Tinnitus is the perception of sound by the human ear, in the absence of a corresponding external sound. Otherwise, this condition is called tinnitus, or tinnitus. Tinnitus can be perceived in one or both ears, as well as in the head. This is usually described as a ringing sensation, but sometimes takes the form of buzzing, hissing, humming, whistling, or the sound of waves. The intensity of the perceived sound can vary from a barely audible background noise to a very strong, deafening noise.
Tinnitus itself is not a disease, but is a symptom of various, including dangerous conditions. The causes of this phenomenon include:
- inflammatory diseases of the ear (otitis externa, otitis media);
- sulfur plug;
- osteochondrosis of the cervical spine;
- various head and ear injuries (mechanical, acoustic, barotrauma);
- arterial hypertension;
- age changes;
- Meniere’s disease;
- thyroid disease;
- head and neck tumors.
Tinnitus can also be a side effect of some medications, such as aspirin, quinidine, gentamicin, etc., and can result from an abnormally low serotonin level. At the same time, in many cases the main cause of tinnitus remains undefined.
Scientists Heller and Bergman in 1953 conducted a study in which students from among 80 people were alternately placed in a soundproof chamber for 5 minutes. As a result of such an experiment, 93% reported hearing a buzzing, pulsing or whistling sound. In this case, none of the participants in the experiment did not suffer from tinnitus. Based on the results obtained, scientists concluded that ear injuries from an unnatural level of noise exposure in industrialized countries were widespread.
In order to diagnose objective tinnitus, auscultation of the skull with a stethoscope is performed. Depending on the reasons for causing objective noise, it can manifest itself as a pulsation or a click. In the first case, vascular noise is diagnosed, which may be a consequence of arterial aneurysm, arteriovenous malformation, a glome tumor and other diseases requiring surgical treatment. In the second case, the muscular noise caused by convulsive contractions of the middle ear and soft palate is diagnosed. When detecting muscle noise prescribe treatment with anticonvulsants. In cases where the noise is not heard using auscultation, a subjective noise is diagnosed.
Since tinnitus is often defined as a subjective phenomenon, it is difficult to measure using objective tests, like audiometric ones. In this case, the main diagnostic measures are: otorhinolaryngological examination, anamnesis; tonal threshold audiometry, which is used as the main method of quantitative measurement of subjective noise. The use of threshold audiometry is based on the tendency of the brain to selectively perceive only the loudest sounds. On the basis of this tendency, the amplitude of the patient’s tinnitus can be measured as follows – by reproducing samples of sounds of different volume and frequency, the patient is asked to indicate which sounds he hears. According to the results of audiometry, an audiogram is compiled, which gives an idea of the patient’s hearing threshold.
For the threshold of hearing of the inner ear, a bone vibrator is used – a device installed on the temporal region of the head. Through a bone vibrator, signals are transmitted directly to the inner ear (bypassing the middle ear). The difference between the thresholds of air and bone sound conduction (bone-air interval) indicates a decrease in the auditory function of the middle ear. The magnitude of this decline may indicate the need for medical intervention.
Treatment of tinnitus, depending on its causes, involves the use of the following methods:
Drug treatment. Drugs specific action against tinnitus, unfortunately does not exist. Depending on the nature of the noise, the following groups of drugs are used to eliminate its causes:
- anticonvulsants – carbamazepine, phenytoin, valproates; have a positive effect in cases where the noise is caused by clonic contractions of the muscles of the middle ear and soft palate;
- psychotropic drugs – tranquilizers (oxazepam, clonazepam), antidepressants (amitriptyline, doxepin); improve noise tolerance, while having a number of unpleasant side effects (drowsiness, dry mouth, etc.);
- antihistamines – promethazine, hydroxyzine; effective in allergic diseases causing stagnation of fluid in the ear;
- drugs of different groups – misoprostol, sulpiride;
Pneumatic massage of the eardrum. It is an effective treatment for inflammatory diseases of the middle ear (otitis media). In addition to reducing noise, pneumomassage helps to restore reduced hearing by increasing the elasticity of the eardrum and increasing blood flow to the middle ear.
Hardware treatment. Based on the use of noise massers – special devices that reproduce sound masking your own internal noise.
Removal of sulfuric cork. In the case when tinnitus is caused by accumulation of earwax, removal of a sulfuric plug will be the most appropriate treatment option. For this purpose, the washing of the external auditory canal is used, preparations are also used that dissolve sulfur accumulations (remocax, a-cerumen). Mechanical cleaning of the ear with a cotton swab does not help to remove the plug, but on the contrary, it can aggravate the situation.
Surgical treatment to get rid of tinnitus in the absence of other indications is not recommended.