Auditory Hyperactivity, Hallucinations, and Tinnitus
Wible (2012) notes that tinnitus, musical hallucinations, and hearing voices may be considered auditory hallucinations, which may present with a "continuum of complexity." (Editor’s Note – people who hear voices, words, and entire dialogs in the absence of true acoustic speech stimuli may be experiencing schizophrenia. Appropriate referral should be considered in these cases.)
Eggermont (2012) reports that people are often ill-equipped to describe their tinnitus. For example, when given a 4000 Hz pure tone, roughly one-third of the subjects described it as a tone, one-quarter described it as a hissing sound, about one in five described it as a roaring sound, and about one in five described it as whistling/squeaking/other. Eggermont noted that the perceived severity of tinnitus is not solely dependent on loudness or pitch (indeed, these percepts may vary daily) but includes degree of annoyance as well as the associated disability from the perceived tinnitus.
Moller (2012) notes that there are multiple "hyperactive disorders of the auditory system," including subjective tinnitus (the most common hyperactive disorder of the auditory system), phonophobia, hyperacusis, and misophonia. Moller reports that severe tinnitus is a "phantom sensation" (Jastreboff, 1990) similar (in some respects) to central neuropathic pain. In agreement with Eggermont (earlier), Moller notes that the strength of the perceived tinnitus itself is not a valid measure of its impact on the person experiencing it.
With regard to the origin of tinnitus, Moller states most forms of severe tinnitus start with an ear or auditory nerve disorder that eventually changes the auditory nervous system through neural plasticity. Sound deprivation and overstimulation can each promote neural plastic changes within the auditory system. Of note, tinnitus may originate in non-classical auditory nervous system pathways that may include the amygdala, other structures within the limbic system, the motor cortex, the somatosensory system, and more.
For More Information, References, and Recommendations
Baigi A, Oden A, Almlid-Larsen V, Barrenas ML, Holgers KM. (2011) Tinnitus in the General Population With a Focus on Noise and Stress—A Public Health Study. Ear & Hearing 32(6):787–789.
Beck DL. (2011) Hearing Aid Amplification and Tinnitus: 2011. Hearing Journal 64(6):12–14.
Eggermont JJ. (2012) Current Issues in Tinnitus. In "Translational Perspectives in Auditory Neuroscience. Editors: Tremblay KE, Burkard RF. Plural Publishing. Pages 123–163.
Henry JA, Zaugg TL, Myers PJ, Kendall CJ. (2012) Progressive Tinnitus Management, NCRAR, U.S. Dept. of Veterans Affairs. Reviewed/Updated Date: March
Jacobson G. (2012) Tinnitus Relief- At What Cost? Journal of the American Academy of Audiology 23(2):80.
Jastreboff P. (1990) Phantom Auditory Perception (tinnitus). Mechanisms of Generation and Perception. NeuroScience Research 8:221–254.
Kochkin S, Tyler R, Born J. (2011) MarkeTrak VIII: The Prevalence of Tinnitus in the United States and the Self-Reported Efficacy of Various Treatments. Hearing Review 18(12):10–26
Moller, A. (2012): Hyperactive Disorders of the Auditory System . In Hearing-Anatomy, Physiology and Disorders of the Auditory System. Chapter 10. Pages 321-340. Published by Plural Publishing.
Newman CW, Sandridge SA. (2012) A Comparison of Benefit and Economic Value Between Two Sound Therapy Tinnitus Management Options. Journal of the American Academy of Audiology 23:126–138.
Stouffer LJ, Tyler RS. (1990) Characterization of Tinnitus by Tinnitus Patients. Journal of Speech and Hearing Disorders 55:439–453.
Tyler RS, (2012) Patient Preferences and Willingness to Pay for Tinnitus Treatment. Journal of the American Academy of Audiology 23:115–125.
Wible CG. (2012) The Brain Bases of Phantom Auditory Phenomena—From Tinnitus to Hearing Voices. Seminars in Hearing 33(3).