Noise that stays inside: In the shadow of the security escalation and repeated exposure to explosions, more Israelis are reporting ringing, buzzing or constant noises in the ears. For some, it is a temporary phenomenon, but for others it becomes chronic and affects sleep, concentration and quality of life.
Tinnitus, or by its foreign name tinnitus is a sensation of sound without an external source. Patients describe ringing, buzzing, humming or whistling, sometimes in one ear and sometimes in both. In some cases it is a constant phenomenon throughout the day, and in others it appears in waves or worsens in a quiet environment.
The main cause in the current period is exposure to intense noise, especially explosions. The blast wave of an explosion, even when no visible damage is caused, may damage the tiny hair cells in the inner ear. These cells are responsible for converting sound waves into electrical signals that are transmitted to the brain. When they are damaged, the brain continues to produce neural activity even without real stimulation, and the result is a constant sensation of noise.
Beyond the direct damage to the ear, there is also a neurological effect. Studies indicate that the brain “compensates” for the loss of input from the ear by increasing activity in auditory regions. This process, called neural plasticity, may perpetuate the tinnitus even after the initial damage has passed.
Tinnitus may also appear following additional factors, such as ear infections, diseases of the inner ear, use of certain medications, hormonal disorders or states of stress and anxiety. However, during periods of exposure to extreme noise, such as sirens and interceptions, the increase in the prevalence of complaints is clear.
One of the central challenges is that there is no single test that confirms the existence of tinnitus. The diagnosis is mainly based on the patient’s complaints and hearing tests. In some cases, imaging tests are also performed to rule out rarer causes.
The treatment of the phenomenon is complex and limited. When it comes to acute tinnitus after noise exposure, there is a time window in which it is possible to try more active treatment. One of the approaches is the administration of steroids, sometimes in pills and sometimes by direct injection into the middle ear. The injection, which is performed in several medical centers in Israel, is intended to reduce inflammation and improve the chances of recovery of the hearing cells. The effectiveness of the treatment varies, and it is considered significant mainly when given early after the injury.
In chronic cases, the emphasis shifts to reducing suffering rather than eliminating the phenomenon. Drug treatments sometimes include anti-anxiety or antidepressant medications, which help in coping with the psychological consequences. At the same time, hearing aids or devices that produce “white noise” are used, with the aim of masking the internal sound.
In recent years, new technologies have been developing that attempt to directly affect brain activity. One of them is combined neural stimulation, which includes playing sounds through headphones together with gentle electrical pulses, sometimes through the tongue. The idea is to teach the brain to distinguish between real signals and the internal noise. Initial studies indicate improvement among some patients, but this is not a complete cure, and the treatment is still not widely available in Israel.
Additional methods include biofeedback, cognitive behavioral therapy and relaxation techniques. Their goal is to reduce stress and the emotional response to tinnitus, more than to affect its source. The effectiveness varies between patients, and sometimes it is only a partial improvement.
Alongside treatments, prevention is important. Use of ear protection, avoiding exposure to loud noise as much as possible, and early referral for examination after exposure to an explosion, may reduce the risk of permanent damage. In the current security reality, this is a recommendation that is not always practical, but awareness of the consequences is important.
For many sufferers, tinnitus is not only a hearing problem but also a psychological one. The constant noise may cause fatigue, sleep disturbances, decreased concentration and even symptoms of anxiety and depression. In these cases, a combination of medical and psychological treatment may help with long-term coping.
The phenomenon that was once the domain of workers in noisy industries or older adults with hearing loss, has recently become relevant also to a young population exposed to explosions. Despite progress in research, a complete solution has not yet been found, and coping with tinnitus remains in many cases a daily challenge. In the meantime, if you suffer from the phenomenon, schedule an appointment with an ear, nose and throat doctor after a hearing test. The doctor will consider referral to tinnitus treatment centers in several hospitals in Israel.