THE UNIVERSITY OF

ZAMBIA
IN ASSOCIATION WITH

TECHINCAL AND VOCATIONAL TEACHER’S

COLLEGE

NAME : HENRY KABONGA

SUBJECT : HEARING IMPAIRMENT

CLASS : GCPEC 12 A

STUDENT NO : 19617

ASSIGNMENT : 1

DUE DATE : 15th March, 2018

LECTURER : MRS MALUBA

DEPT : EDUCATION

TASK : what is tinnitus, what are the causes of

tinnitus and justify why tinnitus is worse at night
The word tinnitus comes from a Latin word tinnre which mean to ring or tinkle. Tinnitus
refers to ringing in the ear when no other sound is present. This sound is like hissing, roaring,
buzzing, or clicking however according to David (2004) “tinnitus is a physical condition
which is experienced as noise or ringing in the ear or head which no such external physical
noise is present”. Tinnitus is a symptom condition and not a disease.

Tinnitus has been identified to be one of the cause of hearing impairment, this essay is going
to discuss the causes of tinnitus and why it become worse at night. However there are several
causes of tinnitus and often the cause is unknown. Just about anything that can cause hearing
loss can also cause tinnitus and mostly tinnitus is accompanied by hearing loss, the most
common cause are.

Exposure to loud sound or noise. Sound is the most common cause of tinnitus 90% of people
with tinnitus they have they high levels of noise which includes hearing loss, in addition
noise can cause damage in the inner part of the ear and the sound reaches the sensitive cells
of the cochlea which is spiral shape organ in the inner part of the ear and the sound that
reaches the cochlea damages the inner part of the ear and cause tinnitus. Some examples on
which one can get affected is by wilding, carpentry, pilot, truck driver, bar man or women
these people are likely to have tinnitus because they are exposed to loud sound Axelsson A,
Sandh. (1985).

Secondly tinnitus is caused by otitis media, it usually affects the middle ear if sustained or not
treated for a long period of time or not flashed fast in very young children the condition may
result in language impairment that could affect future academic learning. Chronic otitis media
can result in conductive hearing loss by damaging the eardrum and in about 84% of cause’s
results in a mild or moderate hearing loss. This can be bacterial infection with symptoms of
otaigia physically are hard of hearing, and they profit from hearing aids because their hearing
loss is conductive resulting into tinnitus. Kelvin (1998).

Thirdly tinnitus is also caused by brain tumors or intracracranial neoplasm occurs when
abnormal cells from within the brain. There are two many types of tumors; malignant or
cancerous tumors and benign tumors. Cancerous tumors can be divided into primary tumors
that start within the brain, and secondary tumors that have spread from somewhere else,
known as brain metastasis tumors. All types of brain tumors may produce symptoms that
vary depending on the part of the brain involved. These may include headaches, seizures,
problem with low vision, vomiting, and mental changes which result to tinnitus. The mental
changes are classically worse at night when the person is alone and undisturbed by any noise
from the surrounding. The cause of most brain tumors is unknown. However risk factors that
may occasionally be involved include a number of inherited conditions known as
neurofibromatosis as well as exposure to the industrial chemical vinyl chloride, the Epstein-
Barr virus, and ionizing radiation. (Richard S, 2000)

Tinnitus can lead to ear problem as a person can stop responding well because it affects the
optic nerve which transmit sound to the brain and it can also lead to problem such as not
interpreting the body massages correctly. Tinnitus also brings chronic health condition which
can affect the hearing centre to the brain. Berry, G.

Tinnitus is also caused by excessive ear wax, the ear wax protect the auditory canal by
trapping particles like, foreign bodies, dirty and denying bacteria’s like cockroach from
entering inside the ear. When the ear has too much ear wax accumulating the ear, it also
cause hearing loss and irritation of the eardrum, which causes the ear to have damage and it
also affect the auditory canals transporting sound waves to the inner part of the ear and it
also stiffens the bones in the muscle ear called otosclerosis. These bones may affect the
hearing and this condition is caused by abnormal bone growth and this also causes tinnitus.
Therefore, tinnitus may also go with age and it also build-up of cholesterol, blood vessels
which is close to the middle and inner part of the ear, it loses some elastics, the ability to fix
or expand slightly with each heartbeat and this causes blood flow to become forceful, this
flow of blood makes the the ear to detect easy to the beats, when a person has hypertension
such stress, alcohol, caffeine, etc. these also lead to cause of tinnitus and also narrowing in
the neck. Dallos, P. and Harries, D (1978).

Smoking has contributed to the factors of hearing impairment according to the American
medical association, June, 1998. They conclude the risk of hearing impairment has increased
with the number of people who smoke cigarette. Hearing impairment has increased
proportion with the intensity and duration of exposure to cigarette smokers. These people
have damaged their hearing ability which results to the ringing of ears which is tinnitus. The
non-smokers living with smokers were found to be 1.94 times more likely to suffer from
hearing problem than those who were not living with the smoker’s. These people who smoke
the damage their inner part of ear which results to tinnitus and when the auditory canal gets
block no sound wave would pass to the inner ear. The nose and sinuses produces about a
quarts of muscles every day. the mucus travel back of the throat then swallow it, the cilia are
damaged by smoking and the muscles they get back in the sinus and the bacteria starts to
multiply there in the sinuses and this leads to irritation in the whole upper airway and then the
sinuses starts to produce in the mucus which leads to tinnitus. Axelsson A, (1940).

Tinnitus is caused because people get destructed during the day such as radios, television,
co-works, and people talking throughout the day. Tinnitus can be noticed during the day with
such noise or sound and the eardrum does not shake the ossicles to take sound wave to the
brain for interpretation and people have the organ of corti which is buried deep to the inner
ear and it is responsible for signalling the brain to hear something and it is because of the
vibration made by the object and we call these vibration as sound waves. Moreover tinnitus
can sometimes be worse when people when people hear something that is not coming from
outside physical source of vibration. These are types of tinnitus, coming from objective
tinnitus. It can be heard by some people, subjective tinnitus: this can only be head by affected
people, neurological tinnitus usually affects the brains function auditory function, somatic
tinnitus: this related to sensory system. Therefore, muscles spasms, jaws and bone and bone
issue, subject or tinnitus is more often the type of tinnitus people hear at night when the world
is free of noise. Subjective tinnitus cannot be heard by another person vascular system or
damage to the organ and it is imagined sound. It is imagined because it comes from the brain
not necessary an actual source of sound. Pulsatile tinnitus can be objective from of ringing in
the ears. Pulsatile tinnitus worse at night because people can hear it roaring Collen G, et-at

Using of hearing aids, is another cause of tinnitus. Hearing aid represent another form of
sound therapy that is usually beneficial to tinnitus patients with significant hearing loss.
Hearing aids are designed to improve the audibility of speech and amplify ambient sounds.
Amplification of speech divert attention away from tinnitus, and amplification of other
ambient sounds serves to partially mask tinnitus. Hearing aids are not appropriate for those
with hearing loss confined to above 6 KHz, because most hearing aids have limited high-
frequency amplification abilities the use of hearing aid can permanently reduce the neural
activity responsible for tinnitus. Searchfied GD. (2006).

Fluid in the inner ear is the other cause of tinnitus. The membrane labyrinth, a system of
membranes in the ear’ contains a fluid called endolymph. In Meniere’s disease, endolymph
bursts from its normal channels in the ear and flows into the other areas, causing damage.
This accumulation of fluid is referred to as “hyddrops”. The membranes become dilated
(stretched thin, like a balloon) when pressure increases and drainage is blocked. This may
related to swelling of the endolymphatic sac or other tissues in the vestibular system of the
inner ear, which is responsible for the body’s sense of balance. In in some cases, the
endolymphatic duct may be too much fluid secreted by the stria vascuularize. The symptoms
may occur in the presence of a middle ear infection, head trauma, or an upper respiratory tract
infection, or from using aspirin, smoking cigarettes, or drinking alcohol. They may be further
exacerbated by excessive consumption of salt in some patients (Theilgaard, 1978)

Tinnitus become worse during the night because, the distraction of activities and sounds
around you make tinnitus less noticeable. When surroundings are quite, tinnitus can seem
louder and more bothersome. However unless you are a profoundly deaf, you ear picks up
certain sounds all day long even if you don’t realise it. The ears hear faint noise like music or
TV humming even if there is no such comprehension of the sound. At the very least, you hear
your own voice, but at night it all stops.

Suddenly, all the sound disappears and the level of confusion in the brain rises in response. It
only knows one thing to do when faced with total silence- create noise even if it’s not real.

In other words tinnitus gets worse at night because it’s too quite. Creating sound is the
solution for those who can’t sleep because their ears are ringing.

To crown it up, tinnitus is worse at night because that’s when our environments become quite
to observe it, in my own opinion when one starts experiencing some signs like damage to the
tympanic membrane, otitis media, he or she has to seek medical attention and if the
profession doctor gives you prescribed medication make sure you follow.
The Difference
Between
Individual Couns
elling and Group
Counselling.Som
e people desire
to attend for a
counselling
session but are
somehow
confusewhether
to pursue for
individual
counselling or
group
counselling. Both
of those
counsellingaltern
atives are meant
as a platform for
any person who
is in need of help
to be aided by
anindividual who
is capable to help
but in a
professional way.
Despite their
similarity in
general purpose, i
ndividual
counselling and
group counselling
in some ways are
different. ne !ey
difference betw
een individual c
ounselling and g
roup counselling
is thenumber of
persons
involved. In a
session of
individual
counselling,
there are only
two persons invol
ved namely a cou
nsellor and no oth
er than a single cl
ient or counselee.
Thoseindividual
s are called
as therapeutic
alliances.
"owever, a group
counselling
involves
morethan two
persons. They are
the counsellor
and two clients
up to a number
that is
appropriatefor a
particular
group.Second !ey
difference is
regarding the
e#pected duration
for a session. $n
individualcounsel
ling session
usually ta!es
time around %&
minutes up to an
hour depending
on theissues
discussed. 'nli!e
individual
counselling, for a
group
counselling, its
single
sessionconsume
longer time as
there are more
people who
commit for that
session. So, it
commonlyta!es
time around two
hours or the
leader
particularly the
counsellor could
decide the
suitableduration.(
astly, individual
counselling
differs from
group counselling
in terms of the
openness.In fact,
both of them ar
e actually close
d sessions whic
h means they ar
e private andcon
fidential. )ven
so, it can be said
that individual
counselling is
less open as
compared
togroup
counselling
meaning that the
session seems to
be more
secretive. n the
other hand,group
counselling
loo!s more open
where the
counselees tend
to be more
convenient
toe#press and
share their
personal
thoughts and
feelings. The act
of openness *can
foster
acorresponding
spirit of openness
within the group+
Corey, Corey, -
Corey, /0%, p.
1/2.In
conclusion, there
are three !ey
differences
between
individual
counselling
andgroup
counselling
which are the
therapeutic
alliances, the
e#pected duration
for a session,
andthe openness.
It is communal
for one to go for
individual
counselling first
but
conversely,attend
ing group
counselling is
wise for certain
people.
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3eferencesCorey,
4. S., Corey, G., -
Corey, C.
/0%2.
Groups, process
and practice
5th
ed.2.Belmont,
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Broo!s7Cole,
Cengage
(earning.Shulman
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 Dynamics and
skills of group
counselling
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REFERENCE

Axelsson A, Sandh A. tinnitus in noise-induced hearing loss. BrJ Audiool. 1985;19:271-

276.(PUB MED )
Berry, G. (1939). The use and Effectiveness of Hearing Aids. Journal of laryngology

David B,et-al; (2004). Tinnitus: Turning the volume Down. Eden prairie: Network 3000
Publishing

Dallos, P. and Harries, D. (1978). Properties of Auditory Nerve Response in absence

Tyler, Richard S. (2000). Tinnitus Handbook. A singular audiology textbook. San diego:
singular publishing Group

Theilgaard A, et al. (1978). Meniere’s disease. II. A Singular audiology textbook. San diego:
singular publishing Group

Searchfiedd GD. Hearing aids and tinnitus. In: Tyler RS, editor. Tinnitus treatment. New York
Thieme; 2006.pp. 161-175