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Tinnitus and ear syringing

MagazineNovember 2005 (Vol. 16 Issue 8)Tinnitus and ear syringing

A Syringing is a common outpatient procedure that is used to remove a buildup of ear wax

A Syringing is a common outpatient procedure that is used to remove a buildup of ear wax. It's performed on around 150,000 people in the US and some 20,000 in the UK every week - and, yet, doctors know that it's not a safe procedure. It can cause tympanic membrane damage and promote infection (Br J Gen Pract, 2002; 52: 906-11), and these major complications occur in one in 1000 procedures. On that basis, nearly 8000 Americans and 1000 Britons suffer ear damage after syringing every year (Aust Fam Physician, 2003; 32: 150-1).

It's very likely that the syringing has caused the constant ringing, or tinnitus, in your husband's ears, although around 136 prescription drugs are also known to cause the condition - with the most likely suspects being pain-relievers, antibiotics, antidepressants and sedatives.

Tinnitus is a symptom and not a disease. It is characterised by a frequent or constant ringing or buzzing sound in the ear. It's a common problem, affecting about 17 per cent of the general population, and 33 per cent of the elderly. It can be caused by an ear injury, infection, wax buildup or constant exposure to loud noises, such as construction tools, gunshots and rock-music concerts.

Conventional medicine has little to offer the tinnitus sufferer, other than suggesting that it's something he has to learn to live with - and surveys have shown that around 75 per cent of sufferers do just that.

The very brave, or perhaps the desperate, opt for surgery to sever the hearing nerve. But this can cause permanent deafness, balance problems and may even make the tinnitus worse.

Tinnitus appears to worsen after smoking, drinking caffeine or alcohol, or eating chocolate, and it seems to be especially affected by stress, so meditation or visualisation techniques could help when the tinnitus seems to be at its worst.

Aside from diet and lifestyle changes, two therapies have come to the fore - acoustic therapy, and tinnitus retraining therapy (TRT).

Acoustic therapy appears to be based on the old Chinese remedy that a stamp on the foot will make a headache seem less painful. The treatment involves fitting a 'sound generator' in the ears, which produces pleasant music or background noises to distract the tinnitus sufferer from hearing the buzzing or ringing.

TRT is more sophisticated, and turns on its head the common perception of tinnitus as an ear problem. Instead, neuroscientists such as Pawel Jastreboff have postulated that tinnitus has associations with the limbic system, which plays a key role in our emotions, and the autonomic nervous system, triggering our 'fight-or-flight' response (Neurosci Res, 1990; 8: 221-54).

Jastreboff argues that tinnitus is a common problem; sometimes it's linked to a negative emotion when the sufferer fears there is something wrong with his hearing or even his brain. This focus alerts the autonomic nervous system, triggering a vicious circle so that the tinnitus, in turn, appears to worsen.

Nevertheless, it's extraordinary that none of the current theories embraces the major breakthrough made by Sir Edward Mellanby and F.R. Nager in 1938 when they discovered that disorders of the inner ear, including tinnitus, were the result of vitamin A deficiency (see box).

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