Tinnitus refers to the subjective sensation of a sound in the ear or head without the presence of a corresponding external sound source. Tinnitus is one of the most common clinical symptoms in otology. 17% of the general population has varying degrees of tinnitus, and the incidence of tinnitus in the elderly can be as high as 33%. About 7% of people need medical help, 3.5% of people have tinnitus that seriously affects their life, work and social activities, and 0.8% of people are unable to live, work and study normally due to long-term, severe tinnitus, and even think about suicide. With the improvement of economic development and living standard, the change of diet structure, the aging of population and the gradual increase of environmental noise pollution, the incidence of tinnitus gradually increases.
Understanding tinnitus.
First of all, we should be clear: tinnitus is not a disease, but only a symptom. Although simple tinnitus can continue to ring for months, years or even decades, it is not life-threatening.
Normal people also have tinnitus, for example, when you cover your ears with your hands, or when your ears touch the pillow in a side-lying position, you can hear a buzzing sound in your ears; when we walk into a well-sealed soundproof room or an anechoic chamber, almost everyone, especially elderly people over 60 years old, will feel a humming sound in their ears. These can be called physiological tinnitus. Physiological tinnitus is due to the sound of blood flow in the ear or in the tissues next to the ear or the sound produced by the tissues themselves being heard after removing or isolating the external noise. Physiological tinnitus is generally below the threshold of hearing, cannot be heard under normal circumstances, and is of short duration.
Tinnitus caused by disease is called pathological tinnitus, and its loudness is generally 5-15dB above the hearing threshold and easily masked by external noise Most tinnitus patients complain that they cannot hear tinnitus during the day or at a haunted place, but tinnitus appears late at night when people are quiet.
What are the common causes of pathological tinnitus? It can be divided into otogenic and non-otogenic.
Otogenic tinnitus.
1. The tinnitus caused by this type of disease is usually not serious and can disappear after the cause is removed;
2.Sensory part (inner ear) lesions: Ménière’s disease, noise deafness, ototoxic drug poisoning, sudden deafness, etc.; tinnitus caused by these diseases is more serious;
3.Posterior cochlear lesions (auditory nerve): Hunter syndrome, auditory neuritis, auditory neuropathy, auditory neuroma;
4. Central auditory lesions from the cochlear nucleus to the auditory conduction pathway of the cerebral auditory cortex: efferent nerve dysfunction, cerebral hemorrhage, dorsolateral cerebral syndrome, etc.; tinnitus caused by these lesions is very persistent.
Non-auricular tinnitus.
1. Tinnitus caused by systemic diseases
Cardiovascular diseases: hypertension, hypotension, anemia, coronary heart disease, arteriosclerosis, cerebral thrombosis, hemangioma, arteriovenous tumor; these diseases often cause ergogenous tinnitus, which is consistent with the pulse.
2, cervical spondylosis: cervical osteophytes or herniated discs compressing the vertebral artery
3.Traumatic brain injury or neurological diseases: head trauma, concussion, encephalitis, meningitis; often cause tinnitus and high frequency hearing loss of sensorineural deafness
4.Psychiatric diseases: anxiety, depression, schizophrenia, etc.
5, metabolic diseases: hyperthyroidism, hypothyroidism, diabetes, hyperlipidemia, fiber bundle or trace element deficiency
6. Other diseases such as kidney disease, gynecological disease and gastrointestinal disease may also cause tinnitus.
7.Tinnitus caused by psychological factors: tension, anxiety, depression, sleep disorders, anger, menopause, etc. can all cause tinnitus.
How to seek medical help after tinnitus occurs?
First of all, it is important to take a history of tinnitus, which is the key to tinnitus diagnosis.
The following tests are often done to assist in the diagnosis after taking a history.
1.Ear, nose and throat specialist physical examination
2.Hearing function examination
3.Nervous system examination
4.Vestibular function examination
5.Systemic examination (such as cervical spine, cardiovascular, endocrine system, etc.)
6.Imaging and laboratory examinations (skull base area, neck and intracranial CT or MRI, etc., blood biochemistry)
The diagnosis of tinnitus is the basis of treatment. However, it is extremely difficult to diagnose tinnitus because it can be a symptom of many systemic and local diseases, and there are many factors that promote and affect it, and it is closely related to the psychological state of the patient.
Treatment of tinnitus – a worldwide medical problem
If the primary lesion can be found by history taking and auxiliary examination, and if the treatment is directed at the cause, a better result can be obtained. If the cause cannot be identified, or if the cause can be identified but not treated, then treatment is more difficult.
This is how we should understand the treatment of tinnitus.
1. There is no specific medicine for tinnitus
2. There is no doctor who can cure tinnitus with drugs.
3. It is a popular view internationally that tinnitus is cured when you adapt to it. Although tinnitus is still ringing, it does not affect you in any way, does not affect your mood, does not bother you, does not worry you, does not scare you, does not affect your sleep, does not affect your work, study and life.
In this regard, we would like to introduce the following treatment for tinnitus, which should be carried out under the guidance of a specialist.
This therapy consists of five components.
1. Low-intensity noise masking
2. relaxation training
3. distraction training
4. Psychological counseling and psychotherapy
5.Medication
Finally, I would like to give my friends a few tips on the problem of tinnitus.
1.Don’t panic and fear when tinnitus occurs to avoid increasing the psychological burden;
2, pay attention to adjust the rhythm of life and work, to ensure sufficient sleep;
3, pay attention to any hearing loss or other discomfort;
4.Don’t believe in any commercial advertisement;
5, bring the medical records to the regular hospital specialist in a timely manner;
6, the last and the most important one, please trust your doctor.