Head injuries can sometimes lead to a persistent ringing in the ears, also known as tinnitus.
Tinnitus is not a disease but rather a symptom of another underlying problem. Therefore, treatment for tinnitus after a head injury will depend on diagnosing the root cause.
In this article, you will learn the possible causes of tinnitus following a head injury as well as how to treat it. We’ll also provide different ways to adjust if treatment is not possible.
What is Tinnitus?
Tinnitus refers to the perception of sound within the ear when there is no outside noise. According to researchers, approximately 53% of traumatic brain injury patients develop tinnitus. This number is higher in those who experience blast-induced brain injuries.
Tinnitus can occur in one or both ears, constantly or intermittently, and can vary in intensity and pitch. Generally, the sound is perceived as originating from inside the ear. Sometimes, however, it can sound like it is coming from the outside.
The sound that people with tinnitus experience is typically described as a high-pitched ringing noise. Other sounds that people describe include:
- Dial tones
Some patients even hear music, although this is rare. Feelings of aural fullness (pressure) and pain in or around the ear can also accompany tinnitus.
Causes of Tinnitus
Tinnitus can occur for a variety of reasons after head injury or concussion. The most common causes that occur as a result of trauma are listed below:
1. Ossicular Chain Disruption
The ossicular chain is composed of three small bones in the middle ear. They help transmit sound from the tympanic membrane to the cochlea of the inner ear.
Head trauma may lead to a loss of alignment between these bones, which may cause conductive hearing loss. It may also cause tinnitus.
Tinnitus caused by damage to bones or other structures is known as somatic tinnitus.
2. Temporomandibular Joint Disorder
Another type of somatic tinnitus occurs after damage to the temporomandibular joint (TMJ). The TMJ is located in front of the ears, where the lower jaw connects to the skull.
The TMJ shares ligaments and nerve connections with the middle ear. Therefore, damage to the muscles or cartilage in the jaw after head injury can lead to tinnitus.
If your tinnitus is caused by a TMJ disorder, you may also experience other symptoms, such as:
- Pain in face or jaw
- Restricted jaw movement
- Popping sounds when talking or chewing
In most cases, treating the TMJ disorder may eliminate tinnitus.
3. Labyrinthine “Concussion”
This occurs when the inner ear becomes damaged. Unlike other causes of tinnitus after a head injury, this does not cause bone fractures. Instead, the extreme force of the injury itself nearly destroys the cochlea.
Labyrinthine concussions typically lead to complete hearing loss and are often accompanied by tinnitus.
4. Meniere’s Syndrome
Sometimes head injury can lead to a problem known as Meniere’s Syndrome. This disorder causes a build-up of pressure within the inner ear.
This pressure causes the fluid in the ear to move too much, which may affect your hearing as well as your balance.
Besides affecting your hearing, this abnormal pressure in the ear may cause tinnitus symptoms.
There is no known cure for Meniere’s syndrome. However, steroids and other medications may alleviate symptoms, including tinnitus.
5. Sensorineural Hearing Loss
Sensorineural hearing loss is often accompanied by tinnitus. This type occurs when there is damage to either the hair-like cells in the inner ear that transfer sound or to the auditory nerve itself.
It usually doesn’t cause complete hearing loss. Instead, it mainly affects certain frequencies.
Researchers still do not fully understand why hearing loss causes tinnitus. However, it is known that loss of certain sound frequencies changes how the brain processes sound. In other words, when the brain receives less external stimuli from a certain frequency, the brain will adapt to this change.
Therefore, some researchers suggest that tinnitus may be a result of the brain filling in the missing sound frequencies it no longer receives.
Treating Tinnitus After Head Injury
Most cases of tinnitus after a head injury may be treated by addressing the root cause. For example, surgery to repair ossicular chain disruption may alleviate tinnitus symptoms. That’s why a thorough diagnosis by a hearing specialist is crucial.
If tinnitus is caused by changes in the way the brain processes sound, there may be no way to cure it. However, there are still ways to manage the symptoms, which we will look at below.
Masking as a Coping Mechanism
In those cases where tinnitus cannot be cured, the alternative is to learn different ways to manage it. One popular technique that many tinnitus patients use is called “masking.”
With masking, a small device that resembles a hearing aid is worn (headphones can also work). This device produces customized sounds that drown out the annoying ringing noise of tinnitus.
You can also use standard masking sounds such as music, nature sounds, or white noise from a fan.
In some cases, masking actually engages neuroplasticity and retrains the brain to tune out annoying or repetitive sounds. Eventually, the person may not need to use masking anymore.
This technique does not always work, however. As a result, patients may need to rely on masking for most of their lives.
Besides masking, there are also other techniques that may reduce tinnitus severity. Tinnitus often increases during periods of high stress, so finding ways to decrease anxiety can sometimes help. Some methods that may reduce tinnitus symptoms include:
While these methods will not directly treat tinnitus, they might help decrease its impact on your mental health.
Tinnitus After Head Injury
Tinnitus causes persistent ringing in the ear after a head injury and is often disturbing and disruptive. It occurs for a variety of reasons, including changes to the way the brain processes sound.
There is no cure for tinnitus, but there are ways to manage it. To find the best course of action, make an appointment with an Audiologist. They may determine the precise cause of your tinnitus and suggest ways to approach treatment.