Post-Concussion Tinnitus Treatment
December 17, 2020

 

Individual experiencing tinnitus pain

Head injuries like concussions can result in a continuous ringing in your ears, known as tinnitus. 

Tinnitus is a symptom of an underlying problem and not a disease in itself. So treating tinnitus post-concussion is dependent on the type of head injury that caused the ringing noise to appear. 

So in this piece, you'll learn the various possible reasons for tinnitus following head injuries like concussions and how to treat them. We will also go through the many ways you can cope with the noise if treatment isn't possible.

Tinnitus Defined

Tinnitus is the perception of noises within the ear without an external source of the sound. Tinnitus can happen in one ear or the two, intermittently or continuously, and varies in pitch and intensity in different patients. 

Most times, the tinnitus noise is perceived as coming from within the ear. And at other times, it may be heard like it has an external source. 

The sound that you may experience when you have tinnitus is explained as a high-pitched ringing sound. Other tinnitus-related noises patients describe are:

  • Pulsing
  • Buzzing 
  • Static
  • Dial tones 
  • Whooshing

Some people may even hear musical sounds, even though this symptom isn't common. Feeling pressure (aural fullness) and a painful sensation around or in the ear is also a tinnitus sign.

What is the Cause of Post-Concussion Tinnitus

Concussion related tinnitus

 

Tinnitus can happen for several reasons post-concussion. So here are the most common reasons for tinnitus as a result of head injury:

1. Concussion "Labyrinthine"

This happens when there is damage to the inner ear. Unlike most causes of tinnitus post head injury, this doesn't result in bone fractures. Instead, the extent of the injury itself almost destroys the patient's cochlea.

Labyrinthine concussions generally result in a total loss of hearing and are usually followed by tinnitus.

2. Ossicular Chain Disruption

The ossicular chain is made up of 3 tiny bones. These bones help in the transmission of sound to the inner ear's cochlea from the tympanic membrane. 

Head trauma can result in the misalignment of these three small bones, leading to conductive hearing loss. And ultimately cause tinnitus. 

When tinnitus is a result of damage to bones, it is called somatic tinnitus.

3. Meniere's Syndrome

At times a head injury can result in a problem called Meniere's Syndrome. This issue occurs due to pressure build-up within the ear.

The pressure makes the ear fluid move more than necessary, affecting both your balance and hearing. 

Besides damaging your hearing, this unusual ear pressure can result in tinnitus symptoms. There isn't a cure for Meniere's Syndrome, but certain medications and steroids can relieve you from its symptoms, including tinnitus.

4. Sensorineural Hearing Loss

Tinnitus often accompanies the sensorineural loss of hearing. This occurs when damage to the auditory nerve or the hair-like cells within the inner ear responsible for transferring sound occurs. 

It may often not result in a total hearing loss, but it usually affects some frequencies. However, researchers do not yet completely understand why tinnitus happens with hearing loss but what's clear is that the loss of particular sound frequencies transforms how the human brain processes sound. 

This means, when your brain receives lower than normal external stimuli from a particular frequency, your brain will adapt to the new change. 

Certain researchers hypothesize that tinnitus could be due to the brain filling the lost sound frequencies it no longer gets.

5. Temporomandibular Joint Disorder

Another type of head injury-related tinnitus (somatic tinnitus) happens post damage to the temporomandibular joint.  This joint is found in front of your ears, where there's a connection of the lower jaw to the skull. 

The temporomandibular joint shares nerve connections and ligaments with the middle ear, making it possible for damage to the jaw cartilage or muscles after a hit to the head to result in tinnitus. 

If you get tinnitus that results from a temporomandibular joint disorder, you'll also get other symptoms like: 

  • Limited jaw motion 
  • Popping noises when chewing or speaking
  • Pain in jaw or face. 

Most times, when you treat the temporomandibular joint disorder, you will get rid of the tinnitus symptoms.

Post-Concussion Tinnitus Treatment

 

Post Concussion tinnitus treatment with hearing aid

 

Most issues of tinnitus after head injuries like a concussion can be treated by fixing the root cause. For instance, undergoing surgery to fix the ossicular chain disruption results in the alleviation of tinnitus symptoms, most times. 

This is why having an in-depth diagnosis with an ear specialist is vital. That said, if tinnitus results from the way the brain processes sounds, there's no way to treat it. But there are still ways the patient can manage the accompanying symptoms. Let's have a look at that below.

Mask the Sound to Manage Tinnitus

In post-concussion situations where tinnitus can't be fixed. The best move is to learn various methods of managing it. A common technique to achieve this used by many tinnitus patients is known as "masking.” 

In masking, a tiny device that looks like a hearing aid is worn by the patient (headphones can also be used).  The device creates customized noises that drown the irritating ringing sounds associated with tinnitus. 

Standard masking sounds like white noise from fans, nature sounds, or music can also be used. 

In certain situations, masking engages neuroplasticity to retrain the brain to tune out repetitive or annoying sounds. In the long run, the result will be that the individual won't have to use masking. But this method doesn't always work. Hence, it's common for most patients to have to depend on masking all their life.

Other Tinnitus Treatments

Besides masking, other techniques can be used to cut down the severity of tinnitus. Tinnitus symptoms often arise in times of high stress and anxiety, so finding ways to reduce your anxiety can sometimes be helpful. Here are other ways you can decrease tinnitus symptoms:

  • Acupuncture
  • Cognitive-behavioral therapy
  • Mindfulness meditation 
  • Exercise 

While such methods cannot directly treat tinnitus can help you reduce the effect of the disorder on your mental well-being.

Conclusion

Tinnitus results in a continuous irritating ringing in the ear post-concussion, and it can be a very annoying condition. It happens for several reasons after damage to the head, including how the brain processes sound.

There's no one-fix-all cure for tinnitus, but you can manage it if the treatment of the cause doesn't work. To know the best move to make, fix an appointment with an ear specialist immediately. They'll help you figure out the root cause of your tinnitus and recommend the best ways to handle it.

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Drew Sutton M.D.

Drew Sutton, MD is a board-certified otolaryngologist. He has extensive experience and training in sinus and respiratory diseases, ear and skull base surgery, and pulmonary disorders. He has served as a Clinical Instructor at Grady Hospital Emory University for more than 12 years.

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