Every other Friday, the Outside/In team here at NHPR answers listener questions about the natural world. This week's question comes from Heidi on Instagram. She asked:
“What is tinnitus? And how can we help somebody who is living with it?”
Producer Taylor Quimby was listening and has this answer.
Transcript
This has been lightly edited for clarity.
Taylor Quimby: Let’s get one thing straight right off the bat. To-MAY-to, To-MAH-toe, TIN-it-us, tih-NITE-us. Either pronunciation is correct—which is fitting, because this is one symptom that’s hard to pin down.
Sarah Theodoroff: Tinnitus is an umbrella term, and there's multiple kinds of tinnitus.
Taylor Quimby: Sarah Theodoroff is an audiologist and hearing scientist at VA Portland—that’s VA as in the Veterans Affairs Department.
Sarah Theodoroff: Almost any way that you can think of to describe sound, somebody has told me their tinnitus sounds like that.
Taylor Quimby: So tinnitus can be tonal…
[tone]
Taylor Quimby: It can be humming…
[humming sound]
Taylor Quimby: It can be buzzing…
[buzzing sound]
Taylor Quimby: And, as anybody who’s ever seen a war movie knows, it can be that high-pitched ringing after an explosion.
[pause]
Taylor Quimby: What did you think I was going to play a clip here? I’m not a monster.
Anyway. That movie cliché is a cliché for a reason — because tinnitus is a major issue among veterans. But in most cases, it is not an actual sound.
Sarah Theodoroff: There’s a signal or a pattern of activity that’s being interpreted as sound.
Taylor Quimby: But there was a time when scientists thought tinnitus was primarily an ear problem. This led researchers in the 1980s to try some pretty drastic sounding measures.
Tara Zaugg: And so they would cut the auditory nerve, understanding that that would cause a person to be deaf in that ear, with the assumption that that would make tinnitus go away. For some people the tinnitus did go away … but for most people it didn't.
Taylor Quimby: This is Tara Zaugg, is an audiologist and clinical lead with a region of the VA called VISN20. And what she’s saying is that most of the time, the real issue is not in the ear, but in the brain.
Sarah Theodoroff: So it's as if the brain's background activity. You can think of it as being tied to a volume dial, and that dial has been turned up. So it's more at the level of the brain, not the ear.
Taylor Quimby: It’s less common, but in some cases tinnitus does have a more physical cause, like a muscle spasm in the middle ear.
Sarah Theodoroff: If that vibration propagates, makes the eardrum move, the bones in that middle ear move and sends a signal to the inner ear to the brain, you might be hearing that as sound.
Taylor Quimby: But, frankly, we don’t always know why it’s happening. For many of us, it can be short-term and not a big deal. Anybody who's ever seen a Metallica show has probably had a little bout of tinnitus. But when people are exposed to too much noise, too often, it can become a chronic issue.
Tara Zaugg: So, for example, people who are living on an aircraft carrier and their bunk is near the engine, they're constantly around sound. And if they're wearing hearing protection, it's better than not wearing any but they’re jet engines! Even if you've got hearing protection in, they’re still going to be exposed to too much sound.
Taylor Quimby: Because of exposure to everything from guns and choppers to IEDs, tinnitus has been the top disability for veterans receiving compensation for over a decade. And in many of those cases, it can be accompanied by anxiety, depression, PTSD, and other issues.
Tara Zaugg: For the people who are seeking care for tinnitus who are really struggling with tinnitus, it's it's not usually a super straightforward situation. There are usually a lot of things going on.
Taylor Quimby: All this helps explain the benefit of the VA’s integrative healthcare system. An audiologist can bring in a mental health professional, or vice versa. And it’s especially important because one of the hardest things about chronic tinnitus is that, most of the time, it’s there to stay. There’s no cure.
But there are coping strategies. 80% of people with tinnitus also have some hearing loss. Some people pop in hearing aids and — bam — the tinnitus is less of an issue.
In other cases, patients can try cognitive behavioral therapy, or play comforting sounds to make their sonic environment more pleasing. Doesn’t sound flashy, but the research says it helps.
Tara Zaugg: Whatever expertise you have on working with chronic pain. You can almost replace the word chronic pain with tinnitus. Those skills apply.
Taylor Quimby: And a word on prevention: if you’re going to see a concert, don’t forget your earplugs.
For more information about tinnitus from the VA, check out the National Center for Rehabilitative Auditory Research.
If you’d like to submit a question to the Outside/In team, you can record it as a voice memo on your smartphone and send it to outsidein@nhpr.org. You can also leave a message on our hotline, 1-844-GO-OTTER.
