You come home from the nightclub with a constant whistling sound in your ears; it is something that has probably happened to everyone at some time. It is due to an irritation of the nerve endings of the inner ear, caused by prolonged exposure to loud noise, and it normally disappears within a few hours. What some people find, though, is that they start to hear this noise and it is still there months later, with no apparent cause. If it happens to you, it's not because somebody is saying bad things about you, as old wives' tales would have us believe, because it is almost certainly due to tinnitus.
Tinnitus occurs in response to noise, which can be constant or intermittent, and can be in both ears or just one. We hear it even though there is no exterior acoustic stimulus. It can take different forms: buzzing, ringing, whistling, clicking or hissing.
The volume of sound varies in each person and in some cases it can be so loud that it affects concentration or makes it difficult to hear anything else. In fact, in 70 per cent of cases tinnitus is accompanied by a loss of hearing and is one of the principal causes of deafness.
It is calculated that in Spain about seven per cent of the population suffers from tinnitus and, curiously, singers such as Phil Collins, Bob Dylan, Barbara Streisand and actors like Gerard Butler, Halle Berry and Robert Redford have undergone treatment for it.
Clinically, tinnitus is divided into two types. One occurs in response to real sounds that are produced elsewhere in the body (such as blood vessels, or small bones in the middle ear) and they can be detected by the sufferer and also by a doctor using a machine.
The others can only be heard by the patient and occur without any perceivable outside source or corporal activity.
Diagnosis and treatment
The causes are varied, from hearing loss due to age, exposure to continued loud noise or blockage by ear wax.
"There are also some medications that cause ototoxicity (damage in the ear), such as aspirin, quinine and certain anti-depressants," said Francisco Lorenzo Molina, head of the Ear, Nose and Throat department at the Viamed-Virgen de la Paloma hospital in Madrid.
Other factors that can make tinnitus worse are depression, anxiety, stress, high cholesterol, diabetes and auto-immune illnesses, among others.
Diagnosis is carried out by an audiometry test, an acuphenometry (to determine the frequency and intensity of the tinnitus) and a magnetic resonance scan.
When it comes to treatment, this may be medical, if the tinnitus is a symptom of an undiagnosed condition; rehabilitation, using sound therapies with white noise; or through medication.
"Surgical treatments are still not well documented," said Dr Lorenzo.
Is there a cure for tinnitus, or not? "It is reversible, but what happens in 70 per cent of cases is that the patients learn to live with it without it affecting their everyday life," he said.