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Definition

Tinnitus is characterized by the constant presence of noise or sounds in the ear. This condition comes from problems in the hair cells, located inside the auditory system, at the level of the cochlea.
In the case of tinnitus, it is estimated that some cells present injuries and continue to send a sound signal to the brain, as if they had been programmed incorrectly by constantly sending sounds, or rather, a perception of sounds.

From a medical point of view, tinnitus is not a disease, but a characteristic symptom of a disease of the auditory system.

In tinnitus, these are not external sounds, they are internal sounds to the auditory system.

People who experience tinnitus attacks occasionally can be bothered and distracted by the symptoms. But the situation is more difficult for people with chronic tinnitus; they may have sleep and concentration problems that affect their quality of life.

Epidemiology

Tinnitus is a frequent symptom, the World Health Organization (WHO) estimates that about 278 million people are affected worldwide.

According to a study published in the specialized journal JAMA Otolaryngology-Head & Neck Surgery in July 2016, carried out mainly by Prof. Harrison Lin of the University of California Irvine Medical Center, about 1 in 10 American adults suffer from tinnitus.

Causes

From a medical point of view, tinnitus is not a disease in itself, but it is a sign or symptom of an underlying disease. In this way, several pathologies may be behind the noises heard in the ear. Often the exact cause is not discovered.

Tinnitus happens with an injury to the inner ear. The hair cells, responsible for transmitting sound signals into the brain, are damaged for some reason and continue to transmit nerve impulses in an erroneous and independent way. These constant impulses are interpreted by the brain as a sound: tinnitus.

The causes of this damage to hair cells are varied and below are the most common:

– Age-related hearing loss. In most cases of tinnitus, hearing loss is observed.

– Problems in the cerebral interpretation of sounds.

– Exposure to very loud sounds: very loud noises or constant exposure to sounds (such as headphones in radios, MP3, etc.), are one of the causes that most cause damage to the ear. Short duration exposures are usually curable. However, chronic exposures can damage the ear permanently.

– Blockage of the ear canal: blockage can be caused by several factors, such as excess dirt, entry of pollutants from the environment and even insects.

– Injuries to the head and neck, as well as tumors in these parts.

– Use of drugs that damage the ear, such as aminoglycoside antibiotics, chloramphenicol, erythromycin, diuretics (furosamine, bumetamide), malaria drugs (quinine and chloroquine) and aspirin (in very high doses, such as 12 or more pills per day).

– Presence of benign tumors in the ear, such as acoustic neuroma.

– Stress and depression , which tend to worsen the condition.
– High vascular pressure : the high pressure with which the blood travels through the vessels can damage the sensitive ciliary cells and cause tinnitus.
– Atherosclerosis: the growth of atheromatous plaques causes blood flow to become more turbulent, which can damage the auditory cells.
– Changes in the bones of the ear, commonly known as otosclerosis.

– A vitamin B12 deficiency

In addition to these causes, there are several others that can result in ear damage, such as malformation of capillaries and disorders of the temporomandibular joint.

Groups of risk

Although tinnitus affects a large part of the world’s population, there are some risk factors that can make some people predisposed. In general, adults are more affected than younger people. However, with the increasing popularity of electronic devices and headphones, teenagers and young people who are exposed to very loud noise are increasingly experiencing tinnitus.
Populations that are constantly exposed to loud noises are also prone to tinnitus. This includes construction and factory workers, transit workers (bus drivers, taxi drivers, etc.), DJs and nightclub musicians, etc.

Men also have a higher incidence of developing tinnitus, especially Caucasians. The incidence is also high in elderly populations (over 65 years), mainly due to normal age-related hearing loss.

Another risk group is people who suffer from post-traumatic stress. In this case, tinnitus is particularly aggravated by loud noises.

Symptoms

The main symptom of tinnitus is hearing a constant, irritating sound in the ear. This sound can resemble a buzzing of a bee, or a roar, hiss, etc. The noise can sometimes be so loud that it interferes with a person’s ability to concentrate. These are phantom noises . The patient may also experience certain noises such as hissing, roaring or hissing.
Doctors differentiate tinnitus in two ways, according to the symptoms:
– Subjective tinnitus: most cases occur this way, in which only the patient hears the noise. This can be caused by damage to the hair cells in the ear and problems with the nerves.

– Objective tinnitus: in this case, both the patient and the doctor can hear the noise after a specific examination. It is a rare condition, normally caused by vascular problems such as high blood pressure , abnormalities in the bones of the ear or undue muscle contractions.

Diagnosis

Usually the initial examination is an interview with the patient. In it, the doctor asks how long the person has been having tinnitus and with what frequency, intensity, etc. To confirm the diagnosis, the doctor may use some complementary tests:
– Audiological test: in this test, the patient enters a special soundproof room and inserts headphones. An expert plays specific sounds and the patient says what he heard.

– Balance check: The doctor may do tests similar to those for labyrinthitis, such as moving the eyes, limbs, and standing up and walking in a straight line. With this, he can find out how much the disease has reached the ear.

– Imaging tests: help in the diagnosis to know the degree of damage to the hair cells and what other possible causes of tinnitus.

The type of sound heard by the patient is very important and can say a lot about the cause of tinnitus. Sounds similar to a heartbeat mean that the cause is possibly vascular. High-pitched sounds denote injury caused by very loud sounds.

Complications

Tinnitus can cause some complications in the patient’s daily life. The constant sound is often tiring and uncomfortable and can cause fatigue and tiredness in the patient. Furthermore, untreated tinnitus leads to sleeping problems , anxiety , irritability, depression and stress .
Concentration problems, hearing and balance failures are also complications commonly seen in patients with tinnitus.

Treatments

As tinnitus is a symptom, treating the cause is the best treatment. Thus, each type of tinnitus is often treated differently according to its cause.
– In case of ear wax (as the main cause), it is important to remove the wax. The doctor may use mechanical techniques to remove the wax or in some cases chemicals such as hydrogen peroxide, paraffin, mineral oil or glycerin. Attention, it is preferable to carry out this treatment with a doctor and not self-medication, which can often make the case worse.
– In case of hypertension. It is necessary to control the pressure, with hypotensive drugs.
– If tinnitus is caused by the ingestion of some medicine (see under Causes). The doctor may have to stop the treatment and switch to other medications.

In some cases, your doctor may prescribe medication to treat tinnitus, such as:

– Tricyclic antidepressants such as amitriptyline or nortriptyline, especially in severe cases of tinnitus. Attention to the side effects of this class of medication, one of the reasons that many doctors are in favor of this class of antidepressant being prescribed only for patients with tinnitus and depression. In cases of presenting only tinnitus without depression, this therapy is too risky (side effects), opinion of some specialists.

– Alprazolam: a medication that requires a medical prescription to treat tinnitus, it is actually an anxiolytic. Attention to the risk of dependence. Other anti-anxiety drugs often prescribed are clonazepam and oxazepam.

– Gabapentin: a drug originally used to treat seizures. A 2006 study demonstrated its usefulness in cases of tinnitus caused by excessive exposure to noise (causing damage to the inner ear).

Acoustic therapies
In some cases, your doctor may prescribe acoustic therapy. There are computer programs that play sounds with a therapeutic purpose. Increasingly, scientific studies show its effectiveness in treating tinnitus. An interesting alternative method, especially when the cause is unknown.

Hearing aids
Hearing aids can often help to reduce tinnitus. This is a complementary means that often does not cure tinnitus.

Sound
masking There are sound broadcasting programs to mask tinnitus, such as the sound of ocean waves or falling water drops. There is often a more pleasant sound than the tinnitus itself. The program will find the right frequency, which ideally should be the same frequency between the hum and the sound that will hide it.

New Treatments (Updated 2018)
– An experimental treatment involves a surgical operation on the vagus nerve, which transmits particular sounds and noises, to “rewire” the brain. This is supposed to be a neuronal stimulator in the brain.

– Another treatment is based on low-frequency transcranial magnetic stimulation (TMS). The treatment acts as if the vagus nerve is trying to “rewire” the brain into transmitting and perceiving sounds. This method seems to work in a small number of patients and not the majority.

– The pharmaceutical industry should bring new drugs against tinnitus to the market in the coming years.

Herbal medicine

There are still not many treatments based on medicinal plants against tinnitus. However, there are reports that ginkgo biloba acts by improving perceived noises. Usually ginkgo is in the form of pills or capsules.
However, according to our information, few studies have shown ginkgo’s true effectiveness in treating tinnitus.
Another plant under study is Centella asiatica , typically given as a tea or infusion. This plant can improve the symptoms of ringing in the ears.

Tips

If the person suffers from ringing in the ears, some measures can be adopted in order to reduce the possibility of irritation and discomfort:

– Avoid sounds, situations and anything that may cause irritation. Common examples are loud noises and nicotine. They can make tinnitus worse.
– Try to accustom your environment to low and pleasant sounds.
– Manage stress. It greatly aggravates cases of tinnitus. For this, adopt techniques such as relaxation, such as exercises, massage and music therapy.

– Reduce the amount of alcohol intake. Alcohol increases blood pressure and makes tinnitus worse.

– Alternative treatment techniques such as acupuncture, massage and hypnosis have been described as helping to treat tinnitus.

– Zinc supplements can also result in significant improvements. Another possibility is treatment with lipoflavonoids, a vitamin complex.

– According to a study, taking vitamin B12 can help treat tinnitus in some patients who are deficient in this vitamin.

Prevention

Tinnitus, when caused by external factors, can be easily prevented:
– Wear ear protection if you work in places with a lot of noise, such as in the middle of the street or in nightclubs. Be particularly aware if you work with music, saws, chainsaws, jackhammers or other noisy appliances.
– Listen to music at low volumes. Pay attention to the volume of devices with headphones so that they do not damage your hearing.

– Keep an eye on your blood pressure and your heart health. Increases in blood pressure cause tinnitus.

– Control your weight and exercise. These practices help in controlling blood pressure. Don’t overdo alcohol, sugar, and caffeine. These products can make tinnitus worse.

– Prevent too much wax from building up in your ear. Do periodic cleaning and always maintain good hearing health.

– Avoid smoking . Cigarette smoking increases blood pressure and is a predisposing factor for tinnitus.

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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