A ringing or buzzing sound fills the ear, yet the surroundings are silent. Tinnitus, a sound heard only by the sufferer, is experienced by up to 30% of adults.
The condition goes beyond mere discomfort, causing sleep disorders and anxiety. Many patients worry they will have to live with it for life, but tinnitus can go away. As underlying causes such as hearing loss have been identified, the condition can now be resolved by improving hearing.
On "Myeongui Now," airing on Seoul Economic Daily TV at 9 p.m. on Thursday, Professor Park Shi-nae, president of the Korean Otological Society and director of the Tinnitus, Hearing Loss, and Dizziness Center at Seoul St. Mary's Hospital, will discuss the causes and latest treatments for tinnitus. "Tinnitus is not a disease but a kind of 'symptom,'" Park said. "It may take time, but complete recovery is fully possible."
Hearing Loss: The Most Common Cause
The most common cause of tinnitus is hearing loss. When hearing declines, the brain's "compensatory mechanism" kicks in, generating sounds on its own to make up for the deficit.
"When you can't hear well, the brain creates sound," Park said. "That's why patients describe the sound as coming from their head, not their ear." Tinnitus can also be an early sign of hearing loss. Hearing typically declines first in the high-frequency range, which does not affect conversation. Because conversation remains unaffected, people often notice hearing loss late, and many develop tinnitus in the process.
Tinnitus is common enough that 30% of adults experience it. About 10% feel discomfort severe enough to visit a hospital, and 1% suffer so seriously that daily life becomes difficult.
The number of tinnitus patients is rising due to an increase in age-related hearing loss driven by population aging, noise exposure from earphone use, and rising stress levels. "Hearing loss is the biggest mechanistic cause, but the factor that actually makes people feel tinnitus is stress," Park emphasized.
Different Sounds for Different People
The sound of tinnitus varies depending on the location of hearing damage. Damage in the high-frequency range produces a ringing sound, damage in the mid-range central to conversation produces a rushing sound, and damage in the low-frequency range produces a humming sound. "The brain creates different sounds to compensate for the damaged frequency range," Park said. Tinnitus can also arise from problems with muscles inside the ear, producing clicking or crackling sounds, while vascular tinnitus produces pulsating sounds that match the heartbeat.
"Temporary tinnitus happens to everyone, and a sound lasting five to 10 seconds when tired is not a major problem," Park said. "But if tinnitus lasts more than five minutes or starts suddenly and persists, you should see a doctor immediately."
Sudden sensorineural hearing loss, in which hearing is lost within three days without any particular cause, has a golden window for treatment of 24 to 48 hours. Without treatment within that window, the condition can progress to permanent hearing loss and subsequent tinnitus, which is why prompt treatment is critical.
Tinnitus Retraining Therapy Improves Symptoms in 70% of Patients
Representative treatments for tinnitus are applied in combination and include drug therapy to address anxiety and sleep, hearing rehabilitation through hearing aids or cochlear implants, sound therapy, and tinnitus retraining therapy (TRT).
TRT, which combines counseling with sound therapy, reportedly improves symptoms in about 70% of patients. Counseling helps patients understand why tinnitus occurs and teaches them that the sound is not dangerous, reducing anxiety and attention to weaken the tinnitus circuit formed in the brain. Sound therapy avoids quiet environments and maintains background sounds such as music or nature sounds to mask tinnitus and make it less noticeable. The process increases exposure to external sounds so the brain does not focus on tinnitus.
"Treatment must change sound, brain, and habits together," Park said. "In the past, people said tinnitus was something to live with for life, but now complete recovery is fully achievable."
Cochlear implant surgery, performed on patients with severe hearing loss, is also effective for tinnitus.
"Studies show that more than 50% of patients experience tinnitus disappearing within six months after cochlear implant surgery," Park said. "Recently, more cases are considering surgery for severe tinnitus patients even when hearing loss is only in one ear."
Avoid Quiet Environments: Lifestyle Matters
The most important habit in managing tinnitus is avoiding quiet environments. The quieter it is, the more clearly tinnitus is heard, and the more the tinnitus circuit in the brain is reinforced.
"Keeping the radio or music on to maintain moderate background sound is helpful," Park said. "However, overly noisy environments or excessive earphone use can actually worsen the condition." People who professionally use earphones frequently or are inevitably exposed to noise are in a high-risk group for tinnitus, and it is advisable to avoid making the home too quiet and to keep moderate background sounds.
"Tinnitus can improve significantly, and complete recovery is possible, so the most important thing is not to give up and to get accurate diagnosis and treatment," Park emphasized. "The day when you no longer feel tinnitus will surely come."
