Some people describe the phantom sounds as so constant and so disabling, they've quit their jobs, living almost as shut-ins in a world dominated by ringing, buzzing, hissing or roaring very often only they can hear.The disorder is called tinnitus. And only now, after having languished for decades as an orphan disorder, are dramatic advances being made.
Experiments are under way mostly in Europe, using sophisticated imaging techniques that allow doctors to "see" areas in the brain where sound signals are no longer translated - progress that could help doctors target new treatments.Dr. Mark Shikowitz, professor of otolaryngology at North Shore University Hospital in Manhasset, estimates that 36 million people in the United States suffer from tinnitus and 7 million are hopelessly crippled by a constant cacophony in their heads. The American Tinnitus Association puts the estimate of those with the condition at 50 million.
"Loud noises are the most common cause" of tinnitus, a condition that inevitably becomes more common with age, Shikowitz said. Young people, he added, are not immune because they, from one generation to another, have had a preference for ear-damaging music."In the '60s and '70s it was the rock concertgoers who were getting it at a young age," he said. "Now it's the kids with iPods."Similar ringing and hissing are becoming major disabilities reported by soldiers returning from Iraq and Afghanistan who've suffered blast injuries in war zones. Patients treated for cancer with certain chemotherapy drugs also develop tinnitus. Aspirin is a known cause of the condition, although the ringing or hissing subside when patients stop taking the drug.
"Mine is a constant hissing at a high pitch, but sometimes there is clicking associated with it," said a Manhattan resident who is part of an American Tinnitus Association awareness campaign. Despite being part of the country's largest tinnitus advocacy organization, he doesn't want his name publicly linked with the disorder.He has no idea what triggered the tortured sounds. But whatever it was, he said, it also robbed him of some of his hearing: "Sometimes it's like a steam kettle." He says he is so severely encumbered that he can no longer hold a job.Tinnitus treatments run a wide gamut from the holistic to the electronic.
Vitamin B-12, zinc and ginkgo biloba all have been suggested. Maskers - devices that produce "white noise" at a pitch above that of the tinnitus - also are sometimes recommended, Shikowitz said.The trouble emerges when tiny hair cells deep within the inner ear are damaged. "In the middle ear there are two bones that vibrate," explained Lynn Spivak, who holds a doctorate in audiology and is director of the hearing and speech center at Long Island Jewish Medical Center in New Hyde Park."Those vibrations are transmitted to the inner ear, and the hair cells are responsible for transducing those vibrations into electrochemical energy, which causes stimulation of the auditory nerve fibers in the brain," she said.
As people age, hair cells naturally diminish, causing more trouble with hearing and an increased incidence of tinnitus.Richard Salvi of the hearing center at the University at Buffalo, who is researching tinnitus treatments, said several advances in Germany and Belgium are making their way to the United States. One involves imaging the brain through positron emission tomography - PET - in which a scan reveals the part of the brain where signals are not translated into meaningful sound.Shikowitz said not all tinnitus is subjective, the kind brought on by loud noise or age. With objective tinnitus, even the physician can hear through a stethoscope a noise caused by a muscle problem in the inner ear. Ringing and hissing also can be caused by vascular problems, a benign tumor or multiple sclerosis, he said.
