With the influence of noise pollution in life, aging population and deterioration of living environment as well as the increase of people’s mental stress, the incidence of tinnitus has gradually increased. The total prevalence of tinnitus in people over 60 years old is reported to be 14.5% in China, and tinnitus patients account for 7.5% of ENT outpatient clinics. In a country with a large population like ours, this is a very alarming figure!
The mechanism of tinnitus is unclear, the cause is complex, the patients suffer, and the treatment is difficult!
I. Definition of tinnitus
Tinnitus is a subjective sensation of sound in the ear or cranium when there is no corresponding acoustic or electrical stimulus in the surrounding environment. It is often accompanied or not by hearing loss, sleep disturbance, distraction, anger, inability to concentrate, anxiety, depression and other adverse psychological reactions.
There are two main points in this definition: a subjective sensation of sound and the absence of an objective source of sound.
Many doctors and patients are confused about the definition of tinnitus and are not aware of the phenomenon. Some objective tinnitus, such as vascular pulsatile tinnitus, intra-auricular muscle spasm, and tympanic fluid, do not fall under the definition of “tinnitus”. Some diseases with tinnitus symptoms are also not included in this category.
Tinnitus as an independent disease, i.e. primary tinnitus, is a disease of unknown origin, with tinnitus as the prominent symptom. It is often accompanied by various degrees of insomnia, irritability, anxiety, depression and other symptoms, causing certain adverse effects on mood, work and life.
Primary tinnitus is an exclusive diagnosis. First, we should try to find the possible causes of tinnitus, and only when tinnitus and related symptoms cannot be explained by other diseases, primary tinnitus can be diagnosed.
Among tinnitus patients, most of them have primary tinnitus of unknown origin.
II. Analysis of the meaning of tinnitus cure
1. Concept: Cure and adaptation.
Cured: It means that the cause of tinnitus is clear or unclear, and the tinnitus disappears completely after treatment.
Adaptation: It means that regardless of whether the cause of tinnitus is clear or not and whether the primary disease is cured or not, tinnitus still exists, but the negative effects of tinnitus completely disappear, mainly including the effects on mood, sleep, work, quality of life and anxiety, etc.
2.Tinnitus treatment
The treatment does not directly target the cause of tinnitus, but takes adaptation to tinnitus as the first goal.
3.Tinnitus treatment
1.Tinnitus consultation and communication
Analyze, explain and interpret the patient’s pathogenesis and relevant examination results. To make the patient consciously release the excessive concern and fear of tinnitus and change it from negative to positive perception.
2.Sound therapy
Through tinnitus consultation, patients basically understand the background of their tinnitus, but they need to cooperate with sound therapy to completely eliminate the undesirable symptoms. The conditioned reflex arc of tinnitus caused by tinnitus can be gradually eliminated through sound therapy. The purpose of living and working in a sound environment is to weaken the stimulation of tinnitus to the cerebral cortex. The volume of sound should not exceed the sound of tinnitus. The purpose of this training is to break the vicious circle between tinnitus and adverse psychological reactions.