So, like a dutiful son, Dibkey incorporated the never-ending noise — he likens it to the sound of a dishwasher heard from two rooms away — into the soundtrack of his life.

"I don't know anything else. It's not really, really loud, but sometimes it sounds like it in a silent room," said Dibkey, 32, a wholesale auto buyer who lives in The Woodlands.

In his early 20s, Dibkey learned that along with tinnitus, hearing sounds in the absence of an external source, from the Latin for "ringing," he had sustained significant hearing loss. The cause remains unknown, though his doctors uncovered no tumors, disease or other organic causes. They assume the condition is congenital.

Hearing aids helped the tinnitus and hearing loss, though he continued to have occasional "flare-ups" of ringing in his ears. Dibkey also had the good fortune to marry an audiologist. His wife, Trish Dibkey, works for Dr. C.Y. Joseph Chang, of the otolaryngology department at the University of Texas Medical School at Houston.

"It's a highly nonspecific condition. It can be caused by noise exposure, trauma, age, or it can be congenital or have no known cause. Even the way people describe it varies a lot — buzzing, whistling, humming, warbling, clicking, ringing. Some people say it sounds like crickets," Chang said.

Like most sufferers, Dibkey has subjective tinnitus — only he can hear the sound. In effect, there is no sound, merely its sensation. Prescription and over-the-counter drugs, including aspirin and other anti-inflammatory medications, can contribute to this form.

Far rarer is objective tinnitus, in which a doctor using a stethoscope on the neck, jaw, temple or ear can hear sounds. The causes include vascular anomalies, repetitive muscle contractions and structural defects of the inner ear.

Chang has kept Dibkey on hearing aids, though he uses them only as needed. By increasing the volume of ambient sounds, the devices enable him to ignore his tinnitus. They don't stop the sound but make it less distracting.

"The doctor was very straight with me. He said, 'Unless I cut your head open, I don't know what's going on in there. The hearing aids help, so let's keep them,' " Dibkey said.

Doctors assume most tinnitus is caused by damage to the microscopic endings of the auditory nerve in the inner ear. In most cases, only the symptom (ringing in the ears), not the actual cause, can be treated.

Dibkey has learned that too much stress and caffeine exacerbate the problem.

"I'm not cured, but I'm sure better than I was," he said.

By Patrick Kurp
http://www.chron.com/cs/CDA/ssistory.mpl/health/3451219