Tinnitus (tinnitus): causes, treatment, what to do, symptoms

What is tinnitus?

Tinnitus is a disorder in which a person begins to hear noise in one or both ears. People typically describe this sound as a ringing sound, but it can also include a hum, clicking, and buzzing. Some tinnitus sufferers experience a more complex noise that changes over time. In addition, this noise can be either constant or periodic.

In most cases with tinnitus, people hear some kind of sound in their head in the absence of any external noise. This type of condition is called subjective tinnitus, and it can be caused by improper functioning of certain nerves or a disorder in some part of the ear. In rare cases, tinnitus can be caused by actual sounds originating in or near the ear, such as noise from nearby blood vessels. This type of disease is called objective tinnitus.

Pathophysiology of tinnitus (tinnitus)

Subjective tinnitus, as a rule, is the cause of pathological activity of neurons in the auditory zone of the cerebral cortex. Such activity occurs when the impulse of the auditory analyzer (cochlea, auditory nerve, brainstem nuclei, auditory cortex) is interrupted for some reason. Interruption of the electrical impulse can cause abnormal activity within the cortex and possibly new neural connections. Some experts compare this phenomenon to phantom limb pain after amputation. Subjective tinnitus can also occur with conductive hearing loss (eg, wax impaction, otitis media, auditory tube dysfunction), and also occurs with subjective tinnitus.

Objective tinnitus is a noise that is a physiological phenomenon that occurs directly next to the middle ear. As a rule, such noise is generated by normal blood vessels or when there is increased turbulence in the blood flow (for example, in atherosclerosis), and blood vessels can also produce a “clicking” noise in various diseases (tumors or other vascular pathology).

What are the causes of tinnitus?

The most common causes of tinnitus include:

• Exposure to loud noise leading to hearing loss over time
• Age-related hearing loss
• Certain drugs that can damage the inside of the ear. For example, taking large doses of aspirin every day can lead to tinnitus.
• Eustachian tube dysfunction
• Infections such as otitis media or labyrinthitis
• Meniere's syndrome, which causes dizziness (vertigo) in addition to noise.

Less common causes of tinnitus include high and low blood pressure, diabetes, tumors, and head trauma.

It is worth noting that in many cases the cause of tinnitus cannot be determined.

What is tinnitus? Causes and treatment methods

The concept of “tinnitus” came to us from the Latin language and translated means “ringing or noise in the ears.” This noise can vary enormously. It ranges from low humming and beating of one's own pulse to high-pitched squeaks and tones. Tinnitus can be felt in one ear, in both ears, or as a noise in the head.

Is Tinnitus a Social Illness?

Tinnitus can rightfully be called a social disease. Although it is actually a symptom (such as fever or pain) and not a disease in the true sense of the word, under certain life circumstances tinnitus can develop into an independent disease. With complex decompensated tinnitus, tinnitus is accompanied by other symptoms, such as depressed mood, sleep disturbances, lack of concentration, anxiety symptoms and various somatic complaints.

Signs of tinnitus and causes of the disease

The question about the causes of tinnitus is asked very often, but it is not so easy to answer. There is no specific way to protect yourself from acute hearing loss and/or tinnitus. Except perhaps for noise, which is one of the main reasons. A healthy lifestyle can also help prevent us from getting tinnitus. Tinnitus often occurs temporarily after intense stress, including noise exposure. If this stress stops and the person has the opportunity to rest in silence, then the tinnitus disappears. But if such situations occur frequently, they can lead to permanent tinnitus. Episodic tinnitus can also be caused by treatment with certain medications. Unfortunately, tinnitus is an accompanying symptom of many other diseases that have nothing to do with the ear, such as multiple sclerosis, metabolic disorders, heart rhythm disorders, thyroid diseases, allergies, problems with teeth and jaw, spinal injuries, etc. . This list can be continued for a long time. All possible combinations of different diseases should be added to it. An important aspect that I would like to pay special attention to is progressive hearing loss, which most people simply do not notice. For them, tinnitus is in the foreground, which they definitely want to get rid of. Therefore, patients often refuse various measures, such as hearing aids and other treatments that require their active participation. All they want is an “anti-tinnitus pill.” In many cases, the exact cause of tinnitus cannot be determined. Except in cases where it is a consequence of acute sensorineural hearing loss or other ear diseases (otosclerosis, inflammation of the middle ear, hereditary diseases leading to hearing loss up to complete deafness, tumors, etc.). Noise is one of the main causes of hearing damage and tinnitus today. More than 50% of young people experience a “ringing” from time to time after listening to music that is too loud.

Acute and chronic tinnitus

First, we need to establish the difference between acute and chronic tinnitus, and in the case of acute tinnitus, between objective tinnitus, which can be heard by others, and subjective tinnitus, which we mainly discuss. Objective tinnitus can be eliminated in most cases through surgery and other medical procedures. In the acute stage of subjective tinnitus, i.e. immediately after its first manifestation and during the first three months, it makes sense to carry out accurate diagnosis and therapy. In this case, it is necessary to diagnose not only the hearing organs, but also other important functional areas of the body. Based on the examination results, the doctor will prescribe treatment. In doing so, otolaryngologists rely on the “Guidelines for Acute Sensorineural Hearing Loss and Tinnitus” developed by the Society of Otolaryngology.

Age structure of tinnitus

The age structure can be described based on the results of our epidemiological study. Of course, with age, the likelihood of developing any health disorder increases, which includes tinnitus. But there are also young people who suffer from tinnitus, which especially bothers them and limits them at the very beginning of their professional life. All patients experience the same basic fear: “What is hidden behind tinnitus, what is a serious disease?” Therefore, first you need to have a conversation with patients, free them from fear and explain the mechanism of tinnitus, regardless of the cause of its occurrence. After all, it is in stressful situations, with tension and physical activity, that tinnitus intensifies even more.

Young people express the following concerns: “What will happen if I talk about tinnitus at work? What will happen to my career? Unfortunately, many of these fears are justified. Short-term tinnitus has recently been increasingly diagnosed in children. But in many cases, parents who themselves suffer from tinnitus are to blame for their child's focus on tinnitus. For example, after inflammation of the middle ear or after a rock concert, short-term tinnitus may occur, which usually disappears. Other causes include poor posture and school stress, as well as classroom acoustics, social relationships and parental pressure to achieve GCSE success. In conversations with parents, it often turns out that tinnitus is more frightening to adults than to the child himself.

The evolution of tinnitus therapy

There is still no cure for tinnitus.
But there are effective therapeutic methods, such as retraining therapy, distraction therapy, etc. The range of methods that require active patient participation is quite wide. It includes the use of masking noise, hearing aids, perception training through yoga, etc., and even psychotherapy. Experience shows that cognitive behavioral therapy has the greatest success. Currently, many studies are being conducted that study the effects of drugs, music therapy, sound therapy, magnetic field therapy, direct magnetic stimulation, antiphase noise, etc. But when conducting any research, it is imperative to take into account who the patient is, what could have caused his tinnitus, how long he has been suffering from it, what is the condition of his hearing, what other diseases may play a role in this process, etc. Only by taking into account all these aspects can targeted treatment begin. Because: “You always need to treat the person, not the tinnitus.” In our experience, the main therapeutic problem is that doctors randomly apply different methods of treatment like "shotgunning", without taking into account either the patient's health status or his individuality. They do not sufficiently differentiate which therapeutic method is suitable for each patient. But numerous studies suggest that new treatments should become available in the coming years. Elke Knor, President of the German Tinnitus League

How is tinnitus treated?

Treatment directly depends on the cause of tinnitus. For example, if it is a drug, the doctor will strongly recommend stopping taking it. At the same time, never stop taking a prescribed drug without the appropriate permission or instructions from your doctor.

If your tinnitus is caused by another disease or condition, your doctor will create a detailed treatment plan. Tinnitus usually goes away immediately after successful treatment of the underlying cause.

If the examination does not reveal the cause, the doctor will most likely focus on relieving the symptoms of tinnitus. The main therapeutic methods in this case include:

• Hearing aids:
  For people who suffer from tinnitus and are losing their hearing, a hearing aid may be the answer. When wearing it, ambient sounds will be louder than the specific ringing, clicking or buzzing noise.
• Noise Maskers:
  Maskers are placed behind the ear and generate so-called white noise (a constant background sound), making tinnitus less noticeable. Some people use special maskers mounted at the head of the bed to improve their sleep quality.
• Combination of hearing aid and maskers
• Psychological help:
  Many people feel depressed because of tinnitus, so getting help from a professional or support groups may be helpful.
• Restrictive therapy:
  This method involves combining psychological assistance with wearing maskers or other treatment methods. An otolaryngologist (ear, nose and throat specialist) and an audiologist (hearing specialist) will work together to develop a treatment plan for tinnitus. This is a rather lengthy process, but over time it gives results.
• Relaxation:
  Stress increases the severity of tinnitus, so your doctor may suggest a number of relaxation techniques to combat it.
• Drugs:
  To date, there are no drug treatments for tinnitus. However, a number of medications, such as certain anti-anxiety drugs, have been shown to be effective in reducing the intensity of symptoms in some people. Talk to your doctor about the possibility and advisability of using them in your case.

What causes tinnitus

Tinnitus can be caused by various factors and diseases. The main causes of pulsating or constant tinnitus:

1. Injuries, tumors of the hearing aid.
2. Diseases of the central and peripheral nervous system.
3. Long stay in a noisy place, overwork. Staying in discos, factories, airfields, or working with a jackhammer provoke residual effects even after leaving the noisy place.
4. Sulfur plug.
5. Inflammatory diseases: otitis media, eustachitis.
6. Problems with cerebral circulation due to atherosclerosis, blood loss, anemia, heart failure, valve defects, hypertensive crisis.
7. Auditory hallucinations in mental pathologies can be symptoms of schizophrenia and other psychiatric pathologies.
8. Endocrine disorders: swelling of the nerves due to hypothyroidism, diabetes mellitus.
9. Side effects of drugs: oral contraceptives, hormones, antibiotics, nitrates.
10. Alcohol and drug intoxication often leads to delirium and tinnitus due to damage to the central nervous system.

All about sharp, dull or ringing noise in the ears. When symptoms are a cause for concern and see a doctor.

It is useful to learn about the causes of ringing and noise in the ears and the treatment of pathology.

Is it possible to prevent the development of tinnitus or at least stop its progression?

To prevent tinnitus or prevent its progression, avoid prolonged exposure to loud noise and any activities that put your hearing at risk. If you know in advance that you will be exposed to noise, take earplugs or hearing protection with you. When listening to music on headphones, limit the volume level.

In general, avoid anything that might make your tinnitus symptoms worse. These include, but are not limited to, nicotine, alcohol and caffeine.

Treatment of tinnitus (tinnitus)

Treating the underlying condition can reduce the symptoms of tinnitus. Thus, hearing correction (using a hearing aid) leads to the disappearance of tinnitus in 50% of patients.

Prevention of stressful conditions can lead to a positive effect in the treatment of tinnitus, because psychoemotional disorders worsen the course of this disease. Patients should be talked to and explained that tinnitus does not pose a risk to their health. Some biostimulants, such as caffeine, can worsen the course of the disease, as a result of which these substances must be excluded from the diet.

Some patients note that extraneous sounds relieve their condition and help them fall asleep faster. In some cases, special hearing aids are used that generate low-frequency sounds that cover the tinnitus. Electrical stimulation of the organ of Corti, along with the use of a cochlear implant, is effective in treating tinnitus in some cases. However, this treatment method is only indicated for patients with complete hearing loss.