Tinnitus – causes, types, symptoms, treatment. What does tinnitus mean?

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Tinnitus is an acoustic ailment that is not caused by any sounds in the environment. It is only heard by the person suffering from this ailment. Tinnitus interferes with daily functioning and can have many causes.

Tinnitus – what is it?

Tinnitus is often described as ringing in the ears without an external source. For many, it is a bell sound, while for others it is a whistle, buzzing, twittering, hissing, buzzing, roaring and even squeaking. The sound may come from one or both ears, inside the head, or from far away. It can be constant, intermittent or pulsating.

Tinnitus – types

There are three types of tinnitus:

1. subjective tinnitus – occurs most often, it is a call that is answered only by the person who hears it. The perception of subjective tinnitus can range from mild to strong and soft to very loud.
2. objective tinnitus – this type of tinnitus is very rare and describes a sound that your doctor may also hear when examining your ear. Objective tinnitus may be the result of a blood vessel problem or muscle spasms, or it may indicate that something is happening in the center of the ear.
3. pulsating tinnitus – resembles a heartbeat and requires medical evaluation due to its association with several medical conditions.

Almost all of us have experienced tinnitus more or less for a short time after being exposed to very loud noise. For example, attending a loud concert may cause short-term tinnitus. Certain medications (especially aspirin and other non-steroidal anti-inflammatory drugs taken in high doses) can cause tinnitus, which disappears after drug discontinuation. When it lasts longer than six months, it is known as chronic tinnitus.

The course of chronic tinnitus is unpredictable. Sometimes the symptoms stay the same and sometimes they worsen. In about 10% of cases, the condition is so disruptive to daily life that professional help is needed.

While there is no cure for chronic tinnitus, it often becomes less noticeable and more manageable over time. You can help relieve symptoms by educating yourself about the disease – for example, understanding that it is not dangerous. There are also several ways to reduce noise and minimize its impact.

If you observe similar symptoms, it is worth going to a consultation with a specialist. Currently, it can be held in a safe and convenient form of teleportation.

Tinnitus – auditory pathways

Sound waves travel through the ear canal to the middle and inner ear, where hair cells in parts of the cochlea help convert the sound waves into electrical signals, which then travel to the auditory cortex of the brain via the auditory nerve.

When hair cells are damaged – for example, by loud noise or ototoxic drugs – the circuits in the brain do not receive the expected signals. This stimulates abnormal neuronal activity, which results in sound illusion or tinnitus.

Are you seeing disturbing symptoms? Analyze them yourself in medical survey and decide whether to go to the doctor.

Tinnitus – causes

Most people who seek medical attention for tinnitus treatment experience it as a subjective, continuous sound, such as constant ringing in the ears or a buzzing noise in the ear, and most have some degree of hearing loss.

Causes that cause hearing loss (and tinnitus) include loud noise, drugs that damage the nerves in the ear (ototoxic drugs), excess earwax, middle ear problems (such as infections and vascular tumors), and aging. Tinnitus can also be a symptom of Meniere’s disease, an imbalance in the balance mechanism in the inner ear.

Tinnitus can appear anywhere in the auditory pathway, from the outer ear through the middle and inner ear to the auditory cortex of the brain, where it is believed to be encoded (imprinted in a way). One of the most common causes of tinnitus is damage to the hair cells in the cochlea. These cells help convert sound waves into nerve signals. If the auditory pathways or circuits in the brain are not picking up the signals they expect from the cochlea, the brain is effectively “turning up the gain” of these pathways while trying to detect the signal – similar to the way you turn up the volume of your car radio when trying to find a station signal.

The resulting electrical noise takes the form of tinnitus – high pitched sound if the hearing loss is in the high frequency range and low pitched sound if it is in the low frequency range. This type of tinnitus is similar to phantom limb pain in an amputee – the brain produces abnormal nerve signals to compensate for missing signals.

Most tinnitus is “sensorineural”, meaning it is caused by hearing loss at the level of the cochlea or cochlear nerve. But the tinnitus may come from other places. Our bodies normally produce sounds (called somatic sounds) that we don’t usually notice because we listen to outside sounds. Anything that blocks normal hearing can bring our attention to somatic sounds. For example, head noise can occur when earwax is blocking the outer ear.

Less common causes of tinnitus include other ear problems, chronic conditions, and injuries or conditions that affect the nerves in the ear or the auditory center in the brain:

1. Eustachian tube dysfunction – In this condition, the ear canal connecting the middle ear to the top of the throat remains stretched all the time, which can cause clogging of the ear.
2. changes in the bones of the ear – Stiffening of the bones in the middle ear (otosclerosis) can affect hearing and cause tinnitus. This condition, caused by abnormal bone growth, tends to occur from generation to generation.
3. muscle spasms in the inner ear – the muscles of the inner ear may tighten (spasm) which can cause tinnitus, hearing loss, and a feeling of fullness in the ear. This happens sometimes for no explainable reason, but it can also be caused by neurological conditions, including multiple sclerosis,
4. Disorders of the temporomandibular joint (TMJ) – TMJ problems, the joint on both sides of the head in front of the ears, where the lower jaw meets the skull, can cause tinnitus
5. acoustic neuroma or other tumors of the head and neck – Acoustic neuroma is a non-cancerous (benign) tumor that grows on the cranial nerve that runs from the brain to the inner ear and controls balance and hearing. Other brain, neck, or brain tumors can also cause tinnitus.
6. blood vessel disorders – Conditions that affect blood vessels – such as atherosclerosis, high blood pressure, or broken or distorted blood vessels – can cause blood to flow through your veins and arteries with greater force. These changes in blood flow can cause tinnitus or make tinnitus more noticeable.
7. other chronic diseases – medical conditions such as diabetes, thyroid problems, migraines, anemia, and autoimmune disorders such as rheumatoid arthritis and lupus are associated with tinnitus.

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Tinnitus – risk factors

There are several risk factors that can contribute to the appearance of tinnitus. Here they are:

1. exposure to loud noise – Loud noises, such as those from heavy equipment, chainsaws and firearms, are common sources of noise-related hearing loss. Portable music devices such as MP3 players can also cause noise-related hearing loss if played back loud for long periods of time. People working in noisy environments, such as factory and construction workers, musicians and soldiers, are at particular risk.
2. age – With age, the number of functioning nerve fibers in the ears decreases, which can cause hearing problems often associated with tinnitus,
3. sex – men experience tinnitus more often,
4. smoking and drinking alcohol – smokers have a higher risk of tinnitus. Drinking alcohol also increases the risk of tinnitus.
5. health problems – obesity, cardiovascular problems, high blood pressure, and a history of arthritis or head trauma all increase the risk of tinnitus.

Also read: Clogged ear – causes, foreign body in the ear. How to unclog your ear?

Tinnitus – duration

Tinnitus can last from a few seconds to a lifetime. It may come on gradually or it may come on suddenly.

Doctors usually define “sharp” or short-lived tinnitus as a sound that lasts for several weeks and then subsides. This type of tinnitus often occurs when you’ve been to a loud concert or have exposed your ears to another very loud noise, such as a gunshot.

Chronic tinnitus is anything that lasts more than a few weeks. If tinnitus lasts for two years or more, doctors will consider it a permanent condition. The good news: more than 75 percent of people who develop tinnitus tend to “get used to” the condition. This means that their brain gets used to it and it stops bothering them.

In a small subset of patients, tinnitus may worsen or become more severe over time. But for most people, tinnitus becomes more bearable as time goes on.

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Tinnitus – treatment

In addition to treating related health problems, there are several strategies that can help reduce the annoyance of tinnitus. No one approach works for everyone, and you may have to try different combinations of techniques before you find what works for you. If you have age-related hearing loss, a hearing aid can often make your tinnitus less noticeable by amplifying outside sounds.

The most effective ways to reduce tinnitus are behavioral strategies and sound-generating devices, often used in combination. Belong to them:

Cognitive behavioral therapy (CBT) – CBT uses techniques such as cognitive restructuring and relaxation to change the way patients think and respond to tinnitus. Patients usually keep a diary and do “homework” to help them build coping skills. Treatment is generally short-term – for example, weekly sessions of two to six months. CBT may not make the sound less loud, but it can significantly reduce the annoyance and improve your quality of life.

Tinnitus Retraining Therapy (TRT) – the technique is based on the assumption that tinnitus is the result of abnormal neural activity. The goal is to get the auditory system accustomed to the tinnitus signals, making them less noticeable or less bothersome. The main elements of TRT are individual counseling and sound therapy. A device is inserted into the ear that generates low-level noise and ambient sounds that correspond to the height, volume, and quality of the patient’s tinnitus. Depending on the severity of symptoms, treatment may take from one to two years.

Masking – Masking devices, worn like hearing aids, generate low levels of white noise (for example, high hiss) which can reduce the perception of tinnitus and sometimes also cause residual inhibition – tinnitus less noticeable for a short time after turning the mask off. A specialized device is not always needed for masking; it is often enough to play music or have a radio, fan or white noise machine in the background. While there is not enough evidence from randomized trials to draw any conclusions about the effectiveness of masking, hearing experts often recommend trying simple masking strategies (such as setting the radio volume low between stations) before turning to the more expensive options.

Coping with stress – tinnitus is stressful and stress can make tinnitus worse. Biofeedback is a relaxation technique that helps control stress by changing the body’s response. Electrodes attached to the skin transmit information about physiological processes such as pulse, skin temperature and muscle tone to a computer, which displays the output on a monitor. Patients learn how to change these processes and reduce the body’s response to stress by changing their thoughts and feelings. Mindfulness-based stress reduction techniques can also help.

Tinnitus – prevention

The two main preventable causes of tinnitus are:

1. exposure to loud noise – for example, noisy lawn mowers or chainsaws. High-risk individuals include industrial workers, farmers and transport workers. Listening to loud music in cars, with headphones, and at rock concerts can also be dangerous
2. certain prescription and over-the-counter medications – always check with your doctor that the medication he is prescribing for you does not cause or worsen the side effects of tinnitus.

Here are some ways to help prevent tinnitus:

1. use earplugs if you will be exposed to loud sounds above 85 decibels (dB),
2. if you are listening to live music, do not stand near the speakers,
3. if you listen to music through headphones, use noise canceling headphones and keep the volume as low as possible (well below 80 percent and for less than 90 minutes a day),
4. if you are in noisy environments, take regular breaks away from noise to rest your ears
5. try to reduce your stress levels – sometimes tinnitus starts when you’re anxious or stressed
6. if you use earplugs or hearing aids, keep them clean and avoid putting things in your ears such as cotton buds. All of these can cause infections that can cause tinnitus.

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