Tinnitus is defined as the patient's perception of sound without any stimulus. This is the tone, which is characterized as distinct. It may have a certain rhythm and character. The sound, which is usually perceived as a ringing, can sometimes be characterized as the sound of a bell, sometimes as the sound of wind, machinery, and sometimes as a humming sound. Instead of being considered a disease, tinnitus is generally considered a symptom of a condition, a disease.
What is Tinnitus?
In general terms, tinnitus is one of the most common conditions in the hearing system. Some tinnitus disrupts the general quality of life of the person and can also negatively affect their psychology. In some cases, this tinnitus may last for a few minutes and may be temporary.
What Causes Tinnitus?
The cause of tinnitus is definitely not an external source. This sound is inside the person's head and it is not possible for anyone other than the person to hear the situation that exists there, so this situation is also defined as ghost sound in general terms. Over time, these voices can put the person in a very difficult situation and can be generally exhausting and challenging. If this situation has reached advanced dimensions, it may even prevent the person from perceiving external sounds in the current environment. As a result of this negative situation, psychological problems may occur. This situation can lead the person to anxiety and depression.
Tinnitus problem can occur in both ears. One of the situations other than this is the evaluation of this problem as objective or subjective tinnitus. The sound referred to as objective tinnitus can be heard both by the person and by others around him/her. The cause of this problem draws attention to an abnormal condition of the blood vessels in the ear.
Objective tinnitus is a type that is not seen very often. Most of the tinnitus is subjective. Subjective tinnitus is the sounds that the person hears and those around him do not perceive and hear.
What are the Symptoms of Tinnitus?
Tinnitus symptoms are symptoms that describe a high-pitched sound heard in the ear. The sound usually perceived in tinnitus is a high-pitched and bell-like sound. The person suffering from subjective tinnitus only hears the sound himself. No one around him/her can hear this sound. This sound varies from person to person. This sound can be a bell sound, a humming sound or a sound similar to the sound of wind. The frequency of these sounds varies from person to person. While the frequency of these sounds is much more severe in some people, in others this ringing in the ear causes symptoms such as difficulty concentrating and hearing loss.
The problem of tinnitus can occur continuously or occasionally in certain courses. Objective tinnitus is rhythmic and usually occurs as a sound similar to the sound of wind.
The sound heard in tinnitus may vary during the day. Generally, this sound can be felt intensely at night. If these sounds are severe, they can even cause hearing loss in the person. This is experienced as a trauma and hearing loss may occur.
Tinnitus problem can usually be seen in military personnel and police officers. Since the weapons and similar tools used make noisy sounds, these people may develop tinnitus due to this noise over time.
Apart from the symptoms of tinnitus, the state of increased hearing perception called hyperacusis, other than hearing loss, is among the complaints accompanying tinnitus complaints. In hyperacusis, patients can often hear loud and intense sounds similar to the sound of a chair or table being moved, and these patients often cannot hear normal sounds around them and this can become unbearable.
What Causes Tinnitus?
Some diseases may be among the causes of tinnitus. Under normal conditions, tinnitus lasts less than 5 days or a week and usually less than 5 minutes. Tinnitus of pathological origin, on the other hand, usually lasts for a long time and this makes it very difficult for the person. Hearing loss can also occur in people who constantly hear tinnitus.
Subjective tinnitus heard by the patient can have many causes;
- Exposure to loud noises
- Foreign body in the ear
- Inflammations in the ear
- Fluid accumulation in the middle ear
- Damage to the inner ear
- Hardening of the bones in the middle ear
- Diabetes
- Anemia and blood pressure changes
- Trauma to the head and neck
- Thyroid disease
- Lesions affecting hearing
- Neurological problems
- Changes in hormones (menopause, etc.)
- Stress
- Heart diseases and vascular diseases
These conditions are among the problems that cause tinnitus. These situations generally give the answer to the question of why tinnitus occurs.
Generally speaking, the basis of tinnitus is exposure to loud noise. People exposed to loud noises are usually people living in city life. Sounds in city life, such as construction sounds, loud music sounds, strong alarm sounds, etc. can cause tinnitus.
Tinnitus can occur when the structures in the middle ear are damaged or hardened. The middle ear is very important for sound waves, the middle ear captures sound waves and transmits these sound waves to the inner ear by amplifying them. The structures in the inner ear convert the sound waves into signals that the brain perceives. After the brain perceives these sounds correctly, the person hears the sound. For this reason, any damage to the inner ear negatively affects the processing and perception of sounds.
In some cases, various medications can cause hearing problems. The cause of this problem is called ototoxicity. Generally used long-term aspirin, diuretics, some antimalarial drugs can cause this condition.
What are the Types of Tinnitus?
Types of tinnitus are classified according to the cause and severity of the complaint. When classified according to their characteristic features, tinnitus types are evaluated as objective and subjective.
Objective Tinnitus
In objective tinnitus, the sound is heard by the patient and can be heard by others.
Objective tinnitus is defined as tinnitus caused by different causes such as vascular, neuromuscular and local inflammation and can be heard by others.
Subjective Tinnitus
Subjective tinnitus can only be heard by the patient themselves.
The cause of subjective tinnitus may be due to the ear, as well as metabolic diseases or neurologically based disorders. Its severity is classified as mild, moderate and severe tinnitus.
Otologic factors include ototoxic drugs, neurologic and metabolic diseases, and psychogenic causes, which are more commonly seen in tinnitus.
How is Tinnitus Classified?
Tinnitus cannot be clearly classified due to uncertainties in its mechanism and perception. Some authors primarily divide tinnitus into normal and pathological.
Normal Tinnitus
Normal tinnitus is defined as tinnitus experienced by most people for less than one week and less than five minutes, but not accompanied by hearing loss.
Pathological Tinnitus
It is defined as tinnitus that lasts more than one week and five minutes and is usually experienced by people with hearing loss.
How is Tinnitus Diagnosed?
Diagnosing tinnitus is the first stage of treatment. The general history of the patient's condition and the relationship between the patient and the doctor are very important in making the diagnosis. In the early stages of tinnitus, the doctor checks whether the patient has a viral disease, and whether the patient is exposed to a violent sound is also included in the evaluation. In addition to the history taken from the patient, attention is paid to whether the ringing is in one ear or both ears. This is also an important detail in terms of diagnosis.
The physician may also refer the patient to different branches while taking the history. Generally, these branches are neurology and audiometric evaluations. The physician may use radiological imaging methods when deemed necessary. This is important in terms of making a definitive diagnosis.
What are Tinnitus Treatment Methods?
Tinnitus treatment methods are personalized. The general history taken from the person is very important in determining the treatment protocol. Recommendations such as avoiding loud noises, having blood pressure checked, not consuming too salty and sugary food and drinks, reducing coffee and alcohol consumption, and doing sports also answer the question of what is good for tinnitus. The treatment method of tinnitus may vary depending on the cause of the person's problem. If the cause of tinnitus is of psychological origin, it is absolutely necessary to be treated and resolved at this point.
Masking Treatment
Tinnitus is especially disturbing when the environment is quiet, especially at night when you are lying down. A sound that competes with tinnitus, such as the ticking of a clock or a radio, will reduce the discomfort. Some doctors recommend listening to FM stations at low volume: Many patients report that they benefit from listening at low volume to the sound that an untuned radio makes between two stations. Such a sound can be very relaxing. This sound is known as white noise. Some patients use electronic devices that produce relaxing sounds. A tinnitus masking device is a small electronic component that is built into or attached to the hearing aid. It produces a continuous but unobtrusive sound, allowing the person to forget about tinnitus.
Psychological treatment
Although tinnitus is not usually a symptom of a life-threatening disease, its psychological effects can seriously impair the quality of life of the sufferer and indirectly of their relatives. Today, many centers offer programs to support patients with tinnitus in this respect.
Psychotherapy, hypnosis, meditation and tinnitus habituation therapy are some of the treatment methods.
Repetitive Transcranial Magnetic Stimulation Therapy
The results of the studies emphasize that this method may be useful in patients with tinnitus and can be included in the treatment program. Research is still ongoing.
Repetitive Transcranial Magnetic Stimulation Therapy can be applied in the Neuromodulation Center in our hospital.
In NPISTANBUL Hospital Ear, Nose and Throat Department; Together with audiology and speech disorders, neurology, psychology departments, patients who apply with tinnitus complaints are provided with personalized therapy programs after detailed evaluations are made.
Recommendations to Prevent Tinnitus
The following dos and don'ts will help to reduce your tinnitus. First of all, it is important to remember that the hearing system is the most sensitive and fragile system in the body. It is therefore recommended that you do the following.
- Avoid exposure to loud music,
- Have your blood pressure checked at all times. Consult your doctor to keep it under control.
- Avoid coffee, cola and cigarettes, which stimulate the nervous system.
- Daily exercise regulates your blood flow.
- Get enough rest and avoid getting too tired.
- Do not worry about the noise. Tinnitus does not make you deaf. Accept these sounds as an unpleasant but insignificant fact and learn to ignore them as much as possible. This kind of control can be achieved either through self-control or masking.
- Minimize your nervousness and tension.
Tinnitus consciously or unconsciously creates tension and stress in the human body. Tinnitus patients can be helped by exercises that teach the patient to reduce body tension and muscle stress.