SINGAPORE: Tinnitus was not a ringing in the ear or a high-pitched tone for Ms Tan, 51. It was like hearing someone tap on a microphone randomly at any time of the day.
The public sector employee said the interruptions were “very irritating” and affected her work and social life.
“When you’re doing work and you’re reading emails … then you also have to think, and this thing suddenly (pops up). It’s very annoying,” she said, mimicking the sound that plagued her for months.
“I was really in a bad shape, it’s like I was in depression,” said Ms Tan, who declined to give her full name.
She was diagnosed with middle ear myoclonus, a type of tinnitus where clicking or knocking sounds are heard because of the twitching of tendons and muscles in the ear.
WHAT IS TINNITUS?
Tinnitus is a condition where a person perceives sounds that are not coming from the external environment and can usually only be heard by the patient.
It is common and affects at least 750 million people around the world, said Dr Goh Xue Ying, a consultant at National University Hospital (NUH) who specialises in ear, nose and throat (ENT) issues.
“But only a fraction (of) these patients have tinnitus that troubles them significantly,” he said.
The condition is common in Singapore as well, afflicting at least 12,240 Singaporeans aged 60 and above.
Among 72,000 of them who went for hearing screenings between 2018 and 2020, 17 per cent said they heard “ringing in the ear”, the Ministry of Health said in response to a parliamentary question on Jan 9.
Population studies worldwide found that tinnitus is more common in older people and peaks between 60 to 69 years of age.
Ms Joanna Tang, an audiologist at NUH, said there was an increase in tinnitus patients seeking help after Singapore’s “circuit breaker” period in 2020. These patients may have had tinnitus for years, but only noticed it when working in a quiet environment at home, she said.
In severe cases, however, tinnitus can have serious consequences on daily life, said Dr Charmain Zhao, a consultant at Raffles ENT Centre.
“It can result in reduced quality of life, insomnia, anxiety and depression if patients are unable to cope with (or) get used to the tinnitus,” said Dr Zhao, who specialises in otorhinolaryngology, the surgical and medical management of ENT conditions.
Ms Tang said it can also be difficult for family members to see a patient in distress.
“Patients who are bothered by their tinnitus also tend to experience a feeling of hopelessness as they may be told or read online that ‘there is no cure’ for tinnitus,” she said.
But tinnitus management can give patients relief and control over the condition, she said. “So there is always hope!”
RISK FACTORS
Experts told CNA that tinnitus can be triggered by a variety of situations including exposure to loud sounds, high cholesterol, ear infections, tumours or head and neck injuries.
Migrant workers may be at risk because of loud noise at their workplaces. Tinnitus linked to age-related hearing loss may also be on the rise given Singapore’s greying population, said Dr Zhao.
“Exposure to sudden or prolonged loud sounds is the most common factor related to tinnitus onset,” she added.
Ms Tan believes her tinnitus was because she used to blast music on headphones when she was a teenager.
Another person with tinnitus who declined to give his full name, Mr Chang, 30, similarly said loud music from when he used to dance and even at church services may have caused his condition.
In cases where there is an underlying disease or injury, treating it can help to resolve tinnitus, doctors said.
However, other forms such as continuous tinnitus mostly “occur spontaneously” and medication cannot completely eliminate it, according to Dr Barrie Tan, an ENT specialist at Gleneagles Hospital.
TREATMENT OPTIONS
In Ms Tan’s case, she was relieved to find out that her condition could be surgically treated. She tried oral medication before opting for surgery when the problem persisted.
At the time, she told Dr Tan of Gleneagles Hospital: “I really can’t tolerate this, I can’t live with this.”
“Everybody was worried for me because suddenly I became very closed off,” she said.
“I’m actually a very happy-go-lucky kind of person that, you know, always talks and laughs. And then suddenly it’s like, so miserable and then always hiding in the room.”
The procedure took about three hours under general anaesthesia, and the recovery was “not that easy”, but it was worth it, said Ms Tan.
Dr Tan said the surgery for middle ear myoclonus involves cutting tendons so that they stop causing “unwanted twitching movements of the middle ear bones”.
“This is immediately beneficial and patients wake up from the surgery immediately without any further pulsatile, clicking tinnitus,” he said.