized as an occupational hazard. In the United States, the National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA) work together to provide standards and enforcement on workplace noise levels.[90][91] The hierarchy of hazard controls demonstrates the different levels of controls to reduce or eliminate exposure to noise and prevent hearing loss, including engineering controls and personal protective equipment (PPE).[92] Other programs and initiative have been created to prevent hearing loss in the workplace. For example, the Safe-in-Sound Award was created to recognize organizations that can demonstrate results of successful noise control and other interventions.[93] Additionally, the Buy Quiet program was created to encourage employers to purchase quieter machinery and tools.[94] By purchasing less noisy power tools like those found on the NIOSH Power Tools Database and limiting exposure to ototoxic chemicals, great strides can be made in preventing hearing loss.[95]
Tinnitus is commonly described as a ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It may be soft or loud, high pitched or low pitched. You might hear it in either one or both ears. Roughly 10 percent of the adult population of the United States has experienced tinnitus lasting at least five minutes in the past year. This amounts to nearly 25 million Americans.
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