Tinnitus (ringing in the ears) is defined as the perception of sound by the patient in the absence of any external stimulus. This specified and differently characterized tone can be of a specific rhythm and character. The sound, which is generally perceived as a ring, can sometimes be described as a chime, a wind sound, a machine sound, and sometimes sounds resembling a roar. Tinnitus is generally not considered a disease, but rather thought of as a condition, meaning a symptom of a disease, in general terms.
What is Tinnitus (Ringing in the Ears)?
In general terms, tinnitus is one of the most common conditions within the auditory system. While some cases of tinnitus disrupt a person's general quality of life, they can also negatively affect his psychological state. In some cases, apart from lasting a long time, this ringing can also be transient, lasting only a few minutes.
What Causes Tinnitus?
The cause of tinnitus is definitely not an external source. This sound is inside the person's head, and it is impossible for anyone other than him to hear the condition existing there; therefore, this condition is generally defined as a phantom sound. These sounds can put a person in a very difficult situation over time and can generally be wearing and challenging. If this condition reaches advanced dimensions, it can even prevent him from perceiving external sounds in his current environment. As a result of this negative situation, psychological problems may develop in him. This condition can drive him to anxiety and depression.
The problem of tinnitus can occur in both ears. Another related situation is that this problem is evaluated as objective or subjective tinnitus. The sound referred to as objective tinnitus can be heard both by the person himself and by other people around him. The cause of this problem draws attention to an abnormal condition of the blood vessels inside the ear.
Objective tinnitus is a rare type. The majority of tinnitus cases are subjective. Subjective tinnitus, on the other hand, consists of sounds that the person hears and that those around him do not perceive or hear.
What Are the Symptoms of Tinnitus?
Tinnitus symptoms are those that describe a high-pitched sound heard in the ear. The sound generally perceived in tinnitus is a thin, high-pitched sound resembling a chime. A person suffering from the problem of subjective tinnitus hears the sound only himself. No one around him can hear this sound. This incoming sound varies from person to person. This sound can resemble a chime, a buzzing, or the sound of wind. The frequency of these sounds shows variations from person to person. While the frequency of these sounds progresses much more mildly in some people, in others, this ringing in the ear causes symptoms such as difficulty in concentration and hearing loss.
The problem of tinnitus can be continuous or can occur intermittently at certain intervals. Objective tinnitus is rhythmic in the person and usually occurs as a sound resembling wind.
The sound heard in tinnitus can vary throughout the day. This sound can usually be felt intensely at night. If these sounds progress severely, they can even cause hearing loss in the person. This is experienced like a trauma, and hearing loss may occur.
The problem of tinnitus can often be seen in military personnel and police officers. Since weapons and similar tools used make loud noises, the problem of tinnitus caused by this noise can develop in these people over time.
In addition to tinnitus symptoms, an increase in the state of auditory perception called hyperacusis, apart from hearing loss, is among the complaints accompanying tinnitus complaints. In the problem of hyperacusis, patients can generally hear loud and intense sounds similar to the sound of a chair or table being moved, and these patients usually cannot hear normal sounds around them, and this situation can become unbearable.
What Are the Causes of Tinnitus?
Some diseases may be among the causes of tinnitus. Under normal conditions, tinnitus lasts for 5 days or a week and usually less than 5 minutes. Tinnitus of pathological origin, on the other hand, usually lasts a long time and severely challenges him. Hearing loss can also develop in a person who constantly hears tinnitus.
Subjective tinnitus heard by the patient can have many causes;
- Exposure to loud noise
- A foreign object getting into the ear
- Infections occurring in the ear
- Fluid accumulations occurring in the middle ear
- Damage to the inner ear
- Hardening of the bones located in the middle ear
- Diabetes
- Anemia and blood pressure changes
- Traumas experienced in 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 conditions generally provide the answer to the question of why tinnitus occurs.
When looked at generally, exposure to loud noise usually lies at the root of tinnitus. People exposed to loud noise are usually those living in city life. Sounds in city life, for example, construction noises, loud music sounds, loud alarm sounds, etc., can cause the problem of tinnitus.
Tinnitus can occur with the damage or hardening of the structures located in the middle ear. The middle ear is very important for sound waves; the middle ear captures sound waves and transmits them to the inner ear by amplifying them. The structures in the inner ear convert sound waves into signals that the brain will perceive. After the brain perceives these sounds correctly, the person hears the sound. For this reason, when any damage occurs in the inner ear, the processing and perception of sounds negatively affects hearing.
In some cases, various medications used can cause hearing problems. The cause of this problem is called ototoxicity. Long-term use of aspirin, diuretics, and some malaria drugs can usually cause this condition.
What Are the Types of Tinnitus?
Types of tinnitus are classified according to the cause, onset, and intensity of the stated complaint. When classified according to their characteristic features, types of tinnitus are evaluated as objective and subjective.
Objective Tinnitus
In objective tinnitus, the sound is heard by the patient himself and can also be heard by those around him.
Objective tinnitus is defined as tinnitus caused by different reasons such as vascular, neuromuscular, and local inflammation, and which can be heard by other people.
Subjective Tinnitus
Subjective tinnitus can only be heard by the patient himself.
The cause of subjective tinnitus may stem from the ear, or it may stem from metabolic diseases or neurologically based disorders. Its intensity is classified as mild, moderate, and advanced tinnitus.
It encompasses more commonly seen tinnitus caused by otological factors, ototoxic drugs, neurological and metabolic diseases, and psychogenic causes.
How Is Tinnitus Classified?
Tinnitus cannot be clearly classified due to uncertainties in its mechanism and perception. Some authors primarily divide tinnitus into two as normal and pathological.
Normal Tinnitus (Tinnitus)
Normal tinnitus is defined as tinnitus experienced by many people lasting less than a week and five minutes, but not accompanied by hearing loss.
Pathological Tinnitus (Tinnitus)
It is defined as tinnitus lasting longer than a week and five minutes and usually experienced by people with hearing loss.
How Is Tinnitus Diagnosed?
Diagnosing tinnitus is the first stage of treatment. The patient's general history and the patient-doctor relationship are very important in making the diagnosis. In the early days of tinnitus, the doctor checks whether the patient has a viral disorder, and whether the patient has been exposed to a loud 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 a single ear or both ears. This is also an important detail in terms of making the diagnosis.
While taking the history from the patient, the physician may also refer him to different branches. Usually, these branches are neurology and audiometric evaluations. The physician can use radiological imaging methods when he deems necessary. This is important for making a definitive diagnosis.
What Are the Treatment Methods for Tinnitus?
Tinnitus treatment methods are tailored specifically to the individual. The general history taken from the person is very important in determining the treatment protocol. Recommendations such as avoiding loud noise, having blood pressure checked, not consuming excessively salty and sugary foods and drinks, reducing coffee and alcohol consumption, and exercising also provide the answer to the question of what is good for tinnitus. The treatment method of tinnitus can vary according to the cause of the person's problem. If the cause of tinnitus is of psychological origin, it is essential to receive treatment and seek a solution at this point.
Masking Therapy
Tinnitus is particularly more disturbing when the environment is quiet, while going to bed at night. A sound that will compete with tinnitus, such as the ticking of a clock or a radio, will reduce the discomfort. Some doctors recommend listening to FM channels at a low volume: Many patients have stated that they benefit from listening to the sound produced by a radio not tuned between two stations at a low volume. 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 masker is a small electronic part made into or added to a hearing aid. By producing a continuous but unobtrusive sound, it allows the person to forget his tinnitus.
Psychological Therapy
Even though tinnitus is usually not a symptom of a life-threatening disease, it can seriously disrupt the quality of life of the person and, indirectly, his relatives with its psychological effects. Today, programs are organized in many centers to support patients with tinnitus in this regard.
Psychotherapy, hypnosis, meditation, and tinnitus habituation therapy are among the applied treatment methods.
Repetitive Transcranial Magnetic Stimulation Therapy
The results obtained from studies emphasize that this method can be beneficial 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 located in our hospital.
At NPİSTANBUL Hospital Ear, Nose, and Throat Department; after detailed evaluations of patients applying with the complaint of tinnitus are made together with the departments of audiology and speech disorders, neurology, and psychology, services are provided with personalized therapy programs.
Recommendations for Preventing Tinnitus
The things recommended for you to do and not do below will help reduce your tinnitus. First of all, it should be remembered that the auditory system is the most sensitive and fragile system of the body. Therefore, it is recommended that you do the following.
- Protect yourself from exposure to loud music,
- Have your blood pressure checked continuously. Consult your doctor to keep it under control.
- Stay away from coffee, cola, and cigarettes, which have a stimulating effect on the nervous system.
- Daily exercises regulate your blood flow.
- Rest enough and avoid getting too tired.
- Do not worry about the sound. Your tinnitus will not cause you to go deaf. Accept these sounds as an annoying but trivial reality and learn to ignore them as much as possible. This kind of control can be achieved either by self-admonition or by the masking method.
- Minimize your nervousness and tension.
Ringing creates tension and stress in the human body, consciously or unconsciously. Tinnitus patients can be helped with exercises that teach the patient to reduce body tension and muscle stress.
