In today’s increasingly fast-paced life, people’s life stress has also increased. As a result, the number of people suffering from tinnitus due to various reasons is also on the rise. First of all, it is emphasized that tinnitus is a common clinical symptom rather than a disease. From ancient times to the present, many medical practitioners have studied tinnitus, but to date, the exact site of origin of tinnitus is still uncertain. Now, with the increased research on tinnitus, as with other medical mysteries, I believe that one day tinnitus will also be solved.
Tinnitus is a subjective sensation of sound in the ear or head in the absence of any external source of sound or electrical stimulation, known as subjective tinnitus. The prevalence of tinnitus accounts for 15% to 20% of the total population, and its etiology is broadly summarized as follows.
1. Spontaneous factors
There are many people who occasionally feel a whistle-like tinnitus and cannot find other causes.
2.Noise
If people are exposed to strong noise for a long time, free radicals will be generated, which morphologically manifests as scattered static cilia of cochlear hair cells, or even changes in the hair cells themselves.
3.Ototoxic drugs
Isoamyl nitrite), corticosteroids (hydrogenated prednisone, paraflumizone), narcotic analgesics (propoxyphene), steroids, and antithyroid drugs. Among them, the main cause of permanent hearing loss is all kinds of antibiotics.
4.Body diseases
(1) External ear and middle ear diseases: When cerumen embolism, cholesteatoma or foreign body touching the eardrum can cause tinnitus. External ear boils, external ear canal mycosis, external ear canal dermatitis, eczema, etc. may cause tinnitus. Acute and chronic purulent inflammation of the middle ear, exudative lesions, vascular malformations, tympanic membrane perforation, otosclerosis and other lesions may cause tinnitus.
(2) Various causes of inner ear pathologies may cause tinnitus: Meniere’s disease, labyrinthitis, sudden deafness, Hunt syndrome, ototoxic drugs, Cogan syndrome, exolymphatic fistula, transverse temporal bone fracture, cochlear otosclerosis, auditory neuroma, senile degeneration, and allergic reactions.
(3) Central lesions: brainstem hemorrhage, auditory neuroma, arachnoid inflammation or tumor, degenerative changes of the auditory nerve, epilepsy, etc.
(4) Some infectious diseases: influenza, scarlet fever, mumps, diphtheria, etc. Systemic systemic disorders: hypertension, diabetes mellitus, anemia, leukemia, etc. In addition, there are also hypothyroidism, renal insufficiency, ulcer disease, habitual constipation, gout, rheumatism, odontogenic diseases, temporomandibular joint syndrome, cervical spondylosis, senile degeneration, etc., which may trigger tinnitus.
There are also many factors that affect tinnitus, such as psychological factors. An unhealthy psychological state such as irritability, apprehension and anger can aggravate tinnitus, while an easy, pleasant and relaxed mood is conducive to reducing the symptoms of tinnitus. Some tinnitus patients complain that their tinnitus worsens when they are tired or have insomnia, and some female patients feel that their tinnitus also worsens during menstruation. Tinnitus can also be aggravated by frequent exposure to high intensity noise. In terms of diet, some patients’ tinnitus is aggravated by the intake of high-fat and spicy foods, and tinnitus is also affected by beverages that have a stimulating effect on the center, such as coffee and strong tea, as well as alcohol and tobacco.
As one of the three major otologic problems (tinnitus, deafness and vertigo), there are many treatment methods for tinnitus, but the effectiveness of each method varies from person to person. The current treatment methods are broadly as follows.
1. Etiological treatment
Treat the original cause of tinnitus. For systemic tinnitus, such as hypertension and diabetes mellitus, medical drugs can be used to treat the original disease; for tinnitus caused by vascular malformation and tumor, surgical treatment is appropriate; some diseases with tinnitus can be treated with drugs or surgery, such as Meniere’s disease.
2.Drug treatment
(1)Benzodioxins Drugs
These drugs can inhibit the activation of the limbic system on the reticular structures, and their toxicity is small, but they are often prone to drug dependence, such as Valium.
(2) Tricyclic antidepressants
They can inhibit the reuptake of the central transmitter norepinephrine, thus increasing the concentration of the transmitter at the receptor site and promoting the synaptic transmission function. Such as amitriptyline, doxepin, etc.
(3)Others
Lidocaine, carbamazepine, etc.
3.Electrical stimulation therapy
This method uses electric current to directly stimulate the auditory structures and suppress tinnitus by changing the functional state of the auditory structures and inhibiting the abnormal activities that lead to tinnitus. At present, there are mainly effective electrical stimulation therapies: external stimulation method, intra-drum electrical stimulation method, and deep brain electrical stimulation method.
4.Habit therapy
(1) Incomplete masking of tinnitus: Use low-intensity broadband noise to mask tinnitus at a volume that is just heard, without masking all of it.
(2) Relaxation training: sit quietly or lie down with eyes closed, control the tension of the nerves and muscles with your mind, starting from the scalp, forehead and facial muscles, and gradually relaxing the muscles of the upper and lower limbs, chest and even the whole body.
(3) Shift your attention: Once you think of tinnitus, immediately shift your attention to other things.
(4) Psychological adjustment and counseling: Build up confidence that you can adapt to it, change the wrong view that tinnitus is cured only when it stops with drugs, give up the long-term dependence on drugs, compare tinnitus to the snoring of relatives and the roaring of trains, try to get used to it or adapt to it as soon as possible, and learn to coexist peacefully with tinnitus.
5.Masking therapy
It is a treatment method to mask the tinnitus through a sound source provided by the outside world. Usually, tinnitus masking devices such as tinnitus masking devices, pure tone audiometers or recorders can be used to mask narrowband noise, broadband noise, FM sound or speech noise.
6.Wearing hearing aids
As early as 1943, Fowler applied hearing aids to treat tinnitus. It is commonly used for tinnitus patients with combined hearing loss and is also suitable for tinnitus patients with low tone. The amplification of external noise into the ear by the hearing aid, together with the background noise of the hearing aid, provides another form of sound masking relative to the patient’s tinnitus. At the same time, the useful external sound signal improves the signal-to-noise ratio relative to the tinnitus, which helps improve the patient’s ability to hear.
Tinnitus may be a concomitant symptom of sudden deafness. Sudden deafness is a sudden onset of sensory nerve deafness, also known as burst deafness. It is an otologic emergency, with an incidence of about 10 out of 10,000 people. The incidence increases with age, and there is a trend of increasing incidence year by year, with 3/4 of them being over 40 years old. In recent years, the occurrence of sudden deafness in young people has also seen an increase. Therefore, for avoiding tinnitus, it is necessary to develop good living habits.