Are you anxious because of tinnitus? Are you worried that tinnitus is a precursor to a serious illness? Did your doctor tell you that “tinnitus is untreatable?” …… is a series of questions that are bothering you, making you unconsciously pay full attention to your tinnitus, making you restless, anxious and confused, which also makes you almost completely unable to sleep and work ……
You tinnitus sufferers, or “tinnitus people” to be exact, because as mentioned above there are actually many people who have tinnitus, some have it for a short time, some for a long time, and even for decades, but not all tinnitus affects us, why is that? This is a very, very important question, and to illustrate this, let’s take an example. Let’s say you have $100 in your hand, how do you feel about this $100? If you plan to take this 100 yuan to buy a bouquet of flowers for your beloved, then you will feel that this 100 yuan is full of the meaning of love; if you plan to take this 100 yuan to buy a toy for your cute little baby, then you will feel that this 100 yuan is full of the meaning of happiness; if you plan to take this 100 yuan to buy a birthday cake for the elderly, then you will feel that this 100 yuan is full of the meaning of happiness; if you intend to take this 100 yuan to pay a ticket, then you will feel that this 100 yuan is the messenger of helplessness; if you intend to take this 100 yuan to do bad things, then you will feel that this 100 yuan is the incarnation of trepidation.
And our brain has a special ignoring function for the habitual sound. For example, a householder at the roadside may have obvious perception of the road noise at first, but after a long time, you will gradually adapt to the road noise and only have a one-off reaction to the occasional loud horn. From this, we can confidently tell you tinnitus people that road noise can be accustomed to without being noticed, let alone our tinnitus. And in fact, when researchers matched the loudness of tinnitus, they found that the loudness of tinnitus is only about 10 dB HL, which is only equivalent to the sound of our whisper. The fundamental reason why we can’t get used to this small sound and ignore it is how we come to understand and perceive it.
The same 100 yuan why when you have a different intention to use it, let you have a different view of him, and thus let you have a completely different feeling? The point is that, as the ancient Greek philosopher Epictetus said, “It is not the thing itself that has an effect on man, but the idea with which he sees it.” In other words, “It is not the sound of tinnitus itself that has an effect on a person, but rather the way a person perceives the sound of tinnitus.”
Tinnitus is really just a symptom, just as pain is, and our researchers do study and dispose of tinnitus and pain as similar symptoms, but compared to pain, which is anything but common, tinnitus seems to be more puzzling. Tinnitus, as a common, common symptom, is actually not terrible. We will tell you what tinnitus is, why it occurs, what it really portends, and what kind of treatment is currently available. After reading this booklet, we hope that people with tinnitus who really need treatment will be able to fully understand tinnitus, and only with a full understanding of tinnitus will you be able to treat it reasonably and cooperate reasonably with your doctor to dispose of it, so that eventually the sound of tinnitus will no longer affect you and allow you to live freely.
Section I. Physiology of hearing Sound production
When it comes to tinnitus, we all know that it is a sound, so let’s first popularize how we hear sound and how our auditory system and brain process sound and produce language meaning.
Sound is a longitudinal wave of energy produced by the vibration of an object. Our ears collect the sound energy, which is transmitted to the outer ear canal and vibrates the eardrum of the middle ear. The movement of the auditory hair cells converts mechanical energy into electrical signals that can be transmitted by nerves, which are transmitted along the auditory nerve to the primary and secondary auditory centers of our brain, where they are processed and then “heard” by us.
Section 2: Mechanisms of tinnitus production
The auditory conduction pathway is relatively easy to understand, which is the process of converting sound from acoustic energy to mechanical energy, and then from mechanical energy to electrical signals. However, the processing of the electrical signals of sound in the auditory center is an extremely complex process that is not fully understood. A few points need to be mentioned here to facilitate our understanding of the characteristics of the brain by which tinnitus is produced.
1. There are inextricable links between various centers in the brain and various neural pathways. Such links may be the sharing and shunting of signals, or they may enhance or inhibit each other. The most typical example is the link between the sensory nerve centers that innervate the peri-auricular area and the cells of other centers, i.e., when we dig our ears, a cough reflex is generated.
2. the nerve cells in the brain responsible for hearing do not remain idle when we cannot hear sounds, rather the loss of inhibition of sound may be in an excited state
3, the sound transmitted in the auditory pathway is in the form of electrical signals, so any abnormal electrical signals in the auditory pathway may be transmitted in the auditory pathway so that the brain “hears the sound”.
4. More and more studies show that subjective tinnitus is essentially a brain problem, not an ear problem.
After understanding the above points, we can now analyze the mechanism of tinnitus. Since tinnitus is only a symptom and not a disease, just like pain, its only a symptom, but there are many causes of pain. The same goes for tinnitus, so let’s follow the process of sound production and see what causes it.
There are basically two main types of tinnitus: objective tinnitus and subjective tinnitus.
First of all, let’s talk about the causes of objective tinnitus. Objective tinnitus is the tinnitus that is produced by the actual sound coming into our ears.
In fact, the normal human body produces a variety of sounds when it performs its functions, such as the sound of muscles moving, teeth clashing, blood flowing through the blood vessels, whistling, etc. Why can’t we hear these sounds? In fact, our ears can hear these sounds, only because our brain has subconsciously defaulted to these sounds as meaningless sounds, thus ignoring them, not to bring them into the higher level of consciousness perception, we feel that we can not hear, which is actually quite understandable, when you and the next person in the lively roadside chat, you think carefully, is not to hear all the roadside sounds? Or do you only hear each other’s voices and loud horns? But when these original sounds change for some reason, become stronger or change in frequency, or when our own endocrine plant nervous system changes, resulting in a change in the perception and sensitivity to sound, these original sounds are no longer only in the subconscious brain, but are submitted to the conscious level by our brain, and we perceive these sounds, and this is This is the reason why objective tinnitus arises.
After talking about objective tinnitus, let’s talk about subjective tinnitus, which is the most mysterious and troubling aspect of tinnitus, that is, the sound that is perceived by the brain purely without a real source. As we have already mentioned, in the absence of a real sound source, our ears do not actually work, so the reason for this is the structures between the auditory pathways behind the hair cells of the hearing and the auditory centers of the brain. And what is actually transmitted in these structures are electrical signals (i.e. brain discharges), which means that any situation that may generate electrical signals and transmit them within the auditory pathway may produce the brain’s perception of sound in the absence of an external sound source, i.e. produce tinnitus, subjective tinnitus.
Section 3: Why does tinnitus make us feel painful?
Now that we understand the mechanism of tinnitus production, why do some people find tinnitus so unbearable that they may even have suicidal thoughts because of it? Here we need to briefly explain our brain. In fact, there are two systems in the brain, one system is to deal with all the various senses in the periphery, including hearing, vision, smell, touch and so on. One system is responsible for transmitting these sensations to the corresponding sensory centers in the brain, but do not think that this completes the task, in fact, up to this point, our brain is only aware of the sensation, but whether we react to this feeling, is the second set of higher centers of things. And it is this second, higher center that determines how we perceive these sensations and what kind of response we make to them. Specifically, it’s our first system that senses tinnitus, but whether we feel distressed by it, whether we have suicidal thoughts, whether it affects our sleep, depends on the second system! When tinnitus annoys us too much to ignore, it means that our second system is involved. But don’t be disappointed, our brain still has a superior skill, which is brain remodeling, which means that the brain will change under certain circumstances. Our adaptation to the various sounds of the body heartbeat, chewing muscle sounds is brain remodeling. In other words, we can use brain remodeling to overcome our thoughts such as irritability of tinnitus. Of course, brain remodeling is different in each person, just as some people learn things quickly and others slowly, but almost everyone learns! Generally this process takes anywhere from 1 month to a few months, depending on the person. This gives us tinnitus people hope. We are perfectly capable of ignoring our tinnitus!
Section 4 Symptoms associated with tinnitus
1. Auditory hypersensitivity. It is the result of increased gain within the auditory pathway and is determined solely by the physical characteristics of the sound (that is, its intensity and frequency spectrum). Hearing hypersensitivity often occurs in the area of the frequency of hearing damage. After hearing damage our brain has a silent area (damaged frequency area) or black hole for surrounding sounds, which we may not be aware of ourselves, but when a strong sound suddenly appears around us, whose frequency happens to be located in this silent area, our brain will be particularly uncomfortable. Just as we suddenly from the dark into a strong light environment appears blinding sensation is the same reason.
2. Acoustophobia. It is the result of a reinforced functional connection between the auditory and limbic systems (which can be thought of as a second set of higher systems within our brain) and the autonomic nervous system, where the energy of sound is secondary or irrelevant to the occurrence of a particular pattern of sound. In acoustophobia, the meaning of the sound and the individual’s previous encounters are key, with the auditory characteristics of the sound playing a secondary role.
3. Phantom hearing. Hallucinations are illusory perceptions that appear in the auditory organs and are a common symptom in psychiatric patients. They are particularly common in schizophrenia. Most of the hallucinations in schizophrenia are true hallucinations, but there can also be false hallucinations. If the patient can tell you clearly. The voice is heard through his ears, and the voice is heard in the outside world, at a certain distance from him. A patient with pseudophakic hallucinations will specifically state that the sound does not come from outside, but is present in his head or stomach. The biggest difference between phantom hearing and tinnitus is that phantom hearing is a sound with content and meaning such as the sound of someone talking, while tinnitus is a sound without content and meaning such as the sound of a cicada.
Section 4: Treatment of Tinnitus
For objective tinnitus, the treatment is relatively purposeful, some of which can be resolved surgically and some of which may require adaptation. Since the cause is clear, it usually does not affect our lives and emotions too much.
For subjective tinnitus, where the cause can be found, we need to confirm the diagnosis and treat some diseases, such as external ear canal cerumen, tympanic membrane perforation, hearing loss, eustachian tube infection, secretory otitis media, temporomandibular joint disease, tumor, microvascular compression, etc.
Basically, the above mentioned can be solved by relying on a doctor. We will mainly talk about the situation that requires the tinnitus person and the doctor to work together to dispose of the tinnitus, that is, for some subjective tinnitus, the tinnitus in which the current examination means have exhausted without finding any disease that endangers human life and health. In fact, the proportion of this type of tinnitus is not small, but it really affects a minority of tinnitus people who come to the hospital for consultation. The key to the problem is the tinnitus sufferer himself! As we mentioned in the beginning, it is the tinnitus sufferer’s own perception of tinnitus that leads to a series of problems due to excessive concern about tinnitus (involvement of the second system of the brain).
Let’s talk about the current treatments for this type of tinnitus.
First we need to analyze the possible causes of tinnitus such as aging, fatigue, try medication, sound therapy, transcranial magnetic stimulation therapy. But what really makes the above treatments work is that the person with tinnitus should be fully aware of his or her tinnitus condition under the consultation and guidance of a doctor, which is crucial! If the person with tinnitus can shift his or her attention away from the tinnitus (reducing the involvement of the second higher system of the brain) and complete the brain remodeling process, then the brain can gradually treat the tinnitus as a background sound and lose attention to it. Eventually, tinnitus is not perceived. Here we can use a diagram to explain how important brain attention is.
How to do it.
Step 1 Go to a professional institution to identify which type of tinnitus you have
Step 2: Receive a good consultation from a professional doctor who specializes in tinnitus, instead of listening to the rumors of lay people, including ENT doctors who do not specialize in tinnitus
Step 3 Obtain appropriate medication and physical therapy from your doctor
Step 4: Talk to your doctor or someone else with the same condition and know that you are not the only one with tinnitus.
Section 5: Current tinnitus treatment methods (you need a professional doctor to evaluate your condition, not every treatment is suitable for you)
1.Drugs Chinese medicine: tranquilize the mind, invigorate the blood, and open the ligaments, etc.
2.Sound therapy
Use a special sound that has no specific meaning but calms the mind, such as the sound of chanting in a temple or the sound of a waterfall or the sound of rain, to help the brain relax, distract the brain from tinnitus and gradually produce acquiescence to the sound, so that tinnitus becomes a background sound, gaining ignorance of tinnitus and achieving the purpose of treatment.
3.Transcranial magnetic stimulation It is a kind of high-frequency magnetic wave, generally 5 days per course, half an hour per day, to stimulate the local cortex of the brain, which plays the role of inhibiting the excitation of neurons to achieve the effect of inhibiting tinnitus.
4.Tinnitus habit therapy (TRT) is a more successful comprehensive tinnitus treatment strategy that combines consultation and conditioned reflexes. Currently, tinnitus clinics basically follow this. Its main purpose is to create habituation to sound and to sever the link between tinnitus and negative influences such as emotions. In short, it is to achieve the effect that tinnitus will not be perceived without attention like the refrigerator at home.
5.Tinnitus therapy machine It is a machine that integrates sound therapy with other factors and works similarly to sound therapy.
6.Masking therapy A method commonly used in the past, the effect is to adjust the loudness of a sound to a level that just covers the tinnitus, so that the brain is temporarily unable to distinguish the sound, which also has some effect.
7.Electrode implantation For patients whose tinnitus can be effectively suppressed by cortical current stimulation, epidural stimulation electrode implantation can be performed.
8.Acupuncture, which is our acupuncture, can be useful for some patients.
9.Hearing devices It is also to compensate for hearing loss, thus eliminating the black hole in the brain.
10.Surgery Including otitis media surgery, otosclerosis surgery, cochlear implantation, etc., which have better effect for tinnitus caused by hearing loss.