What causes ringing in the ears? Tinnitus can have many possible reasons, from age-related hearing loss to certain medications. Learn about the common causes and how to manage this condition.

Understanding Tinnitus: The Ringing in Your Ears

Tinnitus, or the perception of ringing, buzzing, hissing, whistling, swooshing, or other sounds in the ear, is a common condition that affects millions of people worldwide. This phantom noise can be a source of significant distress and disruption to daily life. Understanding the underlying causes and available treatments is crucial for managing tinnitus effectively.

Common Causes of Tinnitus

Tinnitus is not a disease itself but rather a symptom of an underlying condition. Some of the most common causes of tinnitus include:

• Age-related hearing loss: As we grow older, the delicate hair cells in the inner ear can become damaged, leading to tinnitus and hearing difficulties.
• Exposure to loud noises: Prolonged or sudden exposure to loud sounds, such as music concerts, machinery, or explosions, can cause permanent damage to the inner ear and trigger tinnitus.
• Excessive earwax buildup: When earwax accumulates and blocks the ear canal, it can put pressure on the eardrum and contribute to tinnitus.
• Certain medications: Some prescription and over-the-counter drugs, including aspirin, diuretics, and cancer treatments, can have tinnitus as a side effect.
• Ear and sinus infections: Infections that affect the middle or inner ear can cause temporary tinnitus, often accompanied by other symptoms like pain and hearing loss.
• TMJ disorders: Problems with the temporomandibular joint (TMJ), the joint that connects the jaw to the skull, can sometimes lead to tinnitus.
• Cardiovascular issues: Conditions that affect the blood vessels, such as high blood pressure or hardening of the arteries, can contribute to a pulsatile form of tinnitus.
• Other medical conditions: Tinnitus has also been associated with conditions like Meniere’s disease, head and neck injuries, and neurological disorders like Lyme disease and fibromyalgia.

Symptoms and Characteristics of Tinnitus

Tinnitus can manifest in a variety of ways, and the experience can vary greatly from person to person. Some of the common characteristics of tinnitus include:

• The sound may be perceived in one ear, both ears, or originate from within the head.
• The sound can be constant or intermittent, steady or pulsating.
• The pitch and volume of the sound can range from a soft, low-pitched hum to a high-pitched, piercing screech.
• Tinnitus can be a single sound or a combination of different sounds, such as ringing, buzzing, hissing, or whistling.
• For some individuals, the tinnitus sound is only noticeable in quiet environments, while for others, it is a constant presence.

Diagnosing and Evaluating Tinnitus

If you are experiencing persistent or bothersome tinnitus, it is recommended to consult with a healthcare professional, such as an audiologist or otolaryngologist (ear, nose, and throat specialist). During the evaluation, the healthcare provider will likely:

1. Conduct a thorough medical history, asking about the onset, duration, and characteristics of the tinnitus.
2. Perform a physical examination, including an inspection of the ears and assessment of hearing function.
3. Order additional tests, such as audiometry (hearing test), imaging scans, or blood work, to identify the underlying cause of the tinnitus.
4. Determine the appropriate course of treatment based on the findings, which may include medication, counseling, or other therapies.

Managing and Treating Tinnitus

While there is no universal cure for tinnitus, there are various strategies and treatments that can help manage the condition and alleviate its impact on daily life. Some common approaches include:

• Sound therapy: Using external sound sources, such as white noise machines, music, or specialized tinnitus management devices, to distract from the tinnitus sound and reduce its perceived loudness.
• Cognitive-behavioral therapy (CBT): A form of psychotherapy that helps individuals develop coping strategies and reduce the emotional distress associated with tinnitus.
• Medication: In some cases, healthcare providers may prescribe medications, such as antidepressants or anti-anxiety drugs, to help manage the psychological impact of tinnitus.
• Lifestyle modifications: Addressing factors like stress, sleep disturbances, and exposure to loud noises can help mitigate tinnitus symptoms.
• Hearing aids: For individuals with concurrent hearing loss, the use of hearing aids can help mask the tinnitus sound and improve overall hearing function.

Coping with Tinnitus: Tips and Strategies

Living with tinnitus can be challenging, but there are ways to manage the condition and minimize its impact on daily life. Some helpful strategies include:

1. Educate yourself about tinnitus and its potential causes to better understand your condition.
2. Practice relaxation techniques, such as meditation, deep breathing, or progressive muscle relaxation, to reduce stress and anxiety.
3. Avoid exposure to loud noises and ensure proper hearing protection when engaging in activities that may exacerbate tinnitus.
4. Establish a consistent sleep routine and maintain good sleep hygiene to help manage the impact of tinnitus on sleep quality.
5. Seek support from friends, family, or support groups to share your experiences and learn from others who are also managing tinnitus.
6. Work closely with your healthcare provider to develop a comprehensive treatment plan that addresses both the physical and psychological aspects of your tinnitus.
7. Be patient and persistent in your efforts to find effective coping strategies, as the management of tinnitus can be a gradual and individualized process.

Conclusion

Tinnitus is a complex and often frustrating condition, but with the right understanding and management strategies, it is possible to minimize its impact on your daily life. By working closely with healthcare professionals, exploring various treatment options, and incorporating coping techniques, individuals with tinnitus can learn to manage their symptoms and regain a sense of control over their well-being.

Possible Reasons You Have Tinnitus (Ringing in Ears)

Written by WebMD Editorial Contributors

• Tinnitus Triggers

Tinnitus, or ringing in the ears, can be caused by many things. But it isn’t a disease. It’s a symptom of another health problem.

What causes the ringing? Usually it’s from damage to tiny hairs in your inner ear. That changes the signals they send to your brain that control how you hear sound. You might get tinnitus as a normal part of aging, but there are other causes. It could be temporary, or it might last for the rest of your life.

Age-related hearing loss: For many people, hearing gets worse as you age. This usually begins around 60. It usually affects both ears. You’ll probably notice a problem with high-frequency sounds.

Loud noises: Loud noises are a leading cause. It could be something you hear every day for years, or something that only happens once. That includes everything from concerts and sporting events to loud machinery and backfiring engines. They can affect one or both ears, and they may cause hearing loss and pain. The damage can be permanent or temporary.

Too much earwax: Your body makes this gunky stuff to trap dirt and protect your ears. But if it doesn’t wash away on its own and too much piles up, it could lead to ringing or hearing loss. Your doctor can remove the buildup gently. Don’t grab a cotton swab and try to do it yourself.

Certain medicines: Prescription and over-the-counter drugs can trigger ringing or make it louder. This includes aspirin, diuretics, nonsteroidal anti-inflammatory drugs (NSAIDs), quinine-based medication, and certain antibiotics, antidepressants, and cancer drugs. Usually the stronger the dose, the greater your chance of problems. Often if you stop the drug, your symptoms will go away. See your doctor if you think a drug may be to blame. But don’t stop taking any medication without talking to your doctor first.

Ear and sinus infections: You might notice tinnitus when you’ve had a cold. That could be due to an ear or sinus infection that affects your hearing and increases pressure in your sinuses. If that’s the cause, it shouldn’t last long. If it doesn’t get better after a week or so, see your doctor.

TMJ: Problems with your jaw or temporomandibular joint (TMJ) can cause tinnitus. You might notice popping or pain in the joint when you chew or talk. The joint shares some nerves and ligaments with your middle ear. A dentist can treat TMJ disorders and help keep ear ringing from getting worse.

Blood pressure issues: This can include high blood pressure and things that raise it in the short term, like stress, alcohol, and caffeine. Hardening of the arteries can also play a role. Blood vessels close to your middle and inner ear become less stretchy, so your blood flow is stronger and seems louder. This iwhat is known as a pulsatile tinnitus.

Other medical problems: These include changes in your inner ear bones, an inner ear disorder called Meniere’s disease, or head and neck injuries. Conditions like fibromyalgia and Lyme disease also can trigger ear ringing. Your doctor will help you figure out the cause and ease the sounds.

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Tinnitus: Ringing in the ears and what to do about it

Constant noise in the head— such as ringing in the ears—rarely indicates a serious health problem, but it sure can be annoying. Here’s how to minimize it.

Tinnitus (pronounced tih-NITE-us or TIN-ih-tus) is sound in the head with no external source. For many, it’s a ringing sound, while for others, it’s whistling, buzzing, chirping, hissing, humming, roaring, or even shrieking. The sound may seem to come from one ear or both, from inside the head, or from a distance. It may be constant or intermittent, steady or pulsating.

Almost everyone has had tinnitus for a short time after being exposed to extremely loud noise. For example, attending a loud concert can trigger short-lived tinnitus. Some medications (especially aspirin and other nonsteroidal anti-inflammatory drugs taken in high doses) can cause tinnitus that goes away when the drug is discontinued. When it lasts more than six months, it’s known as chronic tinnitus. As many as 50 to 60 million people in the United States suffer from this condition; it’s especially common in people over age 55 and strongly associated with hearing loss. Many people worry that tinnitus is a sign that they are going deaf or have another serious medical problem, but it rarely is.

Most tinnitus is subjective, meaning that only you can hear the noise. But sometimes it’s objective, meaning that someone else can hear it, too. For example, if you have a heart murmur, you may hear a whooshing sound with every heartbeat; your clinician can also hear that sound through a stethoscope. Some people hear their heartbeat inside the ear — a phenomenon called pulsatile tinnitus. It’s more likely to happen in older people, because blood flow tends to be more turbulent in arteries whose walls have stiffened with age. Pulsatile tinnitus may be more noticeable at night, when you’re lying in bed and there are fewer external sounds to mask the tinnitus. If you notice any new pulsatile tinnitus, you should consult a clinician, because in rare cases it is a sign of a tumor or blood vessel damage.

The course of chronic tinnitus is unpredictable. Sometimes the symptoms remain the same, and sometimes they get worse. In about 10% of cases, the condition interferes with everyday life so much that professional help is needed.

While there’s no cure for chronic tinnitus, it often becomes less noticeable and more manageable over time. You can help ease the symptoms by educating yourself about the condition — for example, understanding that it’s not dangerous. There are also several ways to help tune out the noise and minimize its impact.

What’s going on?

Most people who seek medical help for tinnitus experience it as subjective, constant sound like constant ringing in the ears or a buzzing sound in the ear, and most have some degree of hearing loss. Things that cause hearing loss (and tinnitus) include loud noise, medications that damage the nerves in the ear (ototoxic drugs), impacted earwax, middle ear problems (such as infections and vascular tumors), and aging. Tinnitus can also be a symptom of Meniere’s disease, a disorder of the balance mechanism in the inner ear.

Tinnitus can arise anywhere along the auditory pathway, from the outer ear through the middle and inner ear to the brain’s auditory cortex, where it’s thought to be encoded (in a sense, imprinted). One of the most common causes of tinnitus is damage to the hair cells in the cochlea (see “Auditory pathways and tinnitus”). These cells help transform sound waves into nerve signals. If the auditory pathways or circuits in the brain don’t receive the signals they’re expecting from the cochlea, the brain in effect “turns up the gain” on those pathways in an effort to detect the signal — in much the same way that you turn up the volume on a car radio when you’re trying to find a station’s signal. The resulting electrical noise takes the form of tinnitus — a sound that is high-pitched if hearing loss is in the high-frequency range and low-pitched if it’s in the low-frequency range. This kind of tinnitus resembles phantom limb pain in an amputee — the brain is producing abnormal nerve signals to compensate for missing input.

Most tinnitus is “sensorineural,” meaning that it’s due to hearing loss at the cochlea or cochlear nerve level. But tinnitus may originate in other places. Our bodies normally produce sounds (called somatic sounds) that we usually don’t notice because we are listening to external sounds. Anything that blocks normal hearing can bring somatic sounds to our attention. For example, you may get head noise when earwax blocks the outer ear.

Evaluate and treat underlying problems

If you develop tinnitus, it’s important to see your clinician. She or he will take a medical history, give you a physical examination, and do a series of tests to try to find the source of the problem. She or he will also ask you to describe the noise you’re hearing (including its pitch and sound quality, and whether it’s constant or periodic, steady or pulsatile) and the times and places in which you hear it. Your clinician will review your medical history, your current and past exposure to noise, and any medications or supplements you’re taking. Tinnitus can be a side effect of many medications, especially when taken at higher doses (see “Some drugs that can cause or worsen tinnitus”).

Musculoskeletal factors — jaw clenching, tooth grinding, prior injury, or muscle tension in the neck — sometimes make tinnitus more noticeable, so your clinician may ask you to tighten muscles or move the jaw or neck in certain ways to see if the sound changes. If tight muscles are part of the problem, massage therapy may help relieve it.

Tinnitus that’s continuous, steady, and high-pitched (the most common type) generally indicates a problem in the auditory system and requires hearing tests conducted by an audiologist. Pulsatile tinnitus calls for a medical evaluation, especially if the noise is frequent or constant. MRI or CT imaging may be needed to check for a tumor or blood vessel abnormality.

Your general health can affect the severity and impact of tinnitus, so this is also a good time to take stock of your diet, physical activity, sleep, and stress level — and take steps to improve them. You may also be able to reduce the impact of tinnitus by treating depression, anxiety, insomnia, and pain with medications or psychotherapy.

If you’re often exposed to loud noises at work or at home, it’s important to reduce the risk of hearing loss (or further hearing loss) by using protectors such as earplugs or earmuff-like or custom-fitted devices.

Managing tinnitus

In addition to treating associated problems (such as depression or insomnia), there are several strategies that can help make tinnitus less bothersome. No single approach works for everyone, and you may need to try various combinations of techniques before you find what works for you. If you have age-related hearing loss, a hearing aid can often make tinnitus less noticeable by amplifying outside sounds.

There is no FDA-approved drug treatment for tinnitus, and controlled trials have not found any drug, supplement, or herb to be any more effective than a placebo. That includes ginkgo biloba, which is sometimes promoted for this purpose. Some patients believe that acupuncture helps, but it too has been found to be no better than a placebo.

The most effective approaches are behavioral strategies and sound-generating devices, often used in combination. They include the following:

Cognitive behavioral therapy (CBT). CBT uses techniques such as cognitive restructuring and relaxation to change the way patients think about and respond to tinnitus. Patients usually keep a diary and perform “homework” to help build their coping skills. Therapy is generally short-term — for example, weekly sessions for two to six months. CBT may not make the sound less loud, but it can make it significantly less bothersome and improve quality of life.

Tinnitus retraining therapy (TRT). This technique is based on the assumption that tinnitus results from abnormal neuronal activity (see “What’s going on?”). The aim is to habituate the auditory system to the tinnitus signals, making them less noticeable or less bothersome. The main components of TRT are individual counseling (to explain the auditory system, how tinnitus develops, and how TRT can help) and sound therapy. A device is inserted in the ear to generate low-level noise and environmental sounds that match the pitch, volume, and quality of the patient’s tinnitus. Depending on the severity of the symptoms, treatment may last one to two years.

When TRT was developed in the 1980s by neuroscientist Dr. Pawel Jastreboff, it was designed to be administered according to a strict protocol. Today, the term TRT is being used to describe modified versions of this therapy, and the variations make accurate assessment of its effectiveness difficult. Individual studies have reported improvements in as many as 80% of patients with high-pitched tinnitus.

Masking. Masking devices, worn like hearing aids, generate low-level white noise (a high-pitched hiss, for example) that can reduce the perception of tinnitus and sometimes also produce residual inhibition — less noticeable tinnitus for a short time after the masker is turned off. A specialized device isn’t always necessary for masking; often, playing music or having a radio, fan, or white-noise machine on in the background is enough. Although there’s not enough evidence from randomized trials to draw any conclusions about the effectiveness of masking, hearing experts often recommend a trial of simple masking strategies (such as setting a radio at low volume between stations) before they turn to more expensive options.

Biofeedback and stress management. Tinnitus is stressful, and stress can worsen tinnitus. Biofeedback is a relaxation technique that helps control stress by changing bodily responses. Electrodes attached to the skin feed information about physiological processes such as pulse, skin temperature, and muscle tension into a computer, which displays the output on a monitor. Patients learn how to alter these processes and reduce the body’s stress response by changing their thoughts and feelings. Mindfulness-based stress reduction techniques may also help.

Not all insurance companies cover tinnitus treatments in the same way, so be sure to check your coverage. If you’re willing to enroll in a research study, you may be able to receive a cutting-edge treatment free. (For more information, go to www.clinicaltrials.gov, and enter the search term “tinnitus.”)

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Tinnitus, ringing in the ears – symptoms, causes, treatment

What is tinnitus?

The word tinnitus comes from the Latin tinnire, “to tinkle” , but tinnitus can sound more like a hum, hiss, chirp or a thin squeak.

About 40% of adults experience tinnitus from time to time. About 8% suffer from it often or constantly. For 1% of people, tinnitus is a serious problem that interferes with a normal life. It almost never affects children and very often elderly people with hearing loss.

This noise is not associated with external sounds and is “heard” better in silence than with external noise. Tinnitus lasts for a long time (more than 5 minutes) and should be distinguished from a short, transient sound that lasts a few seconds or occurs after a strong sound stimulus. Such noise is in no way connected with the mechanical processes occurring in the ear, its cause is in the nerve cells.

IMPORTANT! Information from the article cannot be used for self-diagnosis and self-treatment! Only a doctor can prescribe the necessary examinations, establish a diagnosis and draw up a treatment plan for a consultation!

Why does tinnitus occur?

There are two theories about its origin.

1) Due to the constant high level of noise in the life of a city dweller, cells in the inner ear are constantly dying, turning sounds into nerve impulses. They do not die immediately, but for some time they are in a “death” state. They can still send information to the brain, but are no longer able to generate impulses specific to each sound. The result is “noise”.

2) According to another theory, tinnitus is something like phantom pains. The auditory cortex of the brain “remembers” that information about external sounds should be transmitted through the auditory pathways, but the corresponding auditory cells have already died, and the brain “has to” find information that is similar to sound impulses. This information travels along pathways through the mood center, which is why tinnitus sufferers have such a hard time with noise. Gradually, as a result of incorrect adaptation, this path becomes the main one for the brain, and the person, as it were, gets used to hearing noise.

What can cause tinnitus?

• Tinnitus is usually caused by hearing loss from constant exposure to loud noises (tractor, lawn mower, loud music on headphones) or acoustic trauma.
• Otitis media, atherosclerosis, traumatic brain injury, cervical osteochondrosis, and hearing loss due to aging or other causes can contribute to tinnitus.
• Much less commonly, tinnitus can be a symptom of diabetes, kidney disease, or head or neck tumors.
• Some drugs cause tinnitus: quinine, non-steroidal anti-inflammatory drugs, paracetamol, diuretics (furosemide…), a number of antibiotics (gentamicin, streptomycin, etc.), certain types of chemotherapy, some psychiatric drugs (amitriptyline, sertraline, anafranil, etc.). e.)

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How to “measure” strength tinnitus?

Since this is a subjective sensation, it cannot be measured in decibels. In fact, the most important thing is how much tinnitus causes discomfort to its “happy” owner.

Therefore, a qualitative scale is used that rates tinnitus from “mild” to “catastrophic”, based on whether the person hears it all the time, whether it interferes with sleep or does something that requires silence.

Severe tinnitus leads to nervous tension, insomnia, inability to concentrate and even depression.

How to cure tinnitus?

There is no cure for tinnitus. Drugs of different groups have been studied, including antiepileptics, antidepressants, tranquilizers, but none of them is able to significantly reduce tinnitus.

Based on the theory that the brain does not adapt properly to the death of nerve cells that conduct auditory impulses, tinnitus is treated with a method called tinnitus retraining therapy (TRT). This is a type of cognitive-behavioral therapy in which a person is taught to be distracted from the noise, to relax, not to hear it. Gradually, a positive feedback is formed, the brain “unlearns” to use the wrong way of conducting impulses, and the noise level really decreases.

In addition to training, the TRT course uses sound therapy individually selected by means of noise measurement – a person is empirically selected “white noise”, which he should listen to from time to time. It can be the sound of the sea, the wind or the rustle of leaves. Such noise is evaluated in the subcortical auditory pathways as a neutral sound, its perception is quickly blocked and it does not reach the cortex, and tinnitus is blocked along with it – the patient ceases to be aware of it.

Both parts of therapy are equally important, but the first is the main one: the patient must stop paying attention to tinnitus, learn to live with it and reduce its significance. The TRT method allows you to completely remove tinnitus in terms of three months to two years.

If you suffer from nocturnal tinnitus, there are Tinnitus Therapy Pro and Tinnitus Therapy Lite mobile apps to help relieve it while you sleep. Applications offer so-called sound maskers (white noise and others), as well as sound tracks developed by doctors lasting 8 hours. There are other apps and tracks, paid and free, that can make life easier and “mask” tinnitus that occurs day or night.

Noise in the ears and head (tinnitus)

What is tinnitus like

Tinnitus (tinnitus) is the sensation of sound in the ear that occurs without any external stimulus.

Noise can appear in one ear or both at once, be permanent or temporary, loud or muffled, monotonous or pulsating.

Up to 45% of adults experience tinnitus from time to time, and 8% experience it constantly.

For some people, buzzing or ringing in the ears does not cause discomfort: it appears and disappears, and the person may not even pay attention to it. But sometimes the noise is so intrusive that it becomes difficult to concentrate on work tasks, communicate with people or fall asleep.

Depending on the cause, tinnitus can be completely cured or corrected so that it does not interfere with normal life.

Objective and subjective tinnitus

Distinguish between objective (vibratory) and subjective (non-vibratory) tinnitus.

Objective tinnitus is rare. It occurs against the background of diseases that provoke vibrations in certain parts of the body: involuntary contractions of the muscles of the middle ear, tremor of the soft palate. Objective noise is called because it can be heard by other people, such as a doctor during a physical examination.

Subjective noise not heard by others. It occurs against the background of irritation of the hearing organs, deterioration of the blood supply to the inner ear as a result of acute inflammation, cerebrovascular accidents, some chronic diseases (including inflammatory ones), medication or injuries. This is the most common form of tinnitus, accounting for up to 99% of cases.

Causes of tinnitus

Most often, tinnitus occurs due to damage to the elements of the ear (inner, middle or outer), damage to the nerve cells of the brain that perceive and decipher sound, or a malfunction of the auditory nerve, through which information about sound is transmitted from the ear to the brain.

Tinnitus can be caused by damage to the elements of the ear, the auditory nerve, or to the part of the brain responsible for sound perception

Up to 85% of patients reporting tinnitus have documented hearing loss. This means that most of the cases of tinnitus are associated with ear pathology.

At the same time, hearing loss may be less noticeable, especially if the damage is not very strong or develops gradually over several months, so tinnitus is often the first sign of such pathologies.

Quite often, tinnitus appears against the background of age-related hearing impairment.

But the symptom may not be associated (or not directly associated) with pathologies of the hearing organs: for example, it may occur with vascular, neuromuscular, endocrine and other disorders, as well as with head and neck injuries.

Pathologies of the inner ear

Injuries, inflammations, neoplasms and other pathologies can disrupt the functioning of the inner ear, the auditory nerve or the part of the brain responsible for recognizing sound – this leads to hearing loss, distorted perception of sounds and tinnitus.

If tinnitus is accompanied by dizziness or sound distortion, the cause is most likely a malfunction of the inner ear, the vestibulocochlear nerve, or its centers in the brain.

Pathologies of the inner ear causing tinnitus:

• sensorineural hearing loss – hearing impairment (including imperceptible to the patient) caused by damage to the elements of the inner ear, auditory nerve or part of the brain responsible for the perception of sound;
• acoustic neuroma — a small, benign lesion that irritates the auditory nerve;
• acoustic injury – damage caused by exposure to very loud sounds (over 120 dB), which is accompanied by hemorrhage in the cochlea, displacement or deformation of the elements of the inner ear;
• vibration injury – damage caused by prolonged or strong vibration exposure – in production, construction or transport – which provokes degenerative processes in the cochlea and other elements of the inner ear;
• otosclerosis – damage to the labyrinth of the inner ear, caused by the growth of bone tissue due to metabolic disorders;
• Meniere’s disease – non-infectious inflammation, which is accompanied by excessive accumulation of fluid in the inner ear;
• labyrinthitis – inflammation of the elements of the inner ear caused by a bacterial or viral infection.

Middle ear disorders

Tinnitus can be caused by trauma, inflammation or growths in the middle ear.

Most often, the symptom occurs in connection with damage to the eardrum or with a violation of intra-ear pressure.

Immersion in water can cause damage to the inner or middle ear due to pressure changes

Middle ear disorders causing tinnitus:

• barotrauma – damage to the middle or inner ear due to a sudden change in pressure – can occur during flight in an airplane, diving to great depths, when a palm strikes the ear, or an explosion nearby;
• Eustachian tube dysfunction (connects the middle ear to the nasopharynx) – a pathology in which there is increased pressure and noise in the ear;
• obstruction of the ear canal by wax buildup or cerumen, foreign objects or water causes increased pressure inside the ear;
• otitis media and other ear infections lead to swelling of the tissues, narrowing of the ear canals and changes in pressure inside the ear;
• otosclerosis – hardening and proliferation of bone tissue, as a result of which the mobility of the elements of the middle ear is impaired;
• Tumors of the tympanic cavity – benign or malignant neoplasms in the middle ear may interfere with the function of the elements of the middle ear, increase intra-aural pressure, or lead to defects in the tympanic membrane;
• myoclonus – short-term contraction of the muscles of the middle ear due to neuromuscular diseases (for example, trigeminal neuralgia or epilepsy). This pathology leads to objective tinnitus.

Outer ear pathologies

Disturbances at the level of the outer ear, as a rule, are accompanied by muscular pathologies or narrowing of the ear canal.

External ear disorders causing tinnitus:

• neoplasms benign or malignant in the external part of the ear canal can cause tissue destruction and distortion of perceived sound;
• exostoses – bony growths in the external auditory canal – may interfere with the penetration of sound into the ear or distort it;
• otitis externa is an acute infectious disease, which is accompanied by severe swelling of the ear canal, closing its lumen.

Other possible causes of tinnitus

Tinnitus can be caused by pathologies that are not directly related to the organs that are responsible for hearing. It can be circulatory disorders, metabolism, work of the musculoskeletal system. In this case, the noise is caused by a deterioration in tissue nutrition, an increase in pressure on the walls of blood vessels, or muscle spasms.

Non-ear causes of noise:

• benign or malignant tumors of the head and neck – can disrupt the nutrition and blood circulation of the elements of the hearing organ or cause their irritation, leading to incorrect operation;
• head and neck injuries – can lead to damage to the auditory nerve or the area of ​​the brain responsible for recognizing sounds. Injuries are characterized by the development of noise in one ear;
• neuropsychiatric disorders , including schizophrenia. Depressive states are accompanied by an imbalance of neurotransmitters – substances responsible for the correct transmission of nerve impulses. This can lead to the appearance of subjective extraneous sounds. In addition, tinnitus in some mental disorders may be part of auditory hallucinations;
• neurodegenerative and demyelinating diseases of the central nervous system: multisystem atrophy, chronic encephalopathy of various nature, multiple sclerosis may be accompanied by disruption of the hearing centers;
• pathologies of the temporomandibular joint , which connects the lower jaw to the skull, can also cause noise because the joint is very close to the ear;
• vascular disorders – hypertension or, conversely, a tendency to hypotension, atherosclerosis, impaired straightness of the course of blood vessels – all these conditions disrupt the blood supply to the inner ear, which leads to the appearance of pathological impulses from the auditory nerve;
• certain chronic diseases diabetes, thyroid disorders, migraine, anemia, rheumatoid arthritis or lupus;
• taking certain medications – non-steroidal anti-inflammatory drugs, antibiotics, chemotherapy, decongestants and antidepressants. As a rule, the noise disappears after the drug is discontinued.

Head trauma can lead to damage to the auditory nerve

Noise or ringing in the head does not always indicate systemic disorders in the body. Under certain circumstances, a local functional impairment occurs on the part of the hearing organ, or a person can more clearly hear blood flow, muscle contractions or joint movements.

Complications. What does constant tinnitus lead to

Depending on the form, tinnitus can occur episodically without causing discomfort, or it can greatly affect the quality of life, causing irritability, cognitive decline, insomnia and other undesirable consequences.

Complications that tinnitus can cause:

• fatigue,
• irritability,
• insomnia,
• inability to concentrate on tasks,
• memory impairment,
• depressive states,
• anxiety,
• headache.

Diagnosis of pathologies accompanied by tinnitus

Tinnitus is not always dangerous: it can talk about anatomical features or accompany natural physiological processes in the body, such as aging. But in some cases, hum, ringing, whistling, squeaking or rustling in the ears indicates serious pathologies – degenerative, inflammatory processes in the hearing organs, tumor neoplasms, vascular and heart disorders, or neurological diseases. In this case, timely diagnosis will help to start treatment sooner, prevent dangerous malfunctions of systems and organs, or even save a life.

Since tinnitus can be a symptom of a variety of pathologies, finding its cause can be difficult. Diagnostics includes work with one or more specialists, laboratory and instrumental methods of examination.

Which doctors to contact

In most cases, the symptom is associated with ear pathology, so it is recommended to start the examination with an otolaryngologist (ENT doctor) – this is especially true if tinnitus is accompanied by hearing loss. If tinnitus is combined with dizziness, it is better to contact an otoneurologist – a specialist working at the junction of two specialties (ENT and neurology).

The doctor will perform a physical examination and a series of tests to look for or rule out damage to the outer, middle, and inner ear, as well as to the auditory nerve and the area of ​​the brain responsible for hearing sound. If ear pathologies are not detected, the doctor will refer to other specialists – a neurologist, cardiologist, endocrinologist, maxillofacial surgeon.

Physical examination

The purpose of the examination is to exclude manifestations of certain pathologies. Each specialist is responsible for his area.

An ENT doctor examines the ear and surrounding areas for visible abnormalities.

A cardiologist identifies external signs of diseases of the cardiovascular system (for example, calculates body mass index and evaluates waist circumference), measures pulse and pressure.

A neurologist evaluates the functions of systems directly or indirectly related to the organ of hearing: balance, eye movements, the muscular frame and the musculoskeletal system, detects or excludes muscle spasms, curvature, checks reflexes, the work of cranial nerves.

An endocrinologist examines a patient for manifestations of endocrine pathologies – diabetes mellitus, thyroid dysfunction, and others.

Dentist or oral surgeon checks temporomandibular joint (TMJ) function.

A psychotherapist tests for anxiety, depression, and other mental disorders.

Laboratory diagnostics

To diagnose ear pathologies and disorders of the main organs and systems, general and biochemical blood tests are prescribed. They allow you to exclude the inflammatory process and evaluate the state of metabolism, the function of internal organs.

Clinical blood test with leukocyte formula and ESR (with microscopy of a blood smear when pathological changes are detected) (venous blood)

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To exclude autoimmune pathologies, an erythrocyte sedimentation rate test, a hemostasiogram, tests for antinuclear antibodies, rheumatoid factor are prescribed.

ESR according to Westergren (venous blood)

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Antinuclear antibodies, IgG (n/col.)

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Hemostasiogram (Coagulogram)

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The doctor may prescribe additional tests to exclude pathologies of the cardiovascular system, to evaluate the functioning of the thyroid gland.

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Thyroid gland

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Instrumental diagnostics

To identify ear pathologies and determine the nature of the disorders, the doctor prescribes instrumental studies: audiometry, magnetic resonance imaging (MRI), computed tomography (CT).

Audiometry is a study performed using a special device (audiometer) that allows you to assess the conduction of sound in all parts of the ear and determine the nature and degree of hearing loss in a patient. Based on the results, an audiogram is formed.

Audiometry is one of the hardware methods for diagnosing hearing loss

Magnetic resonance imaging (MRI) and computed tomography (CT) of the temporal bones allow you to assess the condition of the mastoid processes, internal auditory canals, cochlea and auditory nerve. Magnetic resonance imaging (MRI) and computed tomography (CT) of the brain, including those using special scanning modes, help to assess the safety and blood supply of the hearing centers.

In addition, the doctor may prescribe dopplerography of the vessels of the head and neck – this is necessary to exclude hearing pathologies associated with circulatory disorders.

Also instrumental methods of research (MRI, CT, ultrasound) can be used to exclude disturbances in the functioning of internal organs, the development of tumor processes.

Treatment. What to do about tinnitus

Treatment for tinnitus depends on what caused the pathology. One-time or long-term drug therapy, surgery, or even prosthetics may be required.

The most common treatment for tinnitus is symptomatic.

Conservative therapy

If ear damage is detected during diagnosis, it is important to start treatment as soon as possible: this will stop or slow down the development of destructive processes and prevent tinnitus from progressing.

Depending on the diagnosis and the affected area, the doctor may prescribe antibiotics and painkillers to relieve inflammation, corticosteroid tablets or injections to stop destructive processes, as well as drugs that help improve blood circulation and tissue nutrition. Topical application of non-hormonal and hormonal drugs in the form of drops is also possible.

If acute or chronic processes in the body are identified that could provoke tinnitus, the doctor will prescribe their treatment or correction: antidepressants in case of depression, antispasmodics for muscle spasms, drugs that reduce blood pressure, for hypertension, or hormone therapy for impaired thyroid function.

In some cases, physiotherapy is prescribed – electrophoresis (administration of drugs through the skin using direct electric current), magnetotherapy (impact on tissues using a magnetic field). Mud applications on the ear area and acupuncture are also used. These measures help to normalize the functioning of the ear and neighboring regions and reduce the severity of tinnitus.

Regardless of the origin of tinnitus, sedative drugs, anti-anxiety drugs, antidepressants are effective in reducing it. The specific drug is selected by the doctor.

Surgical treatment

Surgical treatment of tinnitus is used if the pathology is caused by benign or malignant neoplasms. In this case, the removal of an overgrown tissue area can normalize the functioning of the ear and save the patient from noise.

Cochlear Implant

If tinnitus is caused by significant hearing loss, a cochlear implant may be indicated. The therapeutic effect is achieved through direct electrical stimulation of the auditory nerve and acoustic masking.

A cochlear implant has an external (receiving) and an internal (analyzing) element: in fact, it replenishes the function of the ear

Rehabilitation and psychotherapy

Tinnitus can quite strongly affect all areas of the patient’s life – prevent them from concentrating on work tasks, make it more difficult to communicate with other people, interfere with sleep or enjoy usual activities. Therefore, if a symptom cannot be corrected, a person needs to undergo special “training” in order to adapt to new conditions.

Psychotherapy, including cognitive behavioral therapy, plays an important role in this matter. It allows you to smooth out the negative impact of tinnitus on quality of life, reduce anxiety and the risk or severity of panic attacks, and also helps you accept your new features and learn to live with them without getting angry or giving up your usual activities.

In parallel with psychotherapy, it is recommended to add background noise to everyday life: turn on soft music during the day, and fall asleep to white noise or audio recordings with the sounds of the forest, sea or rain. If music distracts from work, devices like a mini fountain or humidifier can help mask the noise. Gradually, the psyche adapts and the person stops noticing tinnitus.

Prevention. Risk factors for tinnitus

There is no specific prevention of noise or ringing in the ears: many diseases, including genetic ones, cannot be prevented. But there are a number of factors that a person can influence in order to prevent the development of pathology.

Factors that increase the likelihood of tinnitus:

• loud sound : short-term or long-term exposure of the ear to loud sounds (above 120 dB) may cause acoustic injury and provoke the development of tinnitus;
• vibration : similar to acoustic trauma, prolonged exposure to vibration can lead to the development of ear pathologies and tinnitus;
• alcohol abuse and smoking : cause spasms, vasoconstriction and greatly increase the risk of tinnitus;
• unhealthy lifestyle : if a person sleeps poorly, eats unhealthy food, sits a lot and moves little, his blood pressure rises, muscle tone is disturbed, immunity decreases – all this increases the likelihood of developing tinnitus;
• past infectious and inflammatory diseases (purulent otitis media, meningitis, influenza).

Prognosis for tinnitus

In most cases, timely and adequate treatment leads to the fact that tinnitus ceases to disturb the patient and he returns to normal life – he can again concentrate on work, communicate with friends, fall asleep normally.

As a rule, treatment and adaptation take from 3 months to 1.5 years. At the same time, the success of treatment directly depends on how soon it was started.

Even with minor tinnitus, it is important to see a doctor and start therapy to prevent deterioration.

Factors affecting treatment outcome:

• early initiation of therapy: the sooner the pathology is identified and treatment initiated, the more likely it is to be effective;
• age: the treatment of hearing pathologies in the elderly can be difficult due to age-related changes in tissues and organs;
• cause of tinnitus: some pathologies are treatable, while others can only be corrected or the patient can adapt to new conditions;
• gender: tinnitus occurs more frequently in men than in women.