Tinnitus – phantom sounds with very real effects

Published on 23 March 2023

With an uptick in the number of patients seeking treatment for tinnitus, here are the ABC’s of the potentially debilitating condition.

Have you ever heard ringing or buzzing sounds in your ears, and wondered where they were coming from?

These ‘phantom sounds’ were not made by a bell, a pesky fly, or any other external source. Rather, they are caused by a condition known as tinnitus.

According to Dr Goh Xue Ying, Consultant, Department of Otolaryngology, Head & Neck Surgery, National University Hospital (NUH), “Tinnitus is usually described as a buzzing, hissing or ringing sound. It can be unilateral (in one ear) or bilaterally (both ears), and can differ in intensity, varying from being soft and barely audible, to being very intense and disturbing.”

Tinnitus can be caused by a variety of factors, including exposure to loud noise, age-related hearing loss, ear infections, and certain medications. Leading a sedentary lifestyle, insomnia, and mood disorders – such as anxiety and depression – also increases the chances of one becoming bothered by their tinnitus.

While tinnitus can affect anyone regardless of age, it is more common in the elderly. This year, the Ministry of Health revealed that more than 12,000 Singaporeans aged 60 and above are afflicted by the condition.

“Since the start of COVID-19, we’ve noticed more patients seeing us for bothersome tinnitus,” revealed Ms Joanna Tang Zhi Ting, Audiologist, NUH. “During the pandemic, most people had to work from home, which is usually a quieter environment. As such, it is likely to have highlighted the phantom sound that might have previously gone unnoticed.”

If left unaddressed, tinnitus can be a crippling condition that greatly affects a person’s quality of life.

“For those whose tinnitus has a severe impact on their lives, it can result in job changes or resignation, lifestyle changes, insomnia, anxiety and depression,” explained Ms Tang. “One impact that people often do not think much about is how it affects the patient’s loved ones. It can be difficult watching a family member in distress due to tinnitus.”  

More often than not, tinnitus is a symptom of an underlying medical condition. A thorough medical investigation is therefore needed to determine if there are any underlying diseases that may be causing the tinnitus.

If there is a medical condition that is causing tinnitus, the treatment will look to address the patient’s active medical issues. Otherwise, patients will be taught how to gain relief and control over the symptoms of tinnitus.

Ms Tang explained, “The most common way we do that is through the use of individualised and customised sound therapy. Ultimately, the goal is to use therapeutic sounds to help the brain learn how to effortlessly ignore the tinnitus over time, and this process is called habituation. So even if the tinnitus does not go away completely, it will no longer be a problem for the patient.”

The management plan for tinnitus is tailored to the varied needs of the patient. Treating tinnitus with sound therapy alone may not entirely prove effective. This is why a comprehensive management plan that considers other coexisting conditions is deemed the most ideal solution. 

“Most importantly, the patient must be seen and managed as a whole, not just for their tinnitus,” said Ms Tang. “Factors including social situations, family dynamics, general or workplace stressors, and a patient’s support systems also play a role in the management of the condition.

“In addition, it is crucial to consider other medical issues that require further investigation and management by specialists such as psychiatrists, psychologists, geriatricians, rheumatologists and neurologists.”

On top of management plans by medical professionals, there are also many smartphone applications and patient support groups to educate, exchange information and help a patient manage tinnitus. Dr Goh, however, highlighted that “these resources are best used in consultation with your healthcare professional to avoid possible misinformation.”

Thankfully, in most cases, the symptoms of tinnitus can subside, as Ms Tang said, “Most patients do improve significantly if they follow through with the management plan. So there is always hope!”

Click here to find out more or to join us as an audiologist.