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Blog

24 May 2017

Is tinnitus the "phantom pain" of the ear?

WZT man V2

Tinnitus is a perceived sound in the ears or head that does not originate from an external sound source. It is often described as a ringing, whistling, whooshing, buzzing or pulsing sound.  Some people describe it as being there all the time, and for others, it can come and go. 

Nearly everyone has experienced temporary tinnitus, especially after a period of very loud noise exposure such as a concert. Chronic tinnitus, however, occurs in approximately 10 to 15% of the population.  Most of these people are not bothered by it, but approximately 20% of them will seek help clinically.

Tinnitus is a symptom of an underlying condition, it is not a disease.  Current research suggests tinnitus is caused by a change in the way the brain perceives sound, usually as a result of damage to “hair cells” in the inner ears. Damage to these cells causes a lack of sound input to the attached nerve cells in the part of the brain that processes sound.  When the sound input is missing in this way, the brain starts to search for it, eventually becoming overactive and creating its own sound to fill in the “holes” of missing information in the soundscape.  

In much the same way, people who have lost a limb through disease or accident often report sensation or pain coming from the missing limb.  This is known as “phantom limb syndrome”. Scientists think that the brain is used to sensory signals coming from the limb and that when those signals suddenly disappear, the brain creates its own signals about what the limb is doing.

In the case of the ear, the “phantom” sound would normally be filtered out before it reaches the cortex: the part of the brain that results in awareness and assigns meaning to sound.  The filtering process is done in the areas of the brain which amongst other functions is responsible for emotional reactions and the fight-or-flight response.  When you think about it, this is an extremely important brain function.  Think of how difficult your life would become if you were aware of and emotionally reactive to every little noise that occurred around you all of the time: the clock ticking, the traffic and air conditioning in the background, the typing and shuffling of your neighbour in the office. How would you ever co concentrate or get any work done?

So the tinnitus is generated by the brain in response to a lack of sound stimulation, it is not filtered out by the usual mechanism, and the person starts to become aware of a sound.  What happens from here on in can determine how distressing the tinnitus becomes.  If an individual attaches a negative connotation to the sound, this causes further excitation of the auditory system which increases the perception of the tinnitus, making it seem louder or more annoying.  Some people, however, are emotionally neutral about the appearance of this new sound in their ears, and this stops the cycle in its tracks, resulting in less perceived disturbance as a result of the tinnitus.  A good deal of tinnitus counselling or therapy is helping people move from the former scenario to a place where the tinnitus is noticed but not intrusive. 

Read more about our approach to tinnitus management here.

Worried about tinnitus?

If you have tinnitus we can help you manage it. All of our clinicians can provide hearing and tinnitus assessments and tinnitus counselling, however, if you are quite distressed by your tinnitus, can't concentrate or sleep because of the tinnitus, we would advise you book an appointment with one of our tinnitus specialist audiologists - Diane and Kath.  Contact us to arrange a "Hearing and tinnitus' appointment.