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What causes ringing in my ears?Ringing in the ears, or tinnitus, is caused by injury or irritation of the inner ear. The cause of tinnitus is often benign. In many instances, the cause of tinnitus is never conclusively found. Tinnitus can also be a presentation for brain tumors and other serious disorders and thus, should be investigated thoroughly.
What is tinnitus?Tinnitus (“TIN-a-tus” or “Tin-EYE-tus”) is the perception of sound in the head when no outside sound is present. It is typically referred to as “ringing in the ears,” but other forms of sound such as hissing, roaring, pulsing, whooshing, chirping, whistling and clicking have been described.
Tinnitus can occur in one ear or both ears and can be perceived to be occurring inside or outside the ear. Tinnitus can be a symptom of a condition that causes hearing loss, or it can exist without any hearing loss
Is tinnitus a common problem?Yes. Almost everyone at one time or another has experienced brief periods of mild ring or other sound in the ear. Some people have more annoying and constant types of tinnitus. One third of all adults report experiencing tinnitus at some time in their lives. Ten percent to 15% of adults have prolonged tinnitus requiring medical evaluation. Prevalence estimates of individuals with tinnitus vary widely, from 7.9 million to more than 37 million
Is tinnitus a disease?No. Just as fever or headache accompanies many different illnesses, tinnitus is a symptom common to many problems, both physiological and psychological.
What causes my tinnitus?Most tinnitus comes from damage to the microscopic endings of the hearing nerve in the inner ear. The health of these nerve endings is important for acute hearing, and injury to them brings on hearing loss and often tinnitus.Chances are the cause of your tinnitus will remain a mystery. Only when a specific factor is linked to the appearance or disappearance of the tinnitus can a cause be stated with certainty. Blows to the head, large doses of certain drugs such as aspirin, anemia, hypertension, noise exposure, stress, impacted ear wax and certain types of tumors are examples of conditions that might cause tinnitus.What happens in my head to produce tinnitus? Although there are many theories about how sounds in the head are produced, the exact process is not known. One thing is certain. Tinnitus is not imaginary.
Why is my tinnitus worse at night?During the day, the distraction of activities and the sounds around you make your tinnitus less obvious. When your surroundings are quiet, your tinnitus may seem louder and more constant. Fatigue may also make your tinnitus worse.
What should I do about my tinnitus?Since tinnitus is a symptom, the first step should be to try to diagnose the underlying cause. You should have a medical examination with special attention given to checking for factors sometimes associated with the tinnitus such as blood pressure, kidney function, drug intake, diet and allergies. Your hearing should be evaluated by an audiologist to determine if hearing loss is present.
What is the treatment for tinnitus?The most effective treatment for tinnitus is to eliminate the underlying cause. Unfortunately, the cause often cannot be identified so, in some cases, the tinnitus itself may need to be treated. Drug therapy, vitamin therapy, biofeedback, hypnosis and tinnitus maskers are types of treatments that have been helpful for some people.The American Tinnitus Association (ATA) Web site has information on various treatment options. Visit www.ata.org or write them at PO Box 5, Portland, Oregon 97207.
Will a hearing aid help my tinnitus?If you have a hearing loss, there is a good chance that a hearing aid will both relieve your tinnitus and help you hear. An audiologist can assist with the selection, fitting and purchase of the most appropriate aid and help with training to use the aid effectively.
What are the most common causes of hearing loss?
- Noise exposure
- Hereditary factors
- Ototoxic medications
What is damage to the inner ear?Your ear receives sound waves and sends them through a delicately balanced system to the brain. Part of this remarkable system, the cochlea, is a chamber in the inner ear filled with fluid and lined with thousands of tiny hair cells. The hair cells signal the auditory nerve to send electrical impulses to the brain. The brain interprets these impulses as sound. When you are exposed to loud or prolonged noise, the hair cells are damaged and the transmission of sound is permanently altered.
What are examples of noise levels?Both the amount of noise and the length of time you are exposed to the noise determine its ability to damage your hearing. Noise levels are measured in decibels (dB). The higher the decibel level, the louder the noise. Sounds louder than 80 decibels are considered potentially hazardous. The noise chart to the right gives an idea of average decibel levels for everyday sounds around you.
- 150 dB = rock music peak
- 140 dB = firearms, air raid siren, jet engine
- 130 dB = jackhammer
- 120 dB = jet plane take-off, amplified rock music at 4-6 ft., car stereo, band practice
- 110 dB = rock music, model airplane
- 100 dB = snowmobile, chain saw, pneumatic drill
- 90 dB = lawnmower, shop tools, truck traffic, subway
- 70 dB = busy traffic, vacuum cleaner
- 60 dB = dishwasher
- 50 dB = moderate rainfall
- 30 dB = whisper, quiet library
What are Warning Signs of Hazardous Noise?
- You must raise your voice to be heard.
- You can’t hear someone two feet away from you.
- You have pain or ringing in your ears (tinnitus) after exposure to noise.
What else can noise affect?Noise not only affects hearing. It affects other parts of the body and body systems. It is now known that noise:
- Increases blood pressure
- Has negative cardiovascular effects such as changing the way the heart beats
- Increases breathing rate
- Disturbs digestion
- Can cause an upset stomach or ulcer
- Makes it difficult to sleep, even after the noise stops
- Intensifies the effects of factors like drugs, alcohol, aging and carbon monoxide.
How can I protect myself from noise?Wear hearing protectors when exposed to any loud or potentially damaging noise at work, in the community (heavy traffic, rock concerts, hunting, etc.) or at home (mowing the lawn, snow blowing the driveway, etc.). Cotton in your ears won’t work. Hearing protectors include ear muffs and ear plugs (not swimmer’s plugs), some that are custom-made and individually molded. This protection can be purchased at drug stores, sporting goods stores or can be custom-made. Check with your audiologist to find out what best suits you.
Limit periods of exposure to noise. Don’t sit next to the speakers at concerts, dance clubs, or auditoriums. If you are at a rock concert, walk out for awhile to give your ears a break. If you are a musician, wear ear protection–it is a necessity! Take personal responsibility for your hearing.
Pump down the volume! When using headsets or listening to amplified music in a confined place like a car, turn down the volume. Remember: if a friend can hear the music from your headset when standing three feet away, the volume is definitely too high. Don’t be afraid to ask others to turn down the volume.
Educate yourself about the damaging effects of noise and what you can do to prevent your exposure to noise.
Educate others and take action! Educate your children through discussion and by example. Wear your ear protection and encourage your children to follow your example.
What other ways can I protect myself from noise?Be a responsible consumer. Look for a noise rating when buying recreational equipment, children’s toys, household appliances, and power tools. Choose quieter models, especially for equipment that you use often or close to your ears like a hair dryer.
Inspect your child’s toys for noise danger just as you do for small parts that can cause choking. Remember, too, that children tend to hold toys close to their ear which can pose additional threat for hearing damage.
Have your hearing tested by an audiologist especially if you are concerned about possible hearing loss.
Be an advocate! Remember there are no regulations governing how loud sound can be in public places such as dance clubs, movie theaters, and exercise centers. Work with owners, managers, and community leaders to create a healthier, less noxious listening environment.
What is an audiologist?
- An audiologist is a hearing care professional, trained specifically in hearing, communication, and balance disorders.
- The audiologists of Ear, Nose and Throat Associates of Frisco, P.A., are state licensed, nationally certified, and hold either a master’s degree or doctoral degree in audiology.
Who is at risk for occupational noise exposure?
- A person that operates loud machinery
- Airplane engineers & airlines ground transportation personnel
- Printing press operators
- Noise of power tools
- Military/ law enforcement
What is recreational noise exposure?
- Lawn Equipment
What styles do hearing aids come in?
- Behind-the-ear (BTE)- the hearing aid components are encased behind the ear.
- In-the-ear (ITE)- the components of the hearing aid are encased in a custom made shell that fills the entire bowl portion of the ear.
- In-the-canal (ITC)- the components of the hearing aid are encased in a custom made shell that fills the canal portion of the ear.
- Completely-in-the-canal (CIC)- the components of the hearing aid are encased in a custom made shell that fits deeply into the canal of the ear.
Hearing aids do not come in a “one-size-fits-all”. Therefore, the audiologists at Ear, Nose and Throat Associates of Frisco work with each patient to meet individualized hearing care needs.
I see Hearing Aids advertised in the paper. How do your Hearing Aid services differ?The offers in the paper are often at facilities which do not have medical backgrounds. Their main interest is in the sale of the hearing aid device. Sometimes, this can be at the expense of needed and beneficial medical treatment. At Ear, Nose and Throat Associates of Frisco, P.A. we are dedicated to the health and well-being of our patients and offer Hearing Aid options as a convenient service to those patients who desire to pursue an improvement in hearing.
How many children have hearing loss?Approximately 6 in 1000 babies are born with a significant hearing loss. Approximately 15% of US children aged six to nineteen years of age have a measurable hearing loss in one or both ears.
What happens if hearing loss isn’t detected or treated?Unmanaged hearing loss in children can affect their speech and language development, academic capabilities and educational and can also affect their self-image and social / emotional development.
What causes hearing loss in children?The most common type of hearing loss is sensorineural hearing loss. These causes include present at birth infections, medications, noise, and genetics. Sensorineural hearing loss can also develop later in life due to excessive exposure to loud noise. In 50 % of at birth hearing loss cases, a cause is never found.
Hearing loss can also be cause by recurrent ear infections and persistent fluid in the middle ear. These are causes that can often be treated medically and surgically.
How can I tell if my child has hearing loss?Hearing loss is invisible, and the signs are subtle in young children. If children are not reaching the speech and language milestones at the appropriate levels, or you suspect your child has hearing difficulties, they should see their physician or audiologist to have their hearing tested.
How is my child’s hearing tested?The audiologist has several tools that allow a child’s hearing to be tested from birth to age one.
Tympanometry introduces air pressure into the ear canal making the eardrum move back and forth. The test measures the mobility of the eardrum and can assist in the detection of fluid in the middle ear, perforation of the eardrum, or wax blocking the ear canal.During soundfield testing in the sound booth, infants and toddlers are observed for changes in their behavior such as sucking a pacifier, quieting, or searching for the sound and are rewarded for the correct response by getting to watch an animated toy ( visual reinforcement audiometry ).
Otoacoustic emissions (OAE) are inaudible sounds emitted by the cochlea when the cochlea is stimulated by a sound. When sound stimulates the cochlea, the outer hair cells vibrate. The vibration produces an inaudible sound that echoes back into the middle ear. The sound can be measured with a small probe inserted into the ear canal and determined to be within a normal range or not.
Auditory brainstem response (ABR) is an auditory evoked potential that originates from the auditory nerve. Electrodes are placed on the head (similar to electrodes placed around the heart when an electrocardiogram is run), and brain wave activity in response to sound is recorded.
How does hearing loss affects children?
- It causes delay in the development of receptive and expressive communication skills (speech and language).
- The language deficit causes learning problems that result in reduced academic achievement.
- Communication difficulties often lead to social isolation and poor self-concept.
- It may have an impact on vocational choices.
What should my child be able to do from birth to one year old?Birth to three months:
- Startles to loud sounds
- Quiets or smiles when spoken to
- Seems to recognize your voice and quiets if crying
- Increases or decreases sucking behavior in response to sound
- Makes pleasure sounds (cooing, gooing)
- Cries differently for different needs
- Smiles when sees you
Four to six months:
- Moves eyes in direction of sounds
- Responds to changes in tone of your voice
- Notices toys that make sounds
- Pays attention to music
- Babbling sounds more speech-like with many different sounds, including “p”, “b” and “m”
- Vocalizes excitement and displeasure
- Makes gurgling sounds when left alone and when playing with you
Seven to twelve months:
- Enjoys games like peekaboo and pat-a-cake
- Turns and looks in direction of sounds
- Listens when spoken to
- Recognizes words for common items like “cup”, “shoe,” or “juice”
- Begins to respond to requests (e.g. “Come here” or “Want more?”)
- Babbling has both long and short groups of sounds such as “tata upup bibibibi”
- Uses speech or noncrying sounds to get and keep attention
- Imitates different speech sounds
- Has one or two words (bye-bye, dada, mama) although they may not be clear
What are ways to help my child develop appropriately?
Check your child’s ability to hear, and pay attention to ear problems and infections, especially when they keep occurring.
Reinforce your baby’s communication attempts by looking at him or her, speaking, and imitating his or her vocalizations.
Repeat his or her laughter and facial expressions.
Teach your baby to imitate actions, such as peekaboo, clapping, blowing kisses, pat-a-cake, itsy bitsy spider, and waving bye-bye. These games teach turn-taking that is needed for conversation.
Talk while you are doing things, such as dressing, bathing, and feeding (e.g., “Mommy is washing Sam’s hair”; “Sam is eating carrots”; “Oh, these carrots are good!”).
Talk about where you are going, what you will do once you get there, and who and what you’ll see (e.g., “Sam is going to Grandma’s house. Grandma has a dog. Sam will pet the dog.”).
- Talk about colors (e.g., “Sam’s hat is red”).
- Practice counting. Count toes and fingers.
- Count steps as you go up and down them.
- Teach animal sounds (e.g., “A cow says ‘moo’”).
What should my child be able to do from one to two years old?
- Points to a few body parts when asked.
- Follows simple commands and understands simple questions (“Roll the ball,” “Kiss the baby,” “Where’s your shoe?”).
- Listens to simple stories, songs, and rhymes.
- Points to pictures in a book when named.
- Says more words every month.
- Uses some one- or two- word questions (“Where kitty?” “Go bye-bye?” “What’s that?”).
- Puts two words together (“more cookie,” “no juice,” “mommy book”).
- Uses many different consonant sounds at the beginning of words.
What are ways to help your child develop appropriately?Talk while doing things and going places. When taking a walk in the stroller, for example, point to familiar objects (e.g., cars, trees, and birds) and say their names. “I see a dog. The dog says ‘woof.’ This is a big dog. This dog is brown.”
Use simple but grammatical speech that is easy for your child to imitate.
Take a sound walk around your house or in the baby’s room. Introduce him/her to Timmy Clock, who says “t-t-t-t.” Listen to the clock as it ticks. Find Mad Kitty Cat who bites her lip and says “f-f-f-f” or Vinnie Airplane who bites his lip, turns his voice motor on and says “v-v-v-v.” These sounds will be old friends when your child is introduced to phonics in preschool and kindergarten.
Make bath time “sound playtime” as well. You are eye-level with your child. Play with Peter Tugboat, who says “p-p-p-p.” Let your child feel the air of sounds as you make them. Blow bubbles and make the sound “b-b-b-b.” Feel the motor in your throat on this sound. Engines on toys can make a wonderful “rrr-rrr-rrr” sound.
Expand on words. For example, if your child says “car,” you respond by saying, “You’re right! That is a big red car.”
Continue to find time to read to your child every day. Try to find books with large pictures and one or two words or a simple phrase or sentence on each page. When reading to your child, take time to name and describe the pictures on each page.
Have your child point to pictures that you name.
Ask your child to name pictures. He or she may not respond to your naming requests at first. Just name the pictures for him or her. One day, he or she will surprise you by coming out with the picture’ s name.
What should my child be able to do from two to three years old?
- Understands differences in meaning (“go-stop,” “in-on,” “big-little,” “up-down”).
- Follows two requests (“Get the book and put it on the table”).
- Has a word for almost everything.
- Uses two- or three- word “sentences” to talk about and ask for things.
- Speech is understood by familiar listeners most of the time.
- Often asks for or directs attention to objects by naming them.
What are ways to help your child develop appropriately?Use clear, simple speech that is easy to imitate.
Show your child that you are interested in what he or she says to you by repeating what he or she has said and expanding on it. For example, if your child says, “pretty flower,” you can respond by saying, “Yes, that is a pretty flower. The flower is bright red. It smells good too. Does Sam want to smell the flower?”
Let your child know that what she or he has to say is important to you by asking him or her to repeat things that you do not completely understand. For example, “I know you want a block. Tell me again which block you want.”
Expand on your child’s vocabulary. Introduce new vocabulary through reading books that have a simple sentence on each page.
Name objects and describe the picture on each page of the book. State synonyms for familiar words (e.g., mommy, woman, lady, grown-up, adult) and use this new vocabulary in sentences to help your child learn it in context.
Put objects into a bucket and have your child remove one object at a time, saying its name. You repeat what your child says and expand upon it: “That is a comb. Sam combs his hair.” Take the objects from the bucket and help your child group them into categories (e.g., clothes, food, drawing tools).
Cut out pictures from old magazines and make a scrapbook of familiar things. Help your child glue the pictures into the scrapbook. Practice naming the pictures, using gestures and speech to show how you use the items.
Look at family photos and name the people. Use simple phrases/sentences to describe what is happening in the pictures (e.g., “Sam swims in the pool”).
Write simple appropriate phrases under the pictures. For example, “I can swim,” or “Happy birthday to Daddy.” Your child will begin to understand that reading is oral language in print.
Ask your child questions that require a choice, rather than simply a “yes” or “no” answer. For example, rather than asking, “Do you want milk? Do you want water?”, ask, “Would you like a glass of milk or water?” Be sure to wait for the answer, and reinforce successful communication: “Thank you for telling Mommy what you want. Mommy will get you a glass of milk.”
Continue to sing songs, play finger games (“Where is Thumbkin?”), and tell nursery rhymes (“Hickory Dickory Dock”). These songs and games introduce your child to the rhythm and sounds of language.
Strengthen your child’s language comprehension skills by playing the yes-no game: “Are you a boy?” “Is that a zebra?” “Is your name Joey?”