Tinnitus – the sensation of ringing, buzzing, hissing, whistling, or other sounds. It can be constant or intermittent and have a different volume. It is often best felt in silence. In rare cases, the noise in the ear is synchronized with the heartbeat and becomes pulsating. This condition can be caused by a wound pathology of the ENT organs or brain, so you need to see a specialist to diagnose and treat it.
What Is It?
Tinnitus or ringing in the ears is a very common pathology that affects about one in five adults. It usually only brings inconvenience, but sometimes it can interfere with the ability to concentrate and normal sleep. As a result, the patient experiences constant stress, which is bad for his personal relationships and work.
This condition often accompanies hearing loss, although it does not cause deafness in itself. Many people with ringing in their ears can hear perfectly. Sometimes they develop hypersensitivity to sounds-hyperacusis, so they are forced to take measures that limit external noise.
In some cases, the pathology disappears after the elimination of its cause, for example, otitis or ear plug. However, often even after treatment, the noise in the ear persists.
Why is there a tinnitus?
The causes of tinnitus can be associated with damage to parts of the auditory system – the outer, middle, inner ear or brain. There are several theories that explain what happens in the body with this pathology:
- spontaneous electroacoustic emission, that is, the spontaneous generation of electrical signals in the cochlea of the inner ear that are perceived as ringing in the ears;
- damage to the cortical organ with a violation of the functions of the auditory cells of the cochlea;
- dissonance between healthy and damaged cells of the cortical organ, which can be caused by the normal aging process;
- increased activity of the posterior cochlear nuclei of the brain caused by exposure to too much external noise;
- auditory plasticity, that is, activation of nerve centers in response to hearing loss due to damage to the cochlea;
- formation of new connections between neurons of the auditory nerves when they are damaged, compressed by a tumor or hemorrhage, and generation of impulses in them in the absence of external sound;
- damage to the trigeminal, facial, lingual and other cranial nerves, activating the so-called oto-somatic interaction;
- increased activity of the limbic and autonomic nervous systems due to increased sensitivity to the first episode of ear noise.
Thus, tinnitus is a complex process that requires accurate diagnosis on modern equipment and competent treatment.
Distinguish between these types of noise in the ear:
- subjective: the patient hears a noise that does not come from the external environment, it is associated with irritation of the auditory nerve;
- pulsating: the patient hears a buzzing, ringing, clicking or other loud sounds that coincide with his heartbeat;
- objective: a fairly rare phenomenon associated with increased sensitivity of the patient to external sounds or vibrations of various parts of the body.
Depending on the cause of the noise, it is divided into the following types:
- associated with vascular system damage;
- caused by damage to the outer or middle ear;
- neurosensory (peripheral and central), associated with the pathology of auditory cells and pathways.
In addition, doctors distinguish 3 degrees of noise: in the first case, the patient notes sound sensations only with active questioning, in the second case-considers it not the main problem with hearing, and in the third case, tinnitus becomes the main complaint.
Causes of ringing in the ears
The causes of tinnitus are usually associated with some disease of the hearing organs or nervous system.
The most common cause of tinnitus is hearing loss. Due to age-related changes, injuries, and the effects of drugs, the sensitive cells of the cochlea are damaged. They do not send electrical signals to the brain, and it begins to produce its own impulses, as if compensating for the absence of external stimuli.
Noise can be caused by diseases of the outer and middle ear: sulfur plug, otitis media, narrowing of the auditory canal, tumor of the tympanic cavity.
Exposure to loud noise is a very common cause of not only hearing loss, but also ear noise. Everyone should be aware of the damaging effect of loud music, the noise of working mechanisms and protect themselves from such influence. Another cause of pathology is barotrauma.
More than 200 medications can cause this symptom, most often aspirin, aminoglycoside antibiotics (gentamicin, kanamycin) and quinine derivatives. Cause noise can nonsteroidal anti-inflammatory drugs, ethacrynic acid, derivatives of platinum, ACE inhibitors and other drugs. Exposure to methyl alcohol and benzene is also dangerous.
Meniere’s disease – a disease accompanied by transient dizziness, ringing and stuffy ears, temporary hearing loss.
Auditory nerve neurinoma is a tumor that affects the nerve pathway leading from the cochlea to the brain centers, and causes noise and hearing loss on one side.
Pulsating noise is usually associated with a pathology of the circulatory system. It is observed in pregnancy, anemia, thyrotoxicosis, arteritis, as well as with increased intracranial pressure; in addition, vascular noise appears in heart defects, vascular abnormalities, stenosis of the arteries of the ear.
The causes of objective tinnitus can be diseases of the temporomandibular joint, pathology of the muscles of the soft palate, middle ear, gaping of the mouth of the Eustachian tube in the nasopharynx.
Manifestations of noise in the ear include a variety of sounds that can be heard by the patient. It can be a ringing, buzzing, the sound of a roaring airplane engine, hissing, whistling, clicking. It can be permanent or appear only occasionally.
If there is noise in the ear, you should consult a doctor. This may be due not only to the pathology of the hearing aid, but also to a manifestation of hypertension, hyperthyroidism, anemia and other diseases.
In infectious diseases of the ear, noise can be accompanied by pain and discharge from the ear canal. Sometimes it can feel ear aches when swallowing.
When noise is combined with dizziness, urgent medical attention is required, as this may be a manifestation of Meniere’s disease or a violation of the cerebral circulation.
In brain tumors, this complaint increases at the height of the headache attack. With a tumor located in the posterior cranial fossa, the noise increases with changes in body position.
To identify the causes of noise in the ear, such diagnostic studies are used:
- complete physical examination, study of the history of the disease, examination of the head and neck, determination of the function of the cranial nerves;
- hearing check (subjective audiography);
- objective audiological examination: methods for studying the auditory response of the brain stem and extratimpanal electrocochleography;
- computed tomography or magnetic resonance examination of the skull;
- endoscopic nasopharyngoscopy to identify the causes of muscle noise;
- in some cases – diagnosis of hypertension, hyperthyroidism and other therapeutic diseases;
- according to the indications – spinal puncture with determination of intracranial pressure.
Treatment of tinnitus
The patient should be examined by an otorhinolaryngologist and a neurologist, according to iytmed.com. Treatment of tinnitus depends on its cause. For this purpose, various methods are used, for example:
- medications, including sedatives and sedatives, as well as tranquilizers and neuroleptics;
- medications that improve blood supply to the hearing organ: vinpocetine, cinnarizine, ergot preparations, preductal, ginkgo biloba-based products;
- betahistine, B vitamins;
- exanotherapy – purging with a Politzer balloon, pneumomassage, massage of the auricle, neck-collar zone, vibro-and acoustic massage;
- method of biological feedback and reflexology;
- use of hearing aids;
- stimulation of the auditory nerve;
- installation of a cochlear implant that replaces the function of damaged auditory cells, even with a small concomitant hearing loss;
- neurosurgical intervention, for example, removal of a tumor of the auditory nerve or its microvascular decompression, impact on the sympathetic nerve nodes and nerves of the middle ear;
- operations to improve hearing – tympanoplasty and stapedoplasty;
- change of lifestyle, change of profession to limit external sound effects;
- the use of sound generators that create so-called white noise, distracting from the feeling of ringing in the ears.
The patient should avoid excessive use of caffeine, aspirin, and aminoglycoside antibiotics.
Often, tinnitus persists, despite the treatment. In this case, the patient is shown cognitive psychotherapy to help him cope with the problems that this unpleasant feeling causes. There is also a new direction to help such patients – re-training therapy. This is a combination of such medicinal methods:
- audio maskers that create white noise, recordings of sea noise, nature sounds;
- breathing exercises.
In addition, it is necessary to be treated by a dentist and eliminate possible pathology of the temporomandibular joint.
Any patient with tinnitus requires an individual approach. It is necessary not only to determine the cause of the pathology, but also to identify concomitant diseases, assess the emotional background, determine unfavorable household and professional factors. The doctor should learn about the use of ototoxic drugs or permanent intoxication. Often the patient requires additional consultation with a cardiologist, a hematologist, an allergist or an endocrinologist. Only a comprehensive examination and treatment helps to eliminate or reduce the patient’s discomfort.