Causes and Symptoms of Tinnitus in Singapore

What is Tinnitus?

Tinnitus typically refers to the ringing in either one or both of your ears in Singapore, in which only the person with tinnitus can hear. This ringing happens intermittently or continuously in varying degrees of volume. Although tinnitus has often been linked to hearing loss, it does not cause hearing loss and the reverse is neither true. There have, in fact, been instances where people with tinnitus become acutely sensitive to sound.

Tinnitus is a common problem, affecting about 15% to 20% of people. In severe cases, tinnitus can make it difficult for people to concentrate or fall asleep. It may eventually disrupt your daily life, resulting in psychological stress.

What causes Tinnitus?

The following can lead to tinnitus:

  • When the hairs in your ear, responsible for receiving sound waves, bend or break as you grow older or when you are frequently exposed to excessive noise
  • An ear blockage or infection can cause pressure in your ears
  • An injury to the neck or head can damage the inner ear, and/or the nerves and brain function linked to hearing
  • Several medications (e.g. non-steroidal anti-inflammatory drugs, certain antibiotics, cancer drugs, and antidepressants) are known to cause tinnitus. Generally, a higher dosage of these medications will worsen tinnitus. On the flipside, the ringing disappears when the dosage is lowered or medication no longer consumed.

In addition to the list above, other causes of tinnitus include problems with the ear, chronic health issues, and conditions affecting the nerves in the ear or the hearing centre in the brain. Examples are:

  • Otosclerosis, or the stiffening of the bones in the middle ear, can affect hearing and cause tinnitus. This abnormal one growth tends to run in the family.
  • Eustachian tube dysfunction is a condition in which the small tube that runs directly from the back of your throat to your ears remains expanded at all times, giving you a plugged sensation in your ear.
  • Muscle spasms in the ear – and they sometimes happen for no explainable reason – can result in tinnitus, hearing loss, and a plugged sensation in the ear.
  • Tinnitus can be an early indicator of Meniere’s disease – an inner ear disorder caused by abnormal inner ear fluid pressure.
  • Acoustic neuroma, a non-cancerous brain tumour that can affect balance and hearing.
  • Neck or jaw problems, as in Temporomandibular joint (TMJ) disorders, blood vessel disorders, and other chronic conditions, like diabetes and thyroid problems, have been associated with tinnitus.

What are the symptoms of Tinnitus?

There are two types of tinnitus and symptoms would depend on which type of tinnitus you have:

  • Subjective tinnitus is a case where only you can hear the noise. This noise varies in pitch – from a very low roar to a high squeak – and you may hear it in either one or both ears. In some extreme cases, the noise can be so loud you are unable to concentrate or hear external sound.
  • Pulsatile tinnitus is a case where tinnitus occurs as a rhythmic pulsing or whooshing sound, in time with your heartbeat. Pulsatile tinnitus is quite rare.

Is Tinnitus painful?

Research has shown that tinnitus and pain have many similarities. But precisely so, two individuals who demonstrate identical tinnitus loudness and pitch matches may be affected in significantly different ways.

Who is at risk of Tinnitus in Singapore?

As you grow older, you become more susceptible to suffering from tinnitus because the number of functioning nerve fibres in your ears naturally decline as you age.

Medical conditions such as cardiovascular problems, high blood pressure, obesity, are known to increase the risk of tinnitus. A previous head injury or a history of arthritis may also contribute to the risk factor.

Frequent exposure to excessive noises, such as those by heavy machinery, can lead to noise-induced hearing loss. Hence, those who work in noisy environments (e.g. factory and construction workers) or work with loud music (e.g. musicians) are at higher risk of tinnitus.

Male individuals and smokers are also more likely to suffer from tinnitus.

How is Tinnitus diagnosed in Singapore?

Testing for tinnitus involves a hearing test, a tinnitus questionnaire, and tinnitus pitch matching. This test takes place in a sound-proof room where you will put on earphones that broadcast specific sounds into one ear at a time and you will have to jot down when you hear the sound. Your results will be measured against those considered normal for your age.

Your doctor may ask you to move your eyes, neck, arms and legs, or clench your jaw. If your tinnitus changes or worsens, this may help identify an underlying disorder that needs treatment.

This may be combined with imaging and lab tests. Depending on the suspected cause of your tinnitus, your doctor may order imaging tests such as CT or MRI scans. Your doctor may also draw blood to check for anaemia, thyroid problems, heart diseases, or vitamin deficiencies – all of which are associated with tinnitus.

Tinnitus Treatment in Singapore?

As tinnitus can be caused by a medical condition, there are instances where it subsides once that medical condition is addressed. More often than that, however, tinnitus will persist even after the underlying condition is treated. That is to say, in some way, tinnitus cannot be treated completely.

Instead of treating tinnitus, there are therapies in place to help patients cope with the condition. With the help of therapy, patients may over time notice the ringing in their ears less, so much so that it only becomes noticeable in an absolutely quiet environment. If this quiet time overlaps with bedtime, patients may opt to switch on some soft or white music in the background.

Assistive devices, like hearing aids, may be useful for those experiencing both hearing loss and tinnitus. Hearing aids amplify environmental sounds and as a result, helps with blocking out the noise caused by tinnitus.

Allergy & Sinus ENT Specialist Centre
Head & Neck Surgery Singapore

Dr Soma Subramaniam
Consultant ENT Specialist and Surgeon
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