What is tinnitus and how does it happen?
Most people have at least once heard a brief ringing after a loud concert or in complete silence - this is normal. Tinnitus is said to occur when the noise persists for a long time or is repeated regularly. Subjective noise is heard only by the person himself; it arises in the auditory system. Objective noise is rare: its source is blood vessels or muscles, and sometimes it can be heard by the doctor. A pulsating noise that coincides with the pulse is isolated separately; it often has a vascular cause and requires a separate examination.
- Subjective - only the patient hears
- Objective - has a physical source
- Pulsating - in rhythm with the heartbeat
- Single-sided and double-sided
- Acute - up to 3 months, chronic - longer
Causes and risk factors
The most common cause is damage to the hair cells of the inner ear associated with age or many years of exposure to noise: loud music on headphones, industrial noise, gunfire. Noise can appear with sulfur plugs, acute and chronic otitis, dysfunction of the auditory tube, otosclerosis. Meniere's disease is characterized by attacks of dizziness with noise and hearing loss. Some medications - certain antibiotics, chemotherapy drugs, high doses of anti-inflammatory drugs - are ototoxic. A rare but important cause of unilateral murmur is acoustic neuroma.
- Age-related hearing loss
- Noise trauma and loud music on headphones
- Sulfur plug and otitis media
- Meniere's disease and otosclerosis
- Ototoxic drugs
- Temporomandibular joint disorders
- Acoustic neuroma
- Anxiety, depression and lack of sleep increase noise perception
How does it manifest itself and what amplifies the noise?
The noise may be constant or appear intermittently, sounding like a squeak, ringing, hissing, buzzing or humming. Usually it is more noticeable in silence, in the evening and when falling asleep, and during the day it is almost not felt against the background of surrounding sounds. Many people with tinnitus simultaneously experience decreased speech understanding, especially in noisy environments, and increased sensitivity to loud noises. Noise is increased by stress, lack of sleep, caffeine and alcohol in some people, and exposure to noise. Significant noise disrupts sleep and concentration, and provokes anxiety.
- Ringing, squeaking, hissing or humming
- Increased in silence and before bedtime
- Decreased speech intelligibility
- Loud noise intolerance
- Sleep and concentration problems
- Anxiety and irritability
What examinations are needed
The examination begins with an examination of the ears: sometimes the cause is a wax plug, and the noise goes away after it is removed. All patients with prolonged noise undergo tone-tone threshold audiometry, which detects even hidden hearing loss, and tympanometry. In case of unilateral noise or hearing asymmetry, an MRI of the brain is prescribed, focusing on the internal auditory canals to exclude neuroma. A pulsatile murmur requires examination of the vessels of the head and neck. A neurologist evaluates accompanying symptoms, and for severe anxiety and insomnia, a consultation with a psychotherapist is useful.
- Otoscopy
- Pure-tone threshold audiometry
- Tympanometry
- MRI of the internal auditory canals with unilateral noise
- Examination of the vessels of the head and neck with pulsating noise
- Blood pressure measurement
- Questionnaires for assessing noise severity
Treatment and what helps
If a removable cause is found—a traffic jam, otitis media, a side effect of a medication—they treat it. In case of sudden noise hearing loss, it is important to start treatment in the first days. There are no tablets that reliably remove chronic noise, so you should not spend money on vascular and vitamin courses without indications. Hearing aids for hearing loss, sound therapy, cognitive behavioral therapy, and treatment of anxiety and insomnia have proven benefits. Over time, the brain gets used to the noise, and it stops disturbing. The doctor selects the treatment.
- Removal of wax plug, treatment of otitis media
- Hearing aids for hearing loss
- Sound therapy - background natural sounds
- Cognitive behavioral therapy
- Treatment of insomnia and anxiety
- Protect your ears from loud noise
- Headphone volume limitation
