The tinnitus are “parasitic” noises that a person hears without these actually existing. It could be hissing, buzzing or clicking, for example. They can be perceived in one ear or in both, but also appear to be present inside the head itself, in the front or in the back. Tinnitus can be occasional, intermittent, or continuous. They result from a dysfunction of the auditory nervous system. This is a symptom which can have many causes.

Un temporary tinnitus can occur after exposure to very loud music, for example. It usually resolves without intervention. This sheet is dedicated to chronic tinnitus, that is to say to those which persist and which can become extremely annoying for those who are affected. However, in the vast majority of cases, tinnitus does not have a significant impact on quality of life.

Prevalence

In general, it is estimated that 10% to 18% of the population suffers from tinnitus. The proportion is 30% among adults. From 1% to 2% of the population is seriously affected.

In Quebec, approximately 600 people are believed to be affected by this problem, 000 of whom are seriously. The large-scale use of personal music players and MP60 players among young people raises concerns about an increase in prevalence in the medium term.

Types

There are 2 main categories of tinnitus.

Objective tinnitus. Some of them can be heard by the doctor or the specialist consulted, as they are caused by disorders which, for example, make the flow of blood more audible. They can also sometimes be manifested by repeated “clicks”, sometimes related to abnormal movements of the muscles of the ear, which those around you can hear. They are rare, but generally the cause is identifiable and we can then intervene and treat the patient.

Subjective tinnitus. In their cases, the sound is only audible by the affected person. These are the most frequent tinnitus: they represent 95% of cases. Their causes and physiological symptoms being very poorly understood for the moment, they are much more difficult to treat than objective tinnitus. On the other hand, we can improve the tolerance of the patient to these internal noises.

The intensity of tinnitus varies from one individual to another. Some people are not very affected and do not consult. Others hear noises all the time, which can affect their quality of life.

Notes. If you hear voices or music, this is another disorder called “auditory hallucination”.

Causes

Hear tinnitus is not a disease in itself. Rather, it is a symptom very often linked to hearing loss. According to one of the hypotheses put forward by specialists, it is a “phantom signal” generated by the brain in response to damage to cells in the inner ear (see the Risk factors section, for more details). Another hypothesis evokes the dysfunction of the central auditory system. Genetic factors could be involved in some cases.

Most often, the factors linked to the appearance of tinnitus are:

• At the elderly, hearing loss due to aging.
• At the adults, excessive exposure to noise.

Among the many other possible causes are the following:

• Long-term use of certain pharmaceuticals that can damage inner ear cells (see Risk Factors section).
• A injury to the head (such as a head trauma) or neck (whiplash, etc.).
• Le spasms a small muscle in the inner ear (stapes muscle).
• Obstruction of the ear canal by a cerumen cap.
• Some disorders or diseases :

  – Ménière’s disease and sometimes Paget’s disease;

  – theotospongiose (or otosclerosis), a disease that reduces the mobility of a small bone in the middle ear (the stapes) and can lead to progressive deafness (see diagram);

  – ear or sinus infections (recurrent ear infections, for example);

  – a tumor located in the head, neck or on the auditory nerve;

  – a bad alignment of the temporomandibular joint (which allows the movements of the jaw);

  – diseases affecting blood vessels; they can cause so-called tinnitus pulsatiles (About 3% of cases). These diseases, such as atherosclerosis, hypertension, or an abnormality of the capillaries, carotid artery or jugular artery, can make the blood flow more audible. These tinnitus are of the objective type;

  – objective tinnitus non-pulsatile may be caused by an abnormality of the eustachian tube, by neurological disorders or by abnormal contractions of the muscles of the throat or middle ear.

Course and possible complications

Some tinnitus manifest themselves very gradually: before becoming permanent, they are perceived intermittently and only in quiet places. Others appear suddenly, following a particular event, such as a sound trauma.

Tinnitus is not dangerous, but when it is intense and continuous it can become very disturbing. In addition to causing insomnia, irritability and trouble concentrating, they are sometimes associated with depression.