Head injuries, like concussions, can cause a continuous ringing in the ears, which is known as tinnitus.
Tinnitus is a symptom of an underlying problem, not a disease in itself. Therefore, its treatment after a concussion depends on the type of head injury that caused the sound.
In this article, you will discover the different possible causes of tinnitus following a head injury such as a concussion, as well as how to treat it. We will also look at the many ways to live with this noise when no treatment is possible.
What is tinnitus?
Tinnitus refers to the perception of sounds in the ear in the absence of any external sound source. It can affect one or both ears, occur intermittently or continuously, and vary in pitch and intensity from one patient to another.
Most of the time, the sound seems to come from inside the ear. In other cases, it gives the impression of having an external origin.
The sound perceived in cases of tinnitus is generally described as a high-pitched whistling. Patients also report other types of noises:
Pulsations
A humming sound
A crackling sound
A telephone tone
A blowing sound
Some people even perceive musical sounds, although this symptom is rare. A feeling of pressure (blocked ear) and pain in or around the ear are also among the signs of tinnitus.
What are the causes of tinnitus after a concussion?
Tinnitus can appear for several reasons after a concussion. Here are the most frequent causes of tinnitus following a head injury:
1. "Labyrinthine" concussion
This occurs when the inner ear is damaged. Unlike most causes of post-traumatic tinnitus, it is not accompanied by bone fracture. It is the extent of the lesion itself that almost entirely destroys the patient's cochlea.
Labyrinthine concussions generally lead to total hearing loss and are most often followed by tinnitus.
2. Ossicular chain disruption
The ossicular chain is composed of 3 ossicles. These small bones ensure the transmission of sound from the eardrum to the cochlea in the inner ear.
A head injury can misalign these three ossicles and cause conductive hearing loss. This, in turn, leads to tinnitus.
When tinnitus results from bone injury, it is called somatic tinnitus.
3. Ménière's syndrome
A head injury can sometimes lead to a disorder called Ménière's syndrome. This is due to a buildup of pressure inside the ear.
This pressure causes the fluid in the ear to move more than necessary, which disrupts both your balance and your hearing.
In addition to damaging your hearing, this abnormal pressure can cause tinnitus. There is no cure for Ménière's syndrome, but some medications and corticosteroids can relieve its symptoms, including tinnitus.
4. Sensorineural hearing loss
Tinnitus often accompanies sensorineural hearing loss. This occurs when the auditory nerve or the hair cells of the inner ear, responsible for transmitting sound, are damaged.
It does not always lead to total hearing loss, but it generally affects certain frequencies. However, researchers do not yet fully understand why tinnitus accompanies hearing loss; what is certain is that the disappearance of certain sound frequencies changes the way the human brain processes sound.
In other words, when your brain receives fewer external stimuli than normal on a given frequency, it adapts to this change.
Some researchers hypothesize that tinnitus originates from the brain, which fills in the sound frequencies it no longer receives.
5. Temporomandibular joint disorders
Another type of tinnitus linked to head trauma (somatic tinnitus) appears after an injury to the temporomandibular joint. This joint is located in front of the ears, where the lower jaw joins the skull.
The temporomandibular joint shares nerve connections and ligaments with the middle ear: an injury to the cartilage or jaw muscles after a blow to the head can therefore cause tinnitus.
If your tinnitus results from a temporomandibular joint disorder, other symptoms will be added:
Limited jaw opening
Cracking sounds when chewing or speaking
Jaw or facial pain.
In most cases, treating the temporomandibular joint disorder makes the tinnitus disappear.
Treatment of tinnitus after a concussion
Most tinnitus following a head injury such as a concussion is treated by correcting its root cause. Surgical intervention to repair an ossicular chain disruption, for example, most often relieves tinnitus.
This is why a thorough diagnosis by an ear specialist is essential. That said, when tinnitus comes from the way the brain processes sounds, no treatment is possible. However, the patient has solutions to manage the accompanying symptoms. Let's look at this below.
Masking the noise to better live with tinnitus
When post-concussion tinnitus cannot be cured, the best thing to do is to learn different methods to manage it. A common technique, used by many patients, is called "masking."
The principle: the patient wears a small device that resembles a hearing aid (headphones can also do the trick). The device diffuses personalized sounds that cover the unpleasant whistling associated with tinnitus.
Classic masking sounds can also be suitable: white noise from a fan, nature sounds, or music.
In some cases, masking mobilizes neuroplasticity to retrain the brain to ignore repetitive or annoying sounds. In the long term, the person then no longer needs masking. But this method does not always work. It is therefore common for most patients to have to use it throughout their lives.
Other treatments for tinnitus
Beyond masking, other techniques can alleviate the severity of tinnitus. Symptoms often manifest during periods of significant stress or anxiety: finding ways to reduce your anxiety can therefore be helpful. Here are other ways to reduce tinnitus:
Acupuncture
Cognitive-behavioral therapies
Mindfulness meditation
Physical activity
While these methods do not directly treat tinnitus, they help you limit its impact on your mental well-being.
Conclusion
After a concussion, tinnitus results in a continuous and irritating whistling in the ear, a disorder that can quickly become painful. It appears for several reasons after a head injury, particularly because of the way the brain processes sound.
There is no universal cure for tinnitus, but you can learn to manage it when treating the cause doesn't work. To find out what to do, make an appointment without delay with an ear specialist. They will help you identify the origin of your tinnitus and advise you on the best ways to manage it. To learn more about tinnitus and other hearing disorders, visit CLARIA.
