Why do ears ring? Experts explain tinnitus and hearing loss.

Susan Bianco, 87, who lives in Lancaster, began to notice her hearing deteriorating when she frequently had to ask her husband to repeat things. Conversations on the phone became more difficult than before, and large gatherings were almost a real challenge.

 

" It's very difficult to hear clearly in a crowded place ," she shared. " If many people are talking at the same time, I can barely understand what one person is saying. "

Not long after, Bianco noticed a new symptom. She began hearing a constant buzzing in her ears, and this sound became more pronounced when she felt tired.

According to the U.S. Centers for Disease Control and Prevention (CDC), Ms. Bianco is among the 13% of adults in the U.S. who experience hearing loss, and that number rises to 27% in those 65 and older. She is also among the approximately 10% of the population who suffer from tinnitus – a condition often associated with hearing loss. Both of these problems tend to increase with age and exposure to loud noise.

 

" You can't stop the aging process, but you can definitely take proactive steps to protect your hearing and reduce your risk of hearing loss and tinnitus ," says Dr. Jackie Price, an audiologist at Penn State Health (ENT department).

 

What is tinnitus?

Tinnitus is a condition where a person hears sounds such as ringing, buzzing, hissing, hissing, or humming in one or both ears. According to Dr. Price, some people describe this sound as similar to the chirping of cicadas or the sound of a passing train.

In some cases, this sound is persistent and irritating, directly affecting concentration, work performance, and quality of life. Importantly, these sounds don't originate from the external environment, but rather from a 'mismatch' in the communication between the ear and the brain.

Besides tinnitus, there are other sound-related disorders such as hyperacusis, which makes everyday sounds seem too harsh, or misophonia – a condition where certain sounds trigger strong emotional reactions.

Causes of tinnitus and hearing loss

According to Dr. Price, tinnitus and similar auditory disturbances are often early signs of hearing loss. This process begins when the tiny hair cells in the cochlea – the spiral-shaped structure in the inner ear – are damaged. Normally, these cells are responsible for converting sound waves into electrical signals for the brain to process.

 

When hair cells are damaged, sound signals are disrupted, making hearing more difficult. This disruption sometimes distorts the signal, causing the brain to 'imagine' sounds that don't exist, and that's what tinnitus feels like.

Hearing loss and other sound disorders not only affect hearing, but also negatively impact sleep, concentration, and social relationships. In the long term, they can increase the risk of cognitive decline, depression, and even falls in older adults.

How can we prevent tinnitus and hearing loss?

Protecting your ears from loud noise is crucial. When noise levels exceed 85 decibels, you should use hearing protection devices such as earplugs or earmuffs, especially at concerts, sporting events, fireworks displays, or when using high-powered machinery.

Dr. Price says she often advises people to wear ear protection while mowing the lawn instead of listening to music with headphones. "It's a 'double-edged sword,' because you have the lawnmower noise and you have to turn the music up louder to hear clearly, and this can last 45 minutes or more, sometimes even several times a week."

When choosing earplugs or earmuffs, prioritize products with a Noise Reduction Rating (NRR) of 22 decibels or higher. This number indicates the level of sound the product can reduce. Proper usage is also crucial for maximum effectiveness.

Currently, there is no complete cure for both tinnitus and hearing loss, but treatments can significantly improve hearing ability and quality of life.

 

With hearing loss, treatment options will depend on the cause and severity. In many cases, doctors recommend the use of hearing aids or other communication aids.

For tinnitus, a common approach is tinnitus retraining therapy. This approach combines psychological counseling to help patients adapt to the sounds they hear, along with sound therapy using soft background noise, such as white noise, to distract attention from the tinnitus.

Currently, Mrs. Bianco uses a hearing aid and has begun tinnitus retraining therapy. Dr. Price programmed a gentle, pleasant, and continuous sound into her hearing aid to aid in the treatment process.

" It sounds like rain falling, and it's a sound I don't find unpleasant, " Bianco shared.

When should I get my hearing checked?

According to Dr. Price, if you start hearing ringing in your ears, you should get your hearing checked as soon as possible. Many people think they can still hear normally, but in reality, changes have occurred inside the ear, such as damage to the hair cells or a decrease in hearing ability at high frequencies. A check-up will help you understand your condition and proactively manage these changes.