Tinnitus is mainly manifested as the absence of external sound source, but subjectively there is sound sensation in the ear or cranium.
Classification of tinnitus: subjective tinnitus and objective tinnitus.
Objective tinnitus: The tinnitus can be heard by the patient himself or by others. This category is relatively rare.
The common ones are dysfunction of the temporomandibular joint (the joint in front of the ear that moves when chewing) and spasm of the palatal sail muscle (muscle cramp around the soft palate or the uvula, which can be heard as a paroxysmal clicking sound).
Subjective tinnitus: The tinnitus is audible to the patient but not to the next person. This type of patient is more common. It can be unilateral or bilateral, or it can be head ringing, and it can be sustainable or intermittent, and the sound can be various, with different pitch. The causes are diverse and complex, and the common ones are
1. Diseases of the auditory system
Cerumen embolism, swelling or foreign body in the external ear.
Various kinds of otitis media and otosclerosis in the middle ear.
Inner ear Meniere’s disease, sudden deafness, trauma, noise deafness, senile deafness, etc.
2. Systemic diseases
Cardiovascular disease, hypertension, hyperlipidemia, arteriosclerosis, hypotension, etc.
Mental tension,, emotional abnormalities, sleep disorders, etc.
Endocrine diseases: abnormal thyroid function, diabetes, etc.
Pulsatile tinnitus: tinnitus synchronized with pulse rate caused by vascular diseases.
Others: neurodegeneration (such as demyelinating disease), inflammation (viral infection), trauma, drug poisoning, cervical spondylosis.
3. Questions and answers about tinnitus
1. Is tinnitus a disease?
A: Here I prefer a “gentle warning”, the body is telling you that you need to be alert to related diseases such as otitis media, ear nerve damage, high blood pressure, etc. Only when this “warning” is given, can you be alerted to the disease. Only when this “warning” is too serious and affects your life is it called a “disease”.
2. Are there many people with tinnitus?
A: In the population, 10-15% of people have tinnitus in their lifetime, 5% of them have severe persistent tinnitus, and 0.5-3% of them have their lives seriously affected by it. Among the 13 million people in Shenzhen, there are a few people with tinnitus, but the percentage of those who really affect their lives is very low.
3.Does tinnitus necessarily cause hearing problems?
A: Tinnitus is often a concomitant symptom of hearing loss. Some tinnitus patients have hearing loss and some have normal hearing, but tinnitus will not cause or aggravate hearing loss.
4. Is there any relationship between tinnitus and psychological factors?
A: Long-term tinnitus may cause irritability, anxiety or depression, and the bad emotional state may aggravate tinnitus, resulting in a vicious circle between tinnitus and bad emotion, and psychological factors play an important role in the development of tinnitus.
5.What is the mechanism of tinnitus?
A: There are many causes of tinnitus. In fact, the human body is a machine that makes all kinds of sounds by itself, but it is not heard because it is covered up by other sounds in life. Just like when we ride in a car, when you concentrate on the scenery outside the window, you often don’t pay attention to the sound of the engine, but in fact it is always ringing, and when you turn around and listen, you can hear the sound of the engine, which is the brain’s “selective ignoring”. This is the brain’s “selective neglect”. When this “selective neglect” goes wrong, we will be troubled.
6.Will tinnitus become more and more serious if I don’t treat it?
A: Most tinnitus does not affect your life and does not require special attention. However, if tinnitus becomes more and more serious, especially if it is accompanied by hearing loss or vertigo, you need to consult a doctor early. There are not too many malignant diseases such as auditory neuroma here, so don’t worry too much.
7.Is tinnitus a kidney deficiency?
A: “Kidney deficiency” is part of the cause of tinnitus, but only part. There are 7 types of tinnitus, including “kidney yang deficiency and kidney yin deficiency”. For tinnitus, a Western medical examination is needed to exclude at least such causes as “ear wax blockage”, while others need to be treated with evidence. Not all tinnitus can be solved with one “Liu Wei Di Huang Wan”.
8.What kind of medicine can cure tinnitus?
A: No! Those so-called “miracle drugs” advertised in newspapers and commercials are not reliable! Some tinnitus, such as those caused by “ear wax blockage”, can be cured at once; others need to be cured slowly, especially chronic tinnitus (tinnitus over three months).
9.What can the doctor do if the patient has tinnitus?
A: Take medical history for ear and body clinical examination.
Audiological examination: pure tone audiometry, acoustic impedance audiometry, etc.
Etiological treatment: Treat the original cause of the tinnitus. For example, “ear wax obstruction, otitis media”.
Drug treatment. Commonly used drugs: vasodilators, calcium antagonists, neurotrophic drugs, etc.
Psychological counseling: Analyze the causes of tinnitus and its lesions, eliminate the patient’s worries, let the patient try to eliminate the psychological reactions caused by tinnitus, suppress negative emotions, and build up confidence that tinnitus can be treated.
Sound therapy: Apply some equipment to create artificial sound to cover the sound that causes the patient’s discomfort (the reason is like the aforementioned inability to hear the engine sound when riding in a car).
Tinnitus retraining, habituation therapy: The purpose is to make the patient adapt to and get used to the tinnitus, thus reducing the degree of tinnitus and relieving the physical and psychological obstacles caused by tinnitus to the patient. This therapy has been widely used in clinical practice abroad and mainly consists of counseling and sound therapy.
Traditional Chinese medicine treatment, etc., requires dialectical treatment!