1. What is tinnitus?
Tinnitus is a ringing sound in your ears when no outside sound is involved. For example, there is no cicada chirping around you, but there is a cicada chirping sound in your ear. This is tinnitus.
2. How is tinnitus classified?
There are so many different ways to classify tinnitus that there is no single standard. It is usually classified according to the nature of tinnitus, the cause of tinnitus, and the location of the tinnitus lesion. (1) According to the nature of tinnitus; physiological tinnitus, pathological tinnitus; subjective tinnitus, objective tinnitus; persistent tinnitus, fluctuating tinnitus or pulsatile tinnitus; monotonous tinnitus, polytonal tinnitus.
③Classification according to the site of tinnitus lesion: left tinnitus, right tinnitus, binaural tinnitus, cranial tinnitus; otogenic tinnitus and non-otogenic tinnitus; peripheral tinnitus and central tinnitus Peripheral tinnitus refers to tinnitus caused by lesions in the outer ear, middle ear, inner ear and auditory nerve. Central tinnitus refers to tinnitus caused by lesions in the auditory pathway above the cochlear nucleus up to the auditory cortex of the brain. Non-auricular tinnitus refers to tinnitus caused by diseases unrelated to the auditory organs, such as hypertension, heart disease, hyperthyroidism, neurasthenia, hyperlipidemia, etc.
3. What is the difference between tinnitus and phantom hearing?
Tinnitus is a monotonous sound without any linguistic meaning. Phantom hearing, on the other hand, is a symptom of a psychiatric patient, who often hears someone talking to him/her, crying or laughing, or cursing from other people, when in fact there are no such sounds in the outside world.
4. Do normal people have tinnitus?
Normal people also have tinnitus, which is called physiological 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. Once you let go of your hand or turn over, the tinnitus is gone. Another example is that when we walk into a well-sealed soundproof room or anechoic chamber, almost everyone, especially older people over 60 years old, will feel a buzzing sound in their ears. This 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 the removal or isolation of external noise. Physiological tinnitus is generally below the threshold of hearing, cannot be heard under normal circumstances, and lasts for a short period of time.
5. What is pathological tinnitus?
Tinnitus caused by disease is called pathological tinnitus. Its loudness is usually 5-15dB above the hearing threshold and is easily masked by external noise. Most tinnitus patients complain that they cannot hear the tinnitus during the day or in a noisy place, but the tinnitus appears at night when people are quiet.
6. How many people suffer from tinnitus?
An epidemiological survey conducted in the United States and the United Kingdom found that the prevalence of tinnitus is 17%. If we take a conservative estimate of 10%, there should be 130 million tinnitus sufferers in China. This is a huge number, equivalent to the total population of a larger country.
Of all patients, about 7% need medical help, 3.5% have their tinnitus seriously affect their life, work and social activities, and 0.8% are unable to carry out normal life, work and study due to long-term, severe tinnitus, and even think about suicide. The prevalence of tinnitus is even higher in the elderly, accounting for about 33% of people over 65 years of age. The above ratios respectively mean that 91 million tinnitus patients in China often seek medical treatment; 45.5 million tinnitus patients are seriously disturbed by tinnitus and their quality of life is seriously reduced; 1.04 million patients are unable to carry out normal life, work and study due to tinnitus, as if they are disabled; 39 million elderly people suffer from tinnitus. 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 will gradually increase.
7.What are the dangers of severe tinnitus?
(1) Affects hearing: Very loud tinnitus can interfere with the content of what you hear, and you often hear sounds but cannot distinguish what others are saying.
(2) Affects sleep: Tinnitus is especially loud in the dead of night, making it difficult for people to fall asleep. Even if you do fall asleep, it is particularly shallow. Some people complain that they can be woken up by tinnitus when they are not sleeping deeply (tinnitus can wake up the owner as much as outside sounds). Because tinnitus is still ringing after waking up in the middle of the night, it makes people irritable and sleepless.
(3) Affects mood: Long-term severe tinnitus can cause mood changes such as distraction, worry, apprehension, anxiety, and depression. Some people would rather not hear than tinnitus, reaching an unbearable level. Some people even think of committing suicide because they are told that “there is no good cure” or “there is no good solution”.
(4) Affecting work: Because they cannot hear the speeches of others, especially the leaders and teachers, and because they suffer from the great pain caused by tinnitus, they often cannot be understood, so their work efficiency decreases and they gradually lose interest in work and study.
(5) Affecting family life: Seeking medical treatment for a long time because of tinnitus brings financial loss and even leads to great financial pressure. If it is not understood by family members, it affects family harmony.
(6) Affect social activities: Because of poor speech comprehension, you cannot hear other people’s speech, and you are nervous, irritable and bitter, so you are reluctant to participate in social activities for a long time.
8.Is tinnitus hereditary?
If tinnitus is caused by a hereditary disease, it is hereditary. If the tinnitus is not caused by hereditary disease, it will not be inherited.
9. Is chronic, severe tinnitus a terminal illness?
Tinnitus is not a terminal disease! Normal tinnitus, although it can continue to ring for months, years or even decades, will not endanger your life. In terms of time alone, the longer the tinnitus lasts, the less dangerous it is. If the tinnitus is sudden, or occurs within a short period of time, it is important to go to a regular hospital to investigate the cause. If the tinnitus is caused by a serious disease such as intracranial tumor or cerebrovascular disease, the original cause should be actively treated.
10.What is the relationship between tinnitus and deafness?
Tinnitus patients often have deafness, and tinnitus is a sign of impending deafness. Tinnitus is a precursor of deafness. The frequency (pitch) of tinnitus is often similar to the frequency of hearing loss, so the medication used to treat tinnitus and deafness is generally the same.
11.What are the common causes of tinnitus?
(1) Otogenic tinnitus: (1) Lesions of the sound-transmitting parts (outer ear and middle ear): cerumen embolism of the external ear canal, eczema of the external ear canal, tympanitis, otitis media, and Eustachian tube malfunction. Tinnitus caused by these diseases is usually not serious, and it can mostly disappear after the cause is removed. ②Sensory part (inner ear) lesions: Meniere’s disease, noise deafness, ototoxic drug poisoning, sudden deafness, etc. Tinnitus caused by this type of disease is more serious. ③Posterior cochlear lesions (auditory nerve): Hunter syndrome, auditory neuritis, auditory neuropathy, and 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 this type of lesion is very persistent.
(2) Tinnitus caused by systemic diseases: (1) Cardiovascular diseases: hypertension, hypotension, anemia, coronary heart disease, arteriosclerosis, cerebral thrombosis, hemangioma, and arteriovenous tumor. These diseases often cause ergogenic tinnitus, which is consistent with the pulse rate. ② Cervical spondylosis: cervical spine osteophytes or herniated discs compressing vertebral A. ③ Traumatic brain injury or neurological disorders: head trauma, concussion, encephalitis, meningitis. These diseases often cause tinnitus and high frequency hearing loss in sensorineural deafness. ④Psychiatric disorders: anxiety evidence, depression, schizophrenia, etc. ⑤ Metabolic diseases: hyperthyroidism, hypothyroidism, diabetes mellitus, hyperlipidemia, fiber bundle or micronutrient deficiency. (6) Other diseases such as kidney disease, gynecological disease and gastrointestinal disease can also cause tinnitus.
(3) Tinnitus caused by psychological factors: tension, anxiety, depression, sleep disorders, anger, menopause, etc. can all cause tinnitus.
12.How to self-assess the loudness of tinnitus?
In addition to the doctor’s matching of tinnitus loudness and pitch with an audiometer, patients can assess tinnitus loudness by themselves.
(1) Adjective method: extremely strong, strong, moderate, weak and very weak in total 5 levels.
(2) Quantitative method: Grade 0 – no tinnitus; Grade 1 – very little tinnitus loudness, seemingly absent; Grade 2 – slight tinnitus loudness, but definitely audible; Grade 3 – moderate loudness; Grade 4 – louder tinnitus; Grade 5 – very loud tinnitus; Grade 6 – extremely loud tinnitus, unbearable.
(3) Thermometer method: 0℃-no tinnitus 100℃-extremely strong electric drill-like tinnitus, unbearable.
Find your scale in between.
(4) Image method: Draw a 10 cm long straight line on paper, with every 1 cm as a scale. 0 cm means no tinnitus and 10 cm means extremely loud and unbearable tinnitus. The patient himself marks the loudness of his tinnitus on the straight line.
13.How is the severity of tinnitus graded?
(1) Mild tinnitus: intermittent attacks, or only mild tinnitus at night or in a quiet environment; (2) Moderate tinnitus: persistent tinnitus, which is still felt in a noisy environment; (3) Severe tinnitus: persistent tinnitus, which seriously affects hearing, mood, sleep, work and social activities; (4) Very severe tinnitus: long-term persistent tinnitus, which makes it difficult to bear the extreme pain caused by tinnitus.
14.What tests should tinnitus patients have?
Once tinnitus occurs, you should go to a regular hospital to see a doctor. Doctors often ask patients to do the following examinations.
ENT examination, audiological examination, tinnitus pitch and loudness matching, vestibular function examination, systemic examination (such as cervical spine, cardiovascular, endocrine system, etc.), imaging and laboratory examination (CT, MRI, blood biochemistry, etc.).
15.What is objective tinnitus? What are the common causes?
Doctors often classify tinnitus into subjective tinnitus and objective tinnitus. Subjective tinnitus means that tinnitus is a subjective sensation and there is no corresponding sound resistance from outside, but only the patient can hear the tinnitus himself. Objective tinnitus means that not only can the patient hear the tinnitus himself, but others can also hear it, also known as other-perceived tinnitus. Squeaking or chucking, chucking sounds. Some people can control tinnitus by swallowing or by muscle movements in the pharynx.
Common causes of this tinnitus are.
(1) blockage or abnormal opening of the Eustachian tube group; (2) spasm of the muscles in the tympanic chamber or the Eustachian tube group and the soft jaw muscles; (3) mandibular arthropathy; (4) cerumen in the external ear canal; (5) jugular bullae, arteriovenous fistulas, etc.
16.Can we find the cause of tinnitus?
The cause of approximately 60% of tinnitus can be presumed or determined after a detailed history and physical examination, however, there are still about 40% of tinnitus for which no obvious cause can be found. This is obviously due to the limitations of the current level of medical diagnosis.
17. Is there an effective medicine for tinnitus?
No. There is no such thing. There are no drugs that can immediately stop tinnitus and make it disappear in all patients. Therefore, do not believe in the “cure-all” drugs advertised.
18.How can tinnitus be considered cured?
People generally understand that “cured” means that the tinnitus is no longer loud. However, this is very difficult. At present, no doctor can cure tinnitus with drugs! This is because the pathogenesis of tinnitus is still unclear.
Nowadays, the popular international view is that tinnitus is “cured” when you get used to it. Although the tinnitus is still ringing, it does not affect you in any way. It doesn’t affect your mood, doesn’t bother you, doesn’t worry you, doesn’t scare you, doesn’t affect your sleep, doesn’t affect your work, study and life. After you get used to it, you will be able to live with it peacefully.
19.What are the principles of tinnitus treatment?
The first thing is to find the cause of tinnitus, and then treat the cause. In case of (1) long-term severe tinnitus; (2) unclear cause; (3) clear cause but long lasting treatment; (4) long-term severe tinnitus even after the cause is cured, it is better to use “practice therapy”.
20.What is tinnitus treatment?
As the name suggests, the purpose of this therapy is to adapt to or get used to tinnitus. Although the tinnitus is still loud, it has no effect on mood, sleep, work, study or life.
Hazell and Jastroboff first proposed this therapy in 1992, and the application of this therapy for tinnitus has an efficiency of over 80%. 301 Hospital has also conducted clinical verification with good results and an overall adaptation rate of 88%.
21.What are the contents or steps of tinnitus habit therapy?
The therapy consists of five parts.
(1) low-intensity noise masking; (2) relaxation training; (3) distraction training; (4) psychological counseling and psychotherapy; and (5) medication.
22.What is the mechanism of tinnitus habit therapy?
(1) Increase the upstream afferent signal to recode the auditory system; (2) Increase the strength of the central downstream inhibitory system; (3) Cut the connection between the auditory system and the limbic system to interrupt the association and vicious circle between tinnitus and bad mood.
23. What is low-intensity noise masking?
Most tinnitus patients complain that their tinnitus is not too loud during the daytime, while it is very loud at night in the dead of night. This is because the ambient noise during the day is greater than the noise at night, masking the tinnitus.
Take advantage of this phenomenon by using noise to mask tinnitus. In the past, it was thought that it was best to mask tinnitus with narrow band noise or pure tones, with the tinnitus dominant tone as the central frequency. However, white noise, which is available at all frequencies, is now advocated in order to make it easier for the patient to adapt and get used to the tinnitus signal in the noise. The term “low intensity” means that it is just heard or sounds comfortable and not too loud. It is important not to completely mask the tinnitus with a very high intensity. Therefore, it is also called “not fully masked”. High-intensity noise tends to aggravate the acoustic damage to the ear.
24.What devices can be used for noise masking?
(1) Tinnitus masking device: there are types of behind-the-ear, in-the-ear, box type, etc. There are domestic and imported products. Some can only emit white noise, while others can produce pink noise, narrowband noise and speech noise. The tinnitus masking device produced by Tianjin hearing aid factory is complete in model, inexpensive, reliable in performance and convenient in maintenance, which is suitable for most patients in China.
(2) Hearing aid: Because hearing aid can amplify both speech signal and environmental noise, it can play the dual role of hearing aid and tinnitus masking, which can be used for two purposes at once. Patients with tinnitus and hearing loss should prefer hearing aids.
(3) Special tapes and CDs: Before the official release of the tapes, our hospital had already applied tapes and CDs for tinnitus masking in the tinnitus clinic and received better results. Since most families in China have recorders and many people have Walkman, and since cassettes are easy to carry, tinnitus masking with cassettes is very convenient and suitable for national conditions, and it is in line with the principle of individualization and family-oriented tinnitus treatment.
(4) Small radio and TV: If there are no masking devices, hearing aids, special cassettes or CDs, then small semiconductor radios or TVs can be used for tinnitus masking. As long as you know the principle of tinnitus masking, you can still receive good results.
25.How to do relaxation training?
Tension often causes tinnitus or aggravates it, and tinnitus can cause tension. Tension can be the cause of tinnitus or the psychological response to tinnitus, and the two can be mutually beneficial. The purpose of relaxation training is to eliminate tension. The method is as follows: do, lie down or lie down, close your eyes and be quiet, place your hands on your abdomen or hold them together, or use your thumbs and other fingers in order to eliminate private thoughts and relax your muscles. Control the degree of muscle relaxation with your mind, and relax as much as possible. Start with the forehead and scalp and work your way up to the face, neck, chest, abdomen, upper and lower limbs, etc. Do this 1-3 times a day for 10-20 minutes each time. This is similar to pranayama.
26.How to do the training of shifting attention?
Once you get busy, people can forget about tinnitus. This is because your attention is not focused on the tinnitus. To take advantage of this phenomenon, you should do distraction training. Once you think about tinnitus, you should immediately shift your attention to other things. For example, read some novels with particularly attractive storylines, watch TV or listen to comedy or sketch programs on the radio, or do something that can arouse your interest in order to distract or divert your attention from tinnitus.
27.What is psychological counseling and psychotherapy?
Psychological counseling and psychotherapy is a treatment for the psychological problems caused by tinnitus. The approximate process is as follows: First, the doctor will explain to you about the pathophysiology of tinnitus. Then, he or she will explain the dangers of tinnitus with regard to its causes. If the disease causing the tinnitus is not life-threatening, but the tinnitus cannot be relieved immediately, the doctor will persuade you to use tinnitus habit therapy. Some patients often suspect that they have a brain tumor or even a cerebrovascular disease, so they are especially nervous and afraid. Some are very worried, anxious, or even depressed about long-term, severe tinnitus because it cannot be cured for a long time. A few patients often ask the doctor to cut off the auditory nerve because they can hardly bear the pain of tinnitus and would rather not hear than tinnitus. A few people even think of suicide because of severe tinnitus. These psychological reactions can develop into psychological problems or psychological disorders. The doctor will explain each of these problems and, if necessary, recommend that you consult a psychology or mental health department for assistance with treatment.
28.What medications are available to treat tinnitus?
There are many medications available to treat tinnitus, but none of them are potent! There is no medication that can instantly make tinnitus stop. Some people are effective with this medicine and some people are effective with that medicine. The effect of one medication is not duplicated in all patients. Therefore, the principle of medication use is experimental and short-term. Use one medicine for 2-3 months at most, and if it doesn’t work, stop taking it. Because tinnitus can ring for years or even decades, and taking medication cannot last that long without eating the body across. This is because any medicine has a payoff effect. Another principle of medication is to be economical. Don’t believe in some advertisements and buy those expensive drugs that claim to be a “cure” for tinnitus. As a result, you spend a lot of money but your tinnitus is not cured.
Commonly used drugs for tinnitus include: vasodilators such as Meclizine, Mineralon, Nimodipine, etc., nerve-nourishing drugs such as vitamin B1, vitamin B12, Micropol, adenosine cobalt tablets, etc. Commonly used herbal medicines such as Shu Er Dan, Jin Nadu, Zuo Mag Wan, Liu Wei Di Huang Wan, etc. If tinnitus occurs in menopausal women, it can be treated with Jialong tablets.
29.What should I do if I have tinnitus?
If tinnitus occurs occasionally or stops at times, it can be considered as a physiological phenomenon and there is no need to worry too much about it. If the tinnitus is mild, you can press the ear screen and the acupuncture points around it, and the tinnitus will disappear. If tinnitus keeps ringing and affects your mood, work, study and life, you should go to a regular hospital for examination and seek help from a specialist.
Tinnitus patients should review when the tinnitus occurs. Under what circumstances did it worsen? Under what circumstances does it decrease? What factors may be related to it? Is there hearing loss and vertigo in addition to tinnitus? Is blood pressure high? High blood lipids? Is there cervical spondylosis? If these questions are clarified, it will provide very valuable information to the doctor for diagnosis and treatment.
30.What are the characteristics of tinnitus in the elderly?
China has entered an aging society, with 130 million elderly people, which already accounts for 10% of the total population. The prevalence of tinnitus in the elderly is very high, 33%. Based on this percentage, 39 million elderly people in China suffer from tinnitus.
In addition to age-related degenerative changes in the ear, tinnitus in the elderly generally has a variety of systemic causes, such as diabetes, hypertension, hyperlipidemia, cervical spondylosis, cerebral arteriosclerosis, and so on. These diseases are combined together to cause tinnitus, so treating one disease alone is often ineffective and requires comprehensive treatment. Moreover, many age-related diseases are impossible to cure completely. Therefore, it is necessary to use tinnitus habit therapy. In addition to treating the primary disease, we should strengthen the habituation training so as to adapt to and get used to tinnitus as soon as possible.