Have you ever imagined having the feeling of always hearing the same “buzzing” over and over again? Despite the name, it is known that it rarely resembles a “zzzzz”, like a swarm of bees. Reports from those who listen compare it to sea waves and even a pressure cooker on the fire. 

Around 20% of the world's population has some degree of hearing impairment or suffers from tinnitus, perception of a sound in the ears or head that is not generated by an external sound source. According to the Federal Council of Speech Therapy, in Brazil, approximately 28 million people are affected by the problem, which is not considered a disease, but rather a warning sign of hearing loss.

To raise awareness of the issue, the month of November is also known as Orange November and hosts National Tinnitus Awareness Day, on November 11th. 

The causes of tinnitus

Tinnitus can be caused by different factors and affect the well-being of people of different age groups. It may also be associated with dizziness or sound intolerance.

Speech therapist Rogéria Dias, who works at the Hearing Rehabilitation clinic at Center for Health Education and Research Anita Garibaldi, from the Santos Dumont Institute (ISD), explains that the causes can be related to the most diverse natures. “Tinnitus can arise from vascular problems, cardiac and hormonal changes, metabolic problems, muscular changes in the head and neck region, as well as dental deformities. Jaw problems and sensory injuries can also be associated with this discomfort”, said the audiology specialist. 

According to Rogéria, the most common origins come from sensory lesions in the auditory pathways. “Tinnitus can also be a consequence of the accumulation of earwax, colds or aging, exposure to strong or intense sounds, after all, it occurs more frequently in adults and elderly people. At Anita, the majority of tinnitus complaints come from patients who already have some degree of hearing loss”, he adds. 

More than half of patients undergoing auditory rehabilitation at Anita complain of tinnitus

At the Anita auditory rehabilitation clinic – which serves the population of the Metropolitan region of Natal (RN) – 53% of patients received since 2018 complained of tinnitus. 

The number corresponds to 355 of the 669 people served, most of them adults and elderly people, and is part of a survey carried out by ISD speech therapy residents, monitored by preceptors. 

The survey aims to identify the clinical and sociodemographic characteristics of patients who seek the service at the clinic, as explained by the resident of the Multiprofessional Residency Program in Health Care for People with Disabilities, at ISD, Nancy Sotero. “The objective of this survey is to understand the needs of these patients, so that we can establish audiology and multidisciplinary intervention flows and protocols. Furthermore, it is important data to encourage the establishment of assistance policies in the public service”, said the resident. 

According to a study by American Public Health Agency, published by the Federal Council of Speech Therapy, tinnitus is the third most annoying symptom in the world, second only to intense pain and dizziness. Rogéria Dias says that the sensation is described by patients in different ways, such as a whistle, hissing, the noise of a pressure cooker and even sea waves. “This noise can be constant, intermittent, it can appear and disappear, it can be low or loud, sometimes it goes unnoticed, but it is a warning sign – not only for hearing loss, but for other diseases – that needs to be monitored”, he notes.

Treatment 

There are several forms of treatment for tinnitus, recommended according to the causes identified in each case. “When the patient comes to us, we try to identify the frequency range of this tinnitus, its intensity, through audiometry and quantitative assessments, to understand whether the impact is emotional or functional, for example. Once the cause of the tinnitus is identified, we direct you to a specific therapy for each type of case”, said Rogéria. 

According to the specialist, the right thing to do is to follow up with a professional speech therapist and an otorhinolaryngologist who can indicate the best form of treatment, such as dietary changes, medications, sound therapies and adaptation of hearing aids. 

Awareness 

The Association for Interdisciplinary Research and Dissemination on Tinnitus (Apidiz) created, in 2009, the National Tinnitus Awareness Campaign, better known as Orange November, with November 11th as National Campaign Day. The action aims to raise awareness and inform the population about this symptom and is promoted annually by the Ganz Sanchéz Institute, which raises five causes to be embraced during the month:

1. Tinnitus and sound intolerance are symptoms of ears that are more vulnerable to aggression; (i.e., those who are susceptible to hearing loss or other hearing problems, such as the elderly); 

2. It is necessary to correctly investigate its various causes;

3. Early treatment can make a difference in ear recovery and quality of life;

4. A multidisciplinary approach may be more efficient in treating tinnitus and sound intolerance;

5. Changing restrictive thoughts (“there is nothing to do”, “there is no cure”, “learn to live together”) to expand professional performance and the patient’s chance of improvement.