A: Interestingly, ringing (or tinnitus as it’s called) is not an uncommon phenomenon. Most people will experience some level of this at some time during their life. If you take almost anyone and place him or her in a sound deadened environment, when listening very carefully, that high-pitched sound you describe is frequently there.

 

The reason that most people don’t notice tinnitus is that outside sounds and our own central blocking ability filter it out. It only becomes noticeable when there is some form of hearing loss. Nerve (or sensorineural) hearing loss, can be either age, noise-induced, injury or infection related. In these conditions, the hearing end organ, or the cochlea, is no longer functioning at maximal capacity (due to sensory hair cell loss). In this case, the hearing organ will produce an increased aberrant signal of its own that we then perceive as a ringing.  There is actually no sound there, no one else can hear it, but you can. This sound can take on a number of forms from a high-pitched noise, to a hissing, to sounding like the ocean roar, or pretty much anything in between. Occasionally it may manifest as a screeching sound, which can be most troubling. 

 

For the most part, tinnitus is benign and suggests nothing of concern. In almost all cases treatment is not needed. A hearing test is required, but if there are no red flags the patient can be reassured that there isn’t anything to worry about. Tinnitus is only a problem if it is emotionally troubling to the patient in which case it causes stress; stress makes tinnitus much worse so the process snowballs. In this case, medications can be prescribed to dampen the symptoms, or at least the patient’s response to the symptoms. Luckily, this is rare. And since all medications have side effects they are better avoided if possible.

 

Interestingly, people with tinnitus often have enough hearing loss to require a hearing aid. A hearing aid, which produces an amplified extrinsic sound source, will act as a masker making the person’s own intrinsic sounds less noticeable and troubling. Other novel treatments might include biofeedback and acupuncture. There also are organizations to help people cope with tinnitus such as The American Tinnitus Association, which offers resources for people with tinnitus, or Oregon Health Sciences University, that offers a specialized tinnitus clinic for severe cases.

 

Another form of tinnitus is called pulsatile tinnitus. In this case, the tinnitus is not a constant regular sound but can follow the heartbeat or some other rhythm. This particular form can suggest pathology and requires a proper workup beyond the standard hearing test. This form is fairly rare but absolutely requires a doctor visit.

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Yes, tinnitus is very common, and in our increasingly noisy world will only become more so. The best way to prevent the advancement of it is to always protect your ears from any kind of noise. Protect yourself against loud activities and use common sense. Always wear hearing protection if needed whenever possible. The effects of noise exposure are cumulative over a lifetime. A few unprotected rounds of target practice now may create 20 years of ringing later. It’s not worth it.