Causes and symptoms of tinnitus
Tinnitus is the perception of sounds that are actually absent, that is, a person hears certain noise interference, but auditory stimuli are not. Noise can occur both in one organ of hearing, and in both, sometimes there is a feeling that it is noisy not in the external environment, but inside the head.
Tinnitus is a word that healthcare professionals use to refer to ringing and tinnitus, which is not familiar to the average person. The patient may indicate that he hears buzzing, hum and other sound stimuli, although in fact they will be absent. A phenomenon such as tinnitus often occurs with hearing loss. In this case, the strength of the noise is not a constant unit, the sound can either increase or decrease. In old age, tinnitus tends to increase continuously. This may be due to the natural aging of the body, with the development of pathologies of the hearing aid, with vascular diseases that affect the normal blood supply to the ear and not only. In any case, something will make it difficult for the human ear to perceive the real sounds of the environment.
Tinnitus cannot be called an independent disease, it is only a manifestation of a particular pathology. This symptom should not be ignored; if unusual auditory sensations appear, it is necessary to consult a doctor and find out the cause of their occurrence. It is known that chronic tinnitus haunts from 5 to 10% of people on the planet. Moreover, older people most often suffer from tinnitus.
- The mechanism of development of tinnitus
- Why does tinnitus appear? What are the reasons?
- Tinnitus symptoms
- What pathologies are there for noise and pain in the ears?
- Diagnosis of tinnitus
- Treatment methods
The mechanism of development of tinnitus
Sound in the inner ear is picked up by the hairy hearing cells. They convert the noises coming from the external environment into electrical impulses, which are subsequently transmitted to the brain. If all systems are working properly, then the movements of these hairs will reflect the vibrations of sounds.
When the hairs move in a chaotic manner, the human brain receives a mixture of electrical signals, which it recognizes as constant noise.
Why does tinnitus appear? What are the reasons?
The causes of tinnitus are shown in the table:
Why is there tinnitus?
What does a person hear at this time?
Pathological decrease in the diameter of the vessels of the brain, impaired blood supply. A similar situation is observed with atherosclerosis, dystonia of the vegetative-vascular system, with high blood pressure and osteochondrosis.
In this case, a person is haunted by a pulsating noise in the head, which is distinguished by high intensity. It tends to increase during the period when blood pressure increases.
Disorders in the functioning of the auditory nerve in which a failure may occur at the stage of perception, transmission or generation of nerve impulses. The reasons may be as follows: head trauma, cerebral circulation failure, inflammation with damage to the structures of the ear.
A person has a hearing impairment. At the same time, monotonous noises in the head begin to disturb.
Disturbances in the work of the vestibular apparatus. In this case, a person will not be able to coordinate his movements, he will lose balance.
Most often, a similar situation is observed with a sharp shift in body position. For example, when moving quickly from horizontal to vertical position, which is accompanied by tinnitus.
Narrowing of the vessels supplying the cervical spine.
Pathology of the cervical vertebrae leads to the formation of growths. They, in turn, put pressure on the vessels, which can trigger the onset of tinnitus.
Emotional shocks, diseases of the nervous system, chronic fatigue syndrome.
Noise in the ears and in the head can appear against the background of mental instability. This is due to the fact that under stress, the sensitivity of the hearing organ increases.
The following disorders can lead to the occurrence of tinnitus:
All of these reasons can lead to the occurrence of pulsating tinnitus, as the blood supply to the brain suffers.
Taking certain medications.
Tinnitus can occur due to taking NSAIDs, antibiotics, antidepressants, heart medications. Also, tinnitus may indicate drug intoxication. This side effect develops with large doses of salicylates, quinine, and diuretics.
Aging of the body.
The older a person gets, the more the hearing organs wear out. At the same time, hearing loss can be accompanied by various noises: grinding, hum, squeak.
Naturally, this is not a complete list of the reasons that can cause tinnitus.
He can disturb a person with the following diseases and pathological conditions:
- Deficiency of vitamins in the body.
- Brain trauma.
- Pathology of the organs of the urinary system.
- Diseases of the endocrine system that develop against the background of a lack of iodine.
- Temporal bone injury.
- Meniere's disease.
- Tumors of a benign nature that develop in the brain, for example, acoustic neuroma.
- Neoplasms of the brain of malignant origin.
- Postponed stroke.
- Chronic or acute sensorineural hearing loss.
- Diseases of the middle ear.
- Low blood pressure.
- Inflammation of the membranes of the brain of a viral or bacterial nature.
- Nervous system pathologies, such as schizophrenia.
- Vegeto-vascular dystonia.
Video: Elena Malysheva's program "Why is it buzzing in your ears?":
Tinnitus can be different, experts distinguish the following types of it:
- Objective noise that is heard not only by the person himself, but also by the doctor examining him. This phenomenon is rarely observed.
- Subjective noise that only the person himself hears.
- Vibrational noise generated by the ear itself or by structures around the auditory cells. Such noise can sometimes be heard by a doctor examining a patient.
- Non-vibrational noise that only the person himself can recognize. It occurs due to external or internal influences on the nerve endings of the auditory tract or on the inner ear itself.
There are also some types of non-vibration noise:
- Central noise localized in the center of the head.
- Peripheral noise that a person hears in only one ear.
- Constant noise that can appear after surgery with the intersection of the vestibular cochlear nerve. Also, peripheral noise can be a consequence of atherosclerotic vascular lesions.
- There are two-sided and one-sided noises.
From time to time, tinnitus is heard by 15 to 30% of the world's population. Moreover, 20% describe this sound as quite intense. It can bother people of different sexes and different ages, but most often the complaints are presented by patients in the age group from 40 to 80 years. There is evidence that men who work in enterprises with an increased level of noise pollution go to the doctor about the disturbing buzz in their ears.
The noise can vary. Some people indicate that they hear a whistling sound, others indicate a ringing sound, and still others indicate buzzing, tapping or hissing. Often, such patients are diagnosed with hearing impairment, they are worried about headaches, and insomnia may develop.
Other symptoms that may accompany tinnitus:
- Painful sensations.
- The appearance of discharge from the ear canal.
- Feeling of the ear from the inside.
- Swelling of the ear.
At the same time, the noise can be weak, barely perceptible, or it can be characterized by patients, like the deafening roar of a car or a waterfall.
Despite the disturbing symptoms, many people are in no hurry to see a doctor. They adapt to this disorder, suffer from sleep disorders, from decreased performance, their quality of life in general changes. Sometimes, tinnitus prevents even the perception of another person's speech. You should not endure such discomfort, you need to contact a doctor and clarify its reasons. After all, tinnitus itself does not arise, it is almost always accompanied by hearing loss.
What pathologies are there for noise and pain in the ears?
Tinnitus, accompanied by painful sensations, can occur with inflammation of the structures of the middle ear, when lesions touch the eardrum, the middle ear bone, or the mastoid process of the temporal bone. Also, pain and noise in the ears sometimes indicates the penetration of a foreign object into the organ structures. Often such objects are insects that can damage the external auditory canal.
It happens that not one, but several internal structures of the ear are damaged at once, which causes intense pain.
The following pathologies can be distinguished that can lead to pain and tinnitus:
An inflammatory process affecting the structures of the middle ear. At the same time, the vessels expand and begin to pulsate, the swelling of the tissues increases, which leads to increased pressure on the eardrum and provokes the appearance of noise in the ears. Painful sensations are a response to damage to the cells of the mucous membrane of the middle ear by pathogenic microorganisms.
- Aerotitis is an inflammatory change in the structure of the middle ear that develops against the background of a drop in atmospheric pressure. Extraneous sounds and pain are symptoms that indicate damage to the eardrum and middle ear bones.
- Injury to the tympanic membrane. The severity of the injury can range from mild concussion to damage to the integrity of the injury. In parallel, a person will complain about extraneous noises. In addition, bleeding from the ear is not uncommon.
- Mastoiditis is an inflammation of the mastoid process of the temporal bone. The pain is localized behind the concha, or in the ear canal itself. The noise is pulsating, caused by the transmission of vibrations of the venous sinus to the labyrinth.
- Myringitis is an inflammation of the tympanic membrane that causes pain and tinnitus. Extraneous sounds appear due to the expansion and pulsation of the vessels that feed the eardrum.
- Foreign bodies entering the ear canal. Insects can irritate the eardrum or damage its integrity, which leads to characteristic symptoms.
Diagnosis of tinnitus
Since the reasons that can provoke the onset of tinnitus can be very diverse, this causes certain difficulties in diagnosis. The otolaryngologist is looking for etiological factors leading to tinnitus. You may also need to visit other narrow specialists: cardiologist, vascular surgeon, psychiatrist, neuropathologist, endocrinologist, etc.
The otolaryngologist examines the patient and interviews him. It is imperative to clarify the presence of chronic pathologies of internal organ systems (endocrine, cardiovascular, nervous). The doctor already during the examination receives information about the condition of the auricles, can diagnose inflammation or injury.
The doctor will then refer the patient for further examination, which may include:
- Audiometry. This method allows you to determine the acuity of hearing using a special apparatus called an audiometer. Headphones are put on the patient, and a button is given to the patient. He has to click on it when he hears a sound. It will be published with varying frequency and intensity. The output will be an audiogram, which allows you to assess the acuity of hearing.
- Weber's test. A tuning fork is used to determine hearing acuity. It is installed in the region of the crown. If a person hears sounds better from the side of the diseased ear, then he is diagnosed with unilateral conductive hearing loss. When he better distinguishes sounds from a healthy ear, then his internal auditory structures are affected.
- An X-ray examination of the skull will be ordered when a person has suffered a head injury.
- An X-ray of the cervical spine is prescribed if osteochondrosis is suspected.
- Doppler ultrasonography of the cerebral vessels is indicated for suspected atherosclerosis and ischemic damage.
- RheoEG allows diagnosing ischemic disease.
- An X-ray examination of the temporal bone pyramid is performed if retrocochlear hearing loss is suspected.
- MRI or CT is performed if neoplasms are suspected.
- Tumors of the inner ear can be detected by contrast-enhanced computed tomography of the skull.
Also, the patient will need to pass tests for laboratory tests:
- Blood for thyroid hormones.
- General blood analysis.
- Blood chemistry.
- Blood for syphilis.
Video: What does ringing in the ears warn about?
To date, it is not always possible to completely save the patient from tinnitus, however, modern methods of exposure allow you to control this process thanks to a whole range of measures individually selected for each particular case.
After that, the patient's life returns to normal, since it is possible to reduce the noise and alleviate the patient's condition, freeing his consciousness from the obsessive auditory sensation. A person begins to perceive previously unbearable discomfort for him as an ordinary extraneous everyday sound.
The main methods of treatment (achieving control) of tinnitus include pharmacological therapy, apparatus method and psychotherapy. Pharmacotherapy implies the effect of drugs: those affecting the blood circulation in the brain, anticonvulsants, neuroprotective and metabolically active, histaminolytics, psychotropic drugs, zinc preparations, vitamins.
The hardware method of masking noise makes it easier to tolerate, but it cannot completely eliminate the discomfort. There are also other methods of treatment, such as exposure to an electromagnetic field of high frequencies, pneumatic massage, low power laser, surgical treatment.
To get rid of tinnitus, it is necessary to act on the cause of this symptom:
- If the pathology is provoked by osteochondrosis, then analgesics, in particular, Katadolon, help to reduce pain. Also, the patient is prescribed to take drugs from the NSAID group, for example, Nimesulide or Sirdalud. Carbamazepine or Gabapentin can be used to relieve seizures.
- When a sulfur plug leads to tinnitus, it is required to rinse the ear canals with saline or Furacilin solution. The procedure is performed using a special Janet syringe.
- Treatment of vascular pathologies of the brain should be comprehensive. The patient is prescribed nootropic drugs (Cerebramine, Cerebrolysin, Cortexin), drugs to normalize cerebral circulation and improve metabolism (Cavinton, Xanthinol, Cinnarizin, etc.).
- If extraneous sounds in the ears are a consequence of the therapy, then it is necessary to stop taking such drugs. They must be replaced with analogs that do not cause noise and ringing. Most often, hearing in these cases can be completely restored.
A good effect is given by pneumomassage of the tympanic membrane, reflexology, electrical stimulation, acupuncture.
Video: a few tricks on how to remove tinnitus:
If hearing decreases against the background of general aging of the body, then most often it is no longer possible to restore it. The patient will need to use hearing aids. If they do not allow normalization of hearing, then a cochlear implant can be installed.
The author of the article: Lazarev Oleg Vladimirovich | ENT
Education: In 2009, he received a diploma in the specialty "General Medicine" at the Petrozavodsk State University. After completing an internship at the Murmansk Regional Clinical Hospital, he received a diploma in Otorhinolaryngology (2010)