Tinnitus suffering IV. - Concentration difficulties

Anxiety, depression and lack of sleep - all that inevitably brings concentration difficulties (decreased ability to focus on doing something). Although concentration problems could have anyone, by tinnitus it is more serious: not only severe inability to concentrate on work, but often also concentration during talk with friends or colleagues is disturbed. The work remains unfinished or poorly done, communication is complicated. To ease concentration difficulties one must at first alleviate the symptoms of other mentioned mental disturbances.

Tinnitus suffering III. - Sleep disorder

source: flickr

By tinnitus is at most affected your sleeping. A lack of sleep escalates depression, anxiety and creates concentration difficulties. It is simply a serious problem, that can surely erode overall health a life quality. Without enough sleeping may arise health problems and also many aspects of life are complicated. Due to low performance at work one could lost his job. Because person suffering from tinnitus looks generally healthy, thus other people could consider him lazy and think, that he only constantly using various unreal excuses. Overall reliability at work or in social life is downgrading, relationships are getting worser.

Use of melatonin can help - 3 or 5 mg taken before bedtime. Ringing in the ears should be masked, using nature sounds, silent noise, music from the radio or a combination of these things - personally use all three at once. Also, use of benzodiazepines - drugs for anxiety, can have a positive effect.

Anatomy of human ear II. – How work hair cells

Although I am no scientist, I can understand basic principle of hair cells functioning. They are cells of special type and their purpose is to transform mechanic sound waves of acoustic pressure into electrical signals, which is send through Cochlear nerve into hearing centre of brain. On the surface of hair cells there are hair-like projections – stereocilia. Stereocilia are stimulated by incoming sound wave and start to vibrate (they are bending back and forth), and that leads to generating electrical impulses through changes within the hair cells.
Because of aging, hair cells are losing stereocilia and with them also sensitivity to sound – that is natural process. But that could happen also in one moment when one is exposed to acoustic trauma.

Video on functioning of stereocilia in laboratory conditions:



Keep in mind:

One must always keep in his mind, that heavily damaged hair cells die and are replaced with so called support cells. Human hair cells, in contrast with birds, fishes or reptiles, does not regenerate naturally, and up until now there is no known way to regenerate or to stimulate growth of new hair cells medically. Therefore one has to constantly take care about own ears, especially while visiting discotheques, night clubs, music concerts, shooting ranges, fireworks, motorcycles... etc.

More detailed information about hair cells:
http://www.ncbi.nlm.nih.gov/books/NBK10867/

Notched music therapy

Notched music therapy is one of the therapies that are used to relieve ringing in the ears. It belongs to the group a Sound therapies, representing mainly Tinnitus Retraining Therapy and Residual Inhibition.

Notched music therapy works on the basis of theory that tinnitus is a result of maladaptive plasticity in the central pathway auditors. The original tinnitus signal is most often triggered by hearing loss. Based on the auditors neural input deprivation, the excitation-inhibition balance in the central auditors pathway is disturbed, most probably by the weakening of inhibitors networks. Consequently, maladaptive brain changes lead to neuronal hyperactivity, increased neuronal synchrony, and possibly burst firing. All these phenomena have been shown to be associated with the tinnitus perception.

Principle of Notched music therapy is quite simple - the patient chooses music according to his taste, which is adjusted so that frequencies corresponding to his own tinnitus are removed. 

This therapy is applicable not only to music files, according to one study it had a good results with removing tinnitus frequencies of white noise (called windowed sound therapy - WST):

http://www.tinnitusjournal.com/detalhe_artigo.asp?id=48

Conclusions of the WST study are questionable, because they did not confirm that the WST significantly reduced subjective tinnitus volume, but its effectiveness can not be entirely ruled out.

I have not tried Notched music therapy and although I cannot dismiss positive results for some patients, I do not trust this therapy too much. It contradicts the theory of residual inhibition, which I had successfully tested and use it for now. But who knows...? Tinnitus is still "unexplored land" and thus cannot be excluded, that after a intensive and sufficiently long use of Notched music therapy some patients may show positive results.

Most common tinnitus cause III. - Dangerous decibels

source: freeimages.com

Noise is actually the sound pressure measured in decibels (dB) - who is interested in detailed information can read, for example, more on Wikipedia . The main thing that interests us is that decibels are measured logarithmically. In case of sound pressure it means that for every 3 decibels more it has double the energy. For example, the sound with intensity of 13 decibels two times more "noisier" than the sound with intensity of 10 decibels. Sound intensity 16 dB is 2x louder than the sound intensity 13 dB and up to 4 times louder than the sound of an intensity of 10 dB - etc.

Healthy human ear can usually register sounds for intensity of 0 dB - this is the threshold point. Some extremely sensitive individuals can hear sounds even weaker and theoretically should have gone in the measurement of auditory sensitivity to minus values. Simply, the human ear is extremely sensitive organ and is not designed for prolonged toleration of loud noise.

It's good to remember :

Danger to human hearing begins at around 85 dB. Normal human ear can withstand continuous noise of this intensity without damage for about 8 hours a day. Every 3 dB more, shortens time by half. So e. g. 91 dB is a safe value for only two hours a day, then we should take a rest for the day. Of course it also depends on the sensitivity of a particular individual, someone can endure more, someone less. Noise with an intensity of 130 dB and higher causes hearing damage almost immediately.

Tinnitus suffering II. - Depression

source: flickr

As tinnitus persists for a longer time span, anxiety is gradually replaced by depression accompanied with despondency, hopelessness and loss of meaning of existence. Tinnitus removes from life all joy and cheer. I personally went through it and know what it is. Depression is a worse condition than anxiety, one will neglected himself and completely loses all his interest for future and life. At this stage it is necessary to have the support of his loved ones. However, it has one advantage - for it shows you, who are real friends and who not. You can find true value of relationships and the people around you.

What to do about depression? There are a lot of antidepressants, but be careful. Tricyclic antidepressants could make tinnitus worse - I personally have not tried any antidepressant just because of this. So if you want to do it like me, my advice for depression are as follows:

1. Sport is good. During intensive sport activity your body releases hormones of happiness, it can get you in the mood for hours. Personally, I use to go jogging and body workout.
2. Start living healthier. Adjust diet. Skip some meals, especially with increased content of sugar and reduce pastries. Stop smoking and drink alcohol only to a limited extent, or skip it altogether. Drink a soothing herbal teas.
3. Hobbies – try to find more time for hobbies. It will be not easy, but it turn off the depression at last.

Meniere`s disease

Vincent van Gogh (dutch painter)
suffered Meniere's disease.

Meniere's disease or Menier syndrome is one of causes of tinnitus accompanied also with dizziness (vertigo) and fluctuant hearing loss. Source of these problems is not yet exactly defined, it is assumed that this syndrome relates to autoimmune disorder, when human body itself continually eliminates cells of vestibular system; it could be related to increased pressure in inner ear as well as to consequence of some infection.

Symptoms, such as dizziness and partial hearing loss in lower frequency range (in contract with acoustic trauma, by which there is hearing loss in middle and high-pitched frequencies), are temporary, but in case of not being cured they could escalate and become persistent. One can repress them by balanced food with plenty of vitamins and also using vasodilating medications.

More info on this issue:

http://www.nidcd.nih.gov/health/balance/pages/meniere.aspx

Barotrauma of the ear

source: wikimedia

Sudden change in ambient pressure can cause ringing in the ears. Scuba divers or pilots of aircraft that are not equipped with a pressurized cabin are most threatened. Also, ordinary passengers in transport aircraft may be under threat, if they have problems with pressure compensation, because in these planes usually occurs some pressure instability. So, if you have problems with Eustachian tube, it is better to avoid flying or scuba diving.


Barotrauma is actually mechanical damage to structure of inner ear by excessive pressure changes. In certain way it is comparable to acoustic trauma. The primary treatment for barotrauma are the same procedures as for other disorders of inner ear, ie hyperbaric oxygen therapy, corticosteroids, vasodilatation.

Environment	Typical ambient pressure (standard atmospheres)
Hard vacuum of outer space	0 atm
Top of Mount Everest	0.333 atm
Pressurized passenger aircraft cabin altitude 8000 ft (2,400 m)	0.76 atm
Sea level atmospheric pressure	1 atm
10m depth in seawater	2 atm
20m depth in seawater	3 atm
Recreational diving depth limit cca. 130 ft (40 m)	5 atm
Common technical diving depth limit cca. 330 ft (100 m)	11 atm
Maximum ambient pressure a human has survived	54 atm

Residual inhibition

Residual Inhibition is a very interesting phenomenon, which I have basically recognized myself, and later I have learned that it was discovered by James Spalding (or Spaulding, not sure about this) in 1903. This phenomenon was not further investigated until the early seventies of the 20th century.

One of the theories about Residual Inhibition says that tinnitus itself is actually compensation of missing frequencies (originally heard by auditory cells that died) in the auditory center of the brain. When tones very close to to the missing frequencies reach the center, brain stops compensating and tinnitus is muted or disappears for a while.
Personally, however, I think that this theory does not make any sense as by this compensation brain causes suffering to itself.

Several attempts were made to demonstrate the efficacy of Residual Inhibition. It is not yet entirely clear why this is happening, tinnitus is still relatively little explored phenomenon, but the fact is that according to research, this therapy works on average for 5 to 8 of 10 people suffering from tinnitus, for whom, after hearing the same tone externally, disappears their own internal tone for a few seconds to minutes. The ratio of success varies according to different researches, but in any case, 50 per cent or more is a decent result.

There may be long-time or even permanent effects of Residual Inhibition:

• The most extreme case of the permanent outcome of Residual Inhibition was recorded by Jack Vernon, co-founder of ATA (American Tinnitus Asociation). When a patient who suffered from tinnitus 61 years, after listening to the tone for one minute was completely free from ringing in ears for eight weeks.
• For another patient suffering from tinnitus for 20 years, it was enough to undergo Residual Inhibition 15 minutes a day to cancel tinnitus for twelve hours.
• In my case after about four weeks of listening to 4600Hz tone in the right ear, tinnitus of the same frequency had disappeared permanently. I was listening to a very moderate volume and only intermittently. For lower frequencies my tinnitus is still there, but Residual Inhibition helps me to stop perceiving them temporarily.
• There are plenty of other similar cases.

Residual Inhibition is a safe therapy and in any case there is no hearing damage or deterioration of the condition, however there are few documented cases where the tinnitus temporarily worsened. This deterioration was back to normal after a minute. In such case, it is pointless to use the Residual Inhibition.

In my opinion at the moment this is one of the most effective non-invasive therapy that will help us overcome the time until the real cure is discovered.

Sound of tinnitus of music composer Bedrich Smetana

Famous czech composer Bedrich Smetana, who lived in 19th century (this year was 190th birth anniversary and 130th death anniversary), suffered with deafness and also with tinnitus (it happened in year 1874 and it continued until his death, thus its 140th anniversary - strange indeed!). In one of his works, Quartet No. 1 in E Minor (subtitled "From my life" - with autobiographical character), he placed sound which corresponded with his tinnitus - a constant high-pitched tone played by violin. You can hear it now:

Anatomy of human ear I. – An overview

I do not want to bother reader with wide explanation and therefore I provide only quick overview. Human ear, like ear of all mammals, consists of three main parts: outer ear, middle ear and inner ear.

Anatomy of human ear

Outer ear

Outer ear serves to gather sound waves and to lead them into external auditory canal, which is capped with drum called tympanic membrane. This membrane transfers vibrations further into middle ear.

Middle ear

Tympanic membrane carries sound forward to three bones named: hammer (malleus), anvil (incus), and stirrup (stapes). They amplify the sound (nearly thirty times) and bring it to the snail-shaped organ called cochlea, which is already element of inner ear.

Inner ear

Inner ear is neurosensory part of ear, which is literally “electronics” of ear as a whole – and it is highly sensitive to damage. Cochlea or cochlear apparatus or Organ of Corti is placed directly in cranial bone and it contains around 16000 neurosensory hearing cells called hair cells. These are of two types: inner hair cells (IHC) and outer hair cells (OHC). Function of IHC is to change sound waves to electric signal, which goes through auditory nerve or Cochlear nerve into brain. OHC serve as additional amplifier of those signal.
Damaged hair cells (most often by acoustic trauma) can't accomplish their purpose and outcome of such state is hearing loss. IHC are in general more resistant to damage than OHC, which are dying sooner and thus amplifying of sound is not sufficient – it results in lower hearing sensitivity.

Here is very illustrative video on this issue:



On the following image we can see the difference between intact and damaged hair cells:

source: pnas.org

Hyperbaric oxygen therapy as tinnitus treatment

If you are so unlucky and ringing in ears suddenly appears, promptly locate the closest medical facility with a hyperbaric chamber. Hyperbaric oxygen therapy (HBO) can significantly reduce symptoms of acoustic trauma, if applied in short time. Best immediately of course, because each day of delay reduces its effect.

HBO has a very large potential and really cures a lot of human ills, from traumatic brain injury after an accident to the complications caused by diabetes.

Hyperbaric chamber (source: wikimedia.org)

A hyperbaric chamber is substantially pressurized tank, where you breath 100% oxygen at higher pressure than atmospheric. Chamber pressure usually resides around 2.5 atmospheres. Such pressure dissolves up to 460% more oxygen in the blood than the atmospheric pressure. It is not only bound to the hemoglobin of blood cells, but is directly dissolved in the blood plasma and penetrates into the cells by diffusion (remember that auditory cells breathe only by diffusion). Theoretically, if we increase the pressure in the chamber by about 1 more atmosphere, the body would allegedly not need red blood cells for its survival.

With timely application of HBO damaged auditory cells can survive. I have myself attended 36 sessions in a hyperbaric chamber. Unfortunately, I learned about it almost a month after my accident, so its help at that time was only limited. Nevertheless, I believe that without treatment, even though late, I would now have my tinnitus much worse.

See one interesting paper on the basis of experience implies that HBO may be effectivelly used up to 3 months after the acoustic trauma or ototoxic damage:

http://www.ncbi.nlm.nih.gov/pubmed/9547879

Interesting curiosity: During one session in the hyperbaric chamber I have purposely held my breath, so that I can verify purity of oxygen. I endured not to breathe for the whole 5 minutes! While in the atmospheric pressure I can hold breath for less than 40 seconds.

Tinnitus suffering I. - Anxiety

In first moments after onset of tinnitus human organism reacts with stress. Additionally, stress is strengthened with thinking about whether actual state remains permanently or not. It produces intensive anxiety accompanied with loss of appetite, passivity and unwillingness to do anything, indefinitely postponing of other actual problems. Such feelings must undergone everyone who is affected by ringing in the ears.
As first aid with anxiety one can use drugs of benzodiazepine group, which serve as anxiety suppressors; of the most known are those with active substance of Alprazolam, Bromazepam, Clonazepam. One should bear in mind that, as all drugs with influence on brain chemical processes, these too have side effects, such as sleepiness, dizziness etc. As well benzodiazepines are - after specific period of time – addictive, and thus it is possible to stop using them only by gradual lowering of dosage.

For me personally was very helpful drug with Alprazolam. I've use it for one and half year. Then I considered it was enough and gradually stepped out of usage. But I have it always by hand. From time to time – in case of sleeping problems due to tinnitus – I use 0.25 mg and it reliably helps.

Tinnitus in numbers

From tinnitus suffer millions around the world, other millions are in risk of obtaining it. And these numbers grow constantly because of loudness of modern lifestyle and also because tinnitus is more common with advancing age (longevity is constantly rising in many countries).

• In United States suffer up to 50 million citizens, long-time tinnitus have more than 10% of population
• In Britain have tinnitus cca 6 million people (10% of population)
• In Germany 25% of population suffers or has suffered by some form of tinnitus (13% long-lasting, that means about 10 million). Every year increases number of tinnitus sufferers by 340 thousand
• In Australia suffer 50 million, that is 18% of country population
• In China there is 130 million tinnitus sufferers (cca 10% of population)
• In Brasilia approximately 28 million (cca 14% of population)
• Worldwide estimation is 10 to 15% of adult population suffers tinnitus – more than 500 million people

Sources of data:
http://hearinghealthfoundation.org/tinnitus_statistics
http://www.tinnitus.org.uk/facts-and-figures
http://www.tinnitus-mag.de/tinnitus-wissen/geschichte-und-epidemiologie-des-tinnitus/
http://www.tinnitus.asn.au/tinnitus.htm
http://www.hear-it.org/130-million-people-suffer-from-tinnitus
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-86942013000100018&lng=en&nrm=iso&tlng=en

Most common tinnitus cause II. - Prevention, first aid and treatment of acoustic trauma

source: freeimages.com

If anyone has been the victim of acoustic trauma, he or she should act within 48 hours, but ideally within 24 hours! Did you woke up after a noisy concert hard of hearing? Have you been watching live fireworks? Someone threw a firecracker under your legs and whistles blow in your ears? Go straight to your ear doctor, preferably directly to the hospital. Keep in mind that there is time in play.

If your audiologist is a professional, he will send you to the hospital. Ideally, after necessary examinations (audiometry and tympanometry) to determine the degree of hearing damage, you receive cocktail of glucocorticoids, vitamins and vasodilating agents intravenously. Glucocorticoids have anti-inflammatory effects, improving the nourishment of cells and increase the chances, that traumatized auditory cells recover. However, they also have lot of side-effects, but only with prolonged use. Usually overall it is ten drips, one drip per day.

Big doses of NAC and Magnesium as soon as possible after acoustic trauma are very effective too. See study on this issue: http://www.ncbi.nlm.nih.gov/pubmed/24396768.

If you are not hospitalized and taken intravenous therapy only outpatient, try to use hyperbaric chamber for additional treatment. At a pressure of 2.5 atmospheres blood plasma gets several times more oxygen than the normobaric pressure. Oxygen`s diffusion into tissues helps prevent damaged hearing cells and avoid apoptosis (neuro-sensory cells in the inner ear breathe only by diffusion). Reportedly, at 3 atmospheres, the level of oxygen in the plasma is so big that organism could survive without blood cells.

If you do all of this on due time, you have a great chance that your hearing gets almost to its original state and prospective tinnitus can disappear.

NOTE: Above procedure applies even in case of Idiopathic sudden hearing loss (hearing loss that is due to unknown causes). When you lie down to sleep in the evening and in the morning you wake up deaf - usually affects only one ear.

Tinnitus therapy: Sound masking

source: flickr.com

Every tinnitus sufferer knows: it is good to avoid silence. Sound masking is method of tinnitus therapy that consists of playing various masker sounds or masker noises, which work as covering or partial suppressing or drowning ringing in the ears or other tinnitus noise. While hearing to masking sounds and noises, concentration and perception of sufferer is turned to more pleasing sounds and thus providing him temporary relief (although not completely stopping tinnitus).
Results of this method are not big, but it works and that is enough. No surprise, for tinnitus pioneer Jean Itard already in 1821 suggested “noisy machines that are set off by clockwork or the sound of water streaming into a copper basin”.

Tinnitus masker sounds and masker noises

Common masker sounds or noises that could bring partial relief, are these:

• white noise (high pitched), pink noise (medium pitched) and brown noise (low pitched)
• reproduction of various soothing sounds of nature (ocean sounds, sound of flowing water, wind sound, soft rain sound, cicada or locust sounds)
• relaxing and meditation sounds and music compositions

How to generate masking sounds and masking noises

Frequently used are following masking sound and noise generators:

• radio interference (tuned between two stations with low volume)
• indoor water fountain
• room fan
• various software applications for sound generation
• hearing aids or devices with sound masking functions

Additionally you can use your favorite music or radio playing softly on background.

Sound masking software, masking hearing aids, masking devices

Regarding the software applications I want to say that one can find several such applications (for desktop computers or for mobile devices), some of them really amateurish or even harmful. I think that it is better to pay more for good software or to buy professional masking device or hearing aid (it costs more than software) or go to local audiology center (it costs even more). But good software could do the job for fair price.

Most common tinnitus cause I. - What is acoustic trauma

The most common cause for tinnitus is so called acoustic trauma, or the hearing damage by exposition to loud noise. Shooting without hearing protection, fireworks on Fourth July, New Year and other celebrations, petards, motorcycle exhaust strokes without noise reduction, loud music at concerts, discoteques or pubs, workplace with constant high level of noise - all that can be marked as source of acoustic trauma. Cases are known, and not at all rare, that individual caused himself tinnitus by listening to the loud music in car or using MP3 player.

Acoustic trauma generally arises in all situations where ears are exposed to very loud noises for long enough to ensure that the sensory cells are metabolically exhausted. Noise intensity of 140 db or more causes such exhaustion immediately (e.g. shot, explosion etc.). We can say that the cell is literally drowning in their own secretions (various forms of aggressive oxygen free radicals etc.), which it cannot degrade fast enough. After a short time apoptosis (programmed cell death) begins. Unlike birds and reptiles, by mammals dead neuro cells are not replaced by new ones, so the loss is permanent. However, cell death does not occurs instantly, and here is a chance to repair the damage.

Too loud!

Early sign of acoustic trauma is temporary deafness. Overloaded hair cells temporarily cease to function, those most damaged forever. Hearing gradually begins to return to its original value, but never to such state as before acoustic trauma (also depends on the actual severity of acoustic trauma). I myself have realized few days after acoustic trauma, that I hear a little bit worse.
Unfortunately, it still does not stop here. Some research has shown that stabilization of hearing after acoustic trauma can last up to five years from the moment of acoustic trauma, and may get even worse during that time. It is probably related to the gradual death of damaged hair cells, which have survived the acoustic trauma itself, but perish after a few months or years. It also means favorable forecast to gradually improve potential tinnitus, which often accompanies acoustic trauma.

Acoustic trauma results in loss of perception of higher frequencies, shift in the perception of sound (depending on the degree of severity) and distinctive hole in the zone near 4000 Hz. If you stop hearing in 15 kHz band, you do not need to worry much, these are not frequencies that commonly occur in life. But 4 kHz occurs commonly and hearing loss manifests as follows: the sound is blunted, like when you mute heights in equalizer. Everything sounds somewhat differently and you have decline in quality of perception.

Tinnitus symptoms

The tinnitus alone is only symptom of underlying health problems, but ringing or buzzing in ears is almost without exception accompanied by:

• sleep disorder, sleep disturbances
• problems with speech understanding
• frustration and depression
• anxiety and fear, even panic
• annoyace, irritation
• concentration problems
• confusion and pasivity

Psychic problems and necessity of care for mental balance

source: flickr.com

Hope is great thing. New tinnitus sufferers ask again and again, whether their tinnitus will get better, get worse, or stay the same. Answer to this question is individual, but clinic-base studies show that more often it gets worse than better. Although these studies could be misled, because patients with spontaneous tinnitus improvement less care about seeking help and thus they are not included.
Also, besides tinnitus itself it is important to care about overall psychic condition. Complex tinnitus therapy, e. g. Jastreboffs Tinnitus retraining therapy, always strives to achieve full habituation and hence it use also counseling (psychological interviews and consultations). Other approaches, such as behavioral therapy, work with self control of thought patterns, autogenic training and stress management.

Ringing in the ears – what is tinnitus?

Word tinnitus comes from latin "tinnire" which means "to ring" or "to shrill". Thus tinnitus (Tinnitus Auris, Tinnitus Aurius or Tinnitus Aurium) is in general ringing, whistling, buzzing, hissing, humming, chirping or swishing, which one hears constantly or during significant time period (at least 10 minutes) in his head or in his ears. Other people either don't hear this sound in no way (subjective tinnitus), or, in some rare cases, it is measurable by apparatus (objective tinnitus).
About tinnitus symptoms, or better to say, about consequences on life of tinnitus sufferers I write in text Tinnitus symptoms and in serie of articles on Tinnitus suffering.

An epidemic of Tinnitus?

History of tinnitus has five thousand years. Tinnitus was known in antiquity, we find references to it already in Mesopotamia, on ancient egyptian papyruses or in texts of Aristotle and Hippocrates.
With the coming of modern times and with the beginning of the use of firearms and gunpowder, and later with expansion of machine production, the general noise of human environment has steadily increased. In present time we can see wide spread of hearing loud music and even overall fascination with loud noise. So we could say, that today we have the highest noise level in history of human civilization. And inappropriate exposure to loud noise is main cause of tinnitus (see articles about acoustic trauma), thus with overall growth of noise in our environment rises also number of people suffering tinnitus. Actually we could speak about epidemic of tinnitus.

Tinnitus causes

According to contemporary scientific knowledge tinnitus is symptom, thus only side effect of some disease or damage of hearing apparatus. So far it is not clear, how tinnitus arises. There are some common causes of tinnitus:

• most often it is a form of acoustic trauma – when one is exposed to noisy explosions (fireworks), fireshots, loud music (rock concerts, techno parties and nightclub sessions), noisy machines (motorcycles without exhaust mufflers, F1, Dragsters), noisy factory machines, constant workplace noises etc.
• various ear infections
• head injury
• barotrauma
• hypoxia
• diseases of ear apparatus, spine problems, diseases and defects of nervous system
• consummation of some medical drugs or event sweetening agents

I will provide detailed description in section Causes of tinnitus. If you find, that nothing of mentioned is your case and yet you hear ringing in the ears or other noises in your head, then you should visit a doctor, because it is possible, that something of it was neglected in the past.
From the foregoing also results that hearing loss and tinnitus are closely connected. Tinnitus sufferer often has partial hearing loss. Sometimes he is not conscious about it, because it relates to high frequencies, which usually do not exist in our surroundings, but nevertheless is such hearing loss measurable. More about this in article Hearing loss.

Tinnitus treatment

There are multiple treatments and methods, through which medicine strives to help tinnitus sufferers. It requires separate section Tinnitus treatments to handle this theme. In general it is valid, that if cause of problem is not clearly defined, any treatment will be questionable. If someone has tinnitus as a result of spine deformity, then after fixing it also tinnitus will disappear. Likewise, if cause of problem is an ear infection, then after healing this infection will ringing in the ears (or whatever other form tinnitus has) automatically stop. But, if no such root cause of tinnitus has been diagnosed, then probably no effective treatment exists for this specific case and, unfortunately, only various means of temporary relief are available.

Tinnitus therapy

Because of this missing of real and effective treatment, tinnitus therapy could bring sufferers at least temporary relief or adaptation to tinnitus. This issue I handle in Tinnitus therapy section.