Uno whistle, a buzz, a constant sound (often hard to describe) that never seems to go away. Tinnitus is a widespread and complex disorder, capable of affecting concentration, sleep and quality of life. To truly understand it, it is essential to rely on those who study it and deal with it every day. As he explains Dr. Corrado Borsi, ENT specialist at the Auxologico Irccs in Milan: «The term tinnitus means “noise without noise”. The patient reports hearing a sound that doesn’t actually exist.”
A phenomenon that can have different origins – from the ear to the cardiovascular system, to stress – and which requires a careful, never superficial approach. In this comprehensive guide, we combine the expert’s answers with the most recent scientific evidence to try to understand what tinnitus is, why it appears and how to deal with it effectively.
What is tinnitus: when silence disappears
«The term tinnitus means “noise without noise”. The patient reports hear a sound that doesn’t actually exist. And everyone reports it differently. The difficulty for the specialist lies precisely in identifying the cause, or disease, that causes this annoying and disabling symptom.” Tinnitus is not a disease, but a symptom. According to theWorld Health Organizationcan manifest itself in a way intermittent or continuous and have variable intensity. There are those who describe it as a light background and those who, however, experience it as a persistent and debilitating noise.
Tinnitus and causes: why it appears
«The possible causes of tinnitus are local or systemic problems. Inevitably these may occur more frequently or more severely as we age.” The causes can be multiple and often intertwined with each other. Among the most common:
- Aging of the hearing system
- Exposure to intense noise
- Cardiovascular disorders
- Neurological alterations
THE’age remains one of the main risk factorsbut today tinnitus also affects young people, often due to stress or incorrect habits.
Ear problems: from earwax to the auditory nerve
«As regards strictly the auricular district, it could be the more banal earwax plug up to the results of previous ear infections or much more important disorders of the inner ear, that is to say the cochlea or auditory nerve, which reduce their functional capacity over the years. Among the systemic causes, adulthood can manifest circulatory, blood pressure or neurological or cognitive impairment or causes”, explains Doctor Borsi. From the simplest cause to the most complex: tinnitus can also arise from apparently trivial conditions. Institutional sources such as NIDCD And Mayo Clinic indicate hearing loss, damage to the inner ear, exposure to noise and other hearing conditions among the most frequent associations.
High blood pressure and tinnitus: a link that should not be underestimated
«Absolutely yes, high blood pressure and tinnitus are among the most frequent causes. Especially with regards to hypertension”, explains Doctor Borsi. When the perceived sound follows the heartbeat, it is often called pulsatile tinnitus. The cVascular conditions may be involved especially in a specific form called pulsatile tinnitus, in which the sound follows the rhythm of the heartbeat. However, they are not the main cause in most cases.
Stress, anxiety and bruxism: how much do they really weigh?
«They have an important impact, both in causing it and in feeling the discomfort more. In particular the bruxisman increasingly frequent disorder in the post-Covid period due to a condition of greater nervousness.” Stress is not only a trigger, but also an amplifier. Bruxism, in particular, can create tension at the jaw level and directly influence the perception of sounds. It is one of the rapidly growing disorders in recent years.
Tinnitus: the most common mistakes to avoid
As the expert underlines, what should be avoided is «neglecting or ignoring it, or becoming excessively and maniacally alarmed. Together with the specialist, the search for the cause of this symptom must be undertaken with extreme caution and precision.” The key point is to avoid both underestimation and excessive worry. A guided diagnostic process is needed.
Diagnosis: what tests are needed?
The evaluation begins with a specialist visit and hearing test. Imaging tests, such as MRI, are not always necessary, but are required in selected cases, such as when the disorder is unilateral or pulsatile. «You need an initial ENT/audiological visit. Tonal audiometric test, impedance test, auditory evoked potentials and, lastly, a district resonance.»
The diagnostic process is essential to exclude more serious pathologies and identify the precise cause. An accurate diagnosis is the first step towards effective therapy.
Chronic tinnitus: when it doesn’t go away
If it lasts beyond a few months, tinnitus can become chronic and affect sleep, concentration and psychological well-being. «It can persist, annoyingly impacting the patient’s daily life. For this reason, a meticulous search for the possible cause or disease must be undertaken, never dismissing the patient in the first place with the unpleasant phrase “I think he has to learn to live with it”. Tinnitus it may become chronic, but that doesn’t mean giving up.
Today there are therapeutic paths that allow you to reduce discomfort and improve quality of life.
Tinnitus Cures: What Really Works
«Obviously they depend on identifying the cause. You can intervene with peripheral vasodilators, antihypertensives, neurotrophic drugs, supplements, bites for bruxism, muscle relaxants, sedatives, ear or environmental maskers”, clarifies Borsi.
Treatments always depend on the cause. International guidelines indicate as main approaches:
- treatment of the associated condition
- hearing aids in case of hearing loss
- psychological support and cognitive-behavioral therapy.
Medicines and supplements do not represent a universal solution and must be evaluated on a case-by-case basis by the specialist.
Living with tinnitus and TRT therapy: learning to manage it
Listen to your body (even when it “makes noise”)
Tinnitus is a sign not to be ignored. As Dr. Borsi underlines, balance, competence and a personalized approach are needed. The good news is that today, thanks to medicine and targeted therapies, it is possible live better with this disorder – and in many cases reduce it significantly.
