Rushing noise in ear: Pulsatile Tinnitus: Symptoms, Causes, and Treatments
Pulsatile Tinnitus | Weill Cornell Brain and Spine Center
Some cases of pulsatile tinnitus are caused by a narrowing of one of the large veins in the brain (red circles). The narrowing, or stenosis, disrupts the flow of blood and can lead to the whooshing sound or other noises of pulsatile tinnitus.
Tinnitus, which is the perception of sound when no external sound is present, is a complex symptom rather than a syndrome or disease. It can present itself as many possible sounds, including whooshing, ringing, whistling, buzzing, or clicking. These abnormal noises can be perceived in one or both ears, and can occur intermittently or constantly. It is estimated that tinnitus affects about 25 percent of the general population.
Tinnitus has many variants and can be categorized by its level of audibility, rhythm, and etiology. Tinnitus that can be heard by a physician is termed objective tinnitus. Subjective tinnitus is audible only to the patient. Tinnitus can also be categorized by its rhythm, separating it into “continuous” and “pulsatile” tinnitus.
Continuous tinnitus is characterized as a constant “ringing in the ear” and is typically the result of problems with the ear or auditory pathways. Pulsatile tinnitus, on the other hand, is a condition characterized by rhythmic whooshing or thumping sounds within the ear that are in synch with a patient’s heartbeat or pulse. Pulsatile tinnitus affects only a small percentage of the population. Pulsatile tinnitus is mostly reported as an annoying rather than severe symptom; a subset of patients, however, experience it to a debilitating degree. Furthermore, pulsatile tinnitus may be the only presenting symptom of an underlying serious condition such as dural arteriovenous fistula, intracranial arteriovenous malformation, venous sinus stenosis, idiopathic intracranial hypertension (IIH, or pseudotumor cerebri), arteriosclerosis, or vascular tumor such as paragangioma. Any of these conditions may be dangerous if left undiagnosed and untreated.
Pulsatile tinnitus rarely goes away by itself, and it can be difficult to endure for some patients. The sounds can become so intense and frequent as to become incapacitating; the sound may interfere with work, cause difficulty sleeping or concentrating, increase stress, and create feelings of depression or anxiety. Fortunately, pulsatile tinnitus can often be successfully treated and cured once its underlying cause is identified.
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Reviewed by: Srikanth Boddu, MD, MSc
Last reviewed/updated: August 2020
Illustration by Thom Graves Creative, CMI
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What Are Those Sounds in My Ear?
Do you ever hear noises that appear to come from nowhere, such as crackling, buzzing or thumping? If you wear hearing aids, it can mean that they require adjustment or aren’t fitted properly. But if you don’t wear hearing aids the noises are originating from inside your ear. You don’t have to panic. Even though we usually think of our ears with respect to what we see on the outside, there’s a lot more than what you see. Here are some of the more common sounds you may hear inside your ears, and what they may mean is going on. You should talk with a hearing specialist if any of these are lowering your quality of life or are painful and persistent, though most are short-term and harmless.
Crackling or Popping
You may hear a crackling or popping if the pressure in your ear changes, perhaps from a change in altitude or from going underwater or even from yawning. These noises are caused by a small part of your ear called the eustachian tube. The crackling sound happens when these mucus-lined passageways open up, letting air and fluid to circulate and relieving the pressure in your ears. It’s an automatic process, but sometimes, like if you have inflammation from allergies, a cold, or an ear infection, your tubes can actually get gummed up. In serious cases, when antibiotics or decongestants don’t provide relief, a blockage can call for surgical intervention. You probably should see a hearing professional if you feel pressure or persistent pain.
Buzzing or Ringing is it Tinnitus?
It might not be your ears at all if you have hearing aids, as previously mentioned. If you’re not using hearing aids, earwax could be your issue. Itchiness or possibly ear infections make sense when it comes to earwax, and it’s not unexpected that it could make hearing difficult, but how could it cause these noises? The ringing or buzzing is produced when the wax is pushing against the eardrum and suppressing its movement. The good news is, it’s easily solved: You can have the extra wax removed professionally. (Don’t try to do this by yourself!) Intense, persistent buzzing or ringing is called tinnitus. There are a number of kinds of tinnitus including when it’s caused by earwax. Tinnitus isn’t itself a disorder or disease; it’s a symptom that indicates something else is going on with your health. While it could be as straightforward as the buildup of wax, tinnitus is also related to conditions such as anxiety and depression. Tinnitus can be relieved by managing the root health issue; talk to a hearing specialist to learn more.
This sound is caused by our own body and is much less commonplace. Have you ever observed how in some cases, if you have a really big yawn, you hear a low rumbling? It’s the sound of little muscles in your ears which contract in order to provide damage control on sounds you make: They turn down the volume of chewing, yawning, even your own voice! We’re not claiming you chew too loudly, it’s just that those noises are so close to your ears that without these muscles, the volume level would be damaging. (And since you can’t stop speaking or chewing, we’ll stay with the muscles, thanks!) These muscles can be controlled by certain people, although it’s very rare, they’re called tensor tympani, and they’re able to produce that rumble at will.
Thumping or Pulsing
If you sometimes feel like you’re hearing your heartbeat in your ears, you’re probably right. The ears have some of the bodies biggest veins running near them, and if you have an elevated heart rate, whether from that big job interview or a difficult workout, your ears will pick up the sound of your pulse. This is known as pulsatile tinnitus, and when you go to see a hearing professional, unlike other types of tinnitus, they will be able to hear it as well. If you’re experiencing pulsatile tinnitus but you haven’t worked out recently, you need to see a specialist because that’s not common. Like other sorts of tinnitus, pulsatile tinnitus is a symptom rather than a disease; there are most likely health problems if it persists. But if you just had a good workout, you should not hear it when your heart rate goes back to normal.
Managing Your Tinnitus (Ringing in Ears) – Symptoms & Treatment
What Is Tinnitus?
Tinnitus is a condition that affects hearing. A ringing or buzzing sound is heard in the ears. It causes people to hear noise even when everything around them is silent. The noise may be soft or loud. It could also be a rushing sound that matches the heartbeat. The sounds may be constant or on and off.
Tinnitus may develop in one or both ears. For some people, it’s a minor problem. For others, it becomes a serious handicap. Hearing may be lost in the affected ears.
What Causes Tinnitus?
The cause may be an illness or condition, for example, ear infections or very high blood pressure. An injury to the hearing system from loud noise exposure can also cause tinnitus. In most cases, the cause is unknown.
What Are the Symptoms of Tinnitus?
Symptoms include buzzing, ringing, clicking, roaring, and hissing sounds. Other symptoms may include hearing loss, dizziness, and vertigo.
How Is Tinnitus Diagnosed?
The health care provider will do an examination, take a medical history, and maybe order tests. Blood tests may be done to check for other illnesses that may cause tinnitus. Special hearing tests may also be done. The health care provider will pay extra
attention to your emotional state of mind. Many people with chronic tinnitus are depressed or very anxious and frustrated about their problem. You may be referred to an ear, nose, and throat (ENT) specialist for additional evaluation.
How Is Tinnitus Treated?
The health care provider may prescribe a treatment to reduce the annoying noise. The health care provider will also treat any illness or injury causing the tinnitus. For example, medicine may be prescribed to lower high blood pressure.
Several treatments can help reduce the annoying noise. More than one treatment may be used at the same time. Masking uses a device that makes calm, soothing background noise
(called white noise). This background noise helps cover up the more annoying noise. Sometimes, soothing background music helps mask the noise. Another treatment is called tinnitus retraining therapy. People work with hearing experts who help retrain the ear not to hear the annoying noise. Biofeedback also teaches people how to change the way their bodies respond to stress. Biofeedback has helped many people with tinnitus. Some medicines may also help. A hearing aid may be needed if hearing loss has occurred.
People with mild tinnitus may not need treatment.
DOs and DON’Ts in Managing Tinnitus:
- DO try another treatment if one treatment doesn’t help. Different people are helped by different treatments.
- DO try to listen to soothing background music or to the static between stations on a radio if you have trouble sleeping.
The static will help mask the noise.
- DO keep your ears clear of wax.
- DO limit your use of caffeine, tobacco, and alcohol.
- DO call your health care provider if you feel anxious or
- DON’T listen to loud noises. Wear earplugs whenever
- DON’T take medicines that can harm your ears. These
medicines include a certain type of antibiotics called aminoglycoside antibiotics and medicines containing salicylates, such as high-dose aspirin.
FOR MORE INFORMATION
Contact the following source:
- American Tinnitus Association
Tel: (800) 634-8978
Tinnitus – symptoms, treatments and causes
On this page
If you are experiencing ringing or other strange noises in your ears, you might have tinnitus. It’s a relatively common condition, and it’s often temporary. But sometimes it’s a constant problem that can interfere with hearing and concentration.
What is tinnitus?
People with tinnitus experience sounds that aren’t actually being made around them.
Tinnitus is sometimes known as ‘ringing in the ears’, but if you have the condition you might hear humming sounds, or hissing, whistling, clicking, roaring, whooshing or buzzing.
The noise can be faint or loud, and it can occur in one or both ears. Sometimes the noise may feel like a sensation inside the head.
Tinnitus can come and go, or you might experience it all the time. Some people find their tinnitus is an irritation they can learn to live with. For others, it can be very distressing.
There are 2 main types of tinnitus:
- subjective tinnitus, which only you can hear – this is the most common type
- objective tinnitus, which a doctor can hear when they examine the ears – this can be caused by a problem with the blood vessels, or with the bones or muscles in the ear
In rare cases, people hear noises that seem to come and go at the same time as their heartbeat. This is known as pulsatile tinnitus.
About 2 in 3 people in Australia suffer from tinnitus at some point in their life. About 1 in 10 to 1 in 5 have tinnitus that severely affects their quality of life.
What causes tinnitus?
Tinnitus may occur when there is a problem with the auditory (or hearing) system, which is made up of the ears and parts of the brain.
It is more common in people who have some hearing loss or other ear problem, but it can also occur in people who have normal hearing.
Both adults and children can experience tinnitus. Older adults are more likely to experience tinnitus because of age-related hearing loss.
Some of the more common causes of tinnitus include:
Sometimes, however, it’s not clear why people develop tinnitus.
When should I see my doctor?
Talk to your doctor if you suspect you might have tinnitus, especially if the sound is getting worse, affecting your sleep or concentration, or you think it might be pulsatile tinnitus. Make sure you tell them about any medications you are taking.
The doctor may check your ears and look for an underlying, treatable cause of what you are hearing. They might also refer you to an audiologist or ear nose and throat (ENT) specialist.
How is tinnitus treated?
There is no cure for tinnitus, but the underlying cause may be treatable. There are some things you can do to manage tinnitus:
- Work out what makes the tinnitus worse and avoid any triggers.
- Avoid silence — create background noise with the TV or radio.
- Relax and avoid stress, as this will make tinnitus worse.
- Talk to your doctor about medications that may be making the tinnitus worse, such as antibiotics, arthritis medications or antidepressants.
- Limit caffeine in coffee, tea or cola.
To avoid the tinnitus getting worse, wear ear plugs or headphones if you are using noise-generating equipment (such as a lawn mower) or in a loud environment, such as a rock concert.
Good-quality, properly fitted hearing aids reduce and can even eliminate most tinnitus associated with hearing loss. Hearing aids reduce the strain of listening and distract you from the tinnitus by bringing you more sound from the environment around you.
Many people get used to the sounds — they are said to ‘habituate’ so their brain doesn’t notice the tinnitus any more.
Some audiologists run specialist tinnitus clinics to help patients manage their tinnitus and they fit hearing aids and/or therapeutic noise generators if needed.
Help and support
- For more information on some of the services available to support people with tinnitus, visit the Tinnitus Australia
- Contact Beyond Blue on 1300 22 4636 for support and advice about depression.
- Check your symptoms with healthdirect’s online Symptom Checker.
Why Does the Ringing in My Ears Seem Worse at Night?
If you are one of the 25 million people in the U.S. with a medical condition called tinnitus, usually ringing in the ears, then you probably know that it tends to get worse when you are trying to fall asleep, but why? The ringing in one or both ears is not a real noise but a complication of a medical issue like hearing loss, either permanent or temporary. Of course, knowing what it is will not explain why you have this ringing, buzzing or swishing noise more often at night.
The truth is more common sense than you might think. To know why your tinnitus increases as you try to sleep, you need to understand the hows and whys of this very common medical problem.
What is Tinnitus?
To say tinnitus is not a real sound just adds to the confusion, but, for most people, that is true. It’s a noise no one else can hear and does not happen of a real sound close to your ear. The individual lying next to you in bed can’t hear it even if it sounds like a tornado to you.
Tinnitus alone is not a disease or condition, but a sign that something else is wrong. It is typically associated with significant hearing loss. For many, tinnitus is the first sign they get that their hearing is at risk. Hearing loss tends to be gradual, so they do not notice it until that ringing or buzzing starts. This phantom noise works like a flag to warn you of a change in how you hear.
What Causes Tinnitus?
Tinnitus is one of medical sciences biggest mysteries. There are no clear mechanisms that cause it. Instead, it is a symptom of a number of medical problems including inner ear damage. Inside the inner ear is a series of tiny hair cells that move in response to sound waves. Damage to those hair cells means the ear has no way to send electrical messages that allow the brain to translate sound into something you can clearly comprehend like the tea kettle whistling.
The current hypothesis regarding tinnitus has to do with the absence of sound. The brain remains on the alert to get these messages, so when they don’t come, it fills that space with the phantom noise of tinnitus. It gets confused by the lack of feedback from the ear and tries to compensate for it.
That would explain a few things when it comes to tinnitus. For one, why it is a symptom of so many different illnesses that affect the ear from mild infection to age-related hearing loss. It also tells you something about why the ringing gets worse at night for some people.
Why Does Tinnitus Get Worse at Night?
Unless you are profoundly deaf, your ear picks up some sounds during the day whether you realize it or not. It hears very faintly the music or the TV playing in the room. At the very least, you hear your own voice, but that all stops at night when you try to go to sleep.
Suddenly, all the sound disappears and the level of confusion in the brain rises in response. It only knows one thing to do when faced with total silence – create noise even if it’s not real.
In other words, tinnitus gets worse at night because it’s too quiet. Creating sound is the solution for those who can’t sleep because their ears are ringing.
How to Create Noise at Night
If you accept that tinnitus increases at night because there is no distracting noise to keep the brain busy, the answer is clear – create some. For some people suffering from tinnitus, all they need is a fan running in the background. Just the noise of the motor is enough to quiet the ringing.
There is also a device made to help those with tinnitus get to sleep. White noise machines simulate environmental sounds like rain or ocean waves. The soft noise soothes the tinnitus but isn’t distracting enough to keep you awake like leaving the TV on might do.
Can Anything Else Increase Tinnitus?
It’s important to keep in mind that the lack of sound is only one thing that can cause an upsurge in your tinnitus. It tends to get worse when you are under stress and certain medical problems can lead to a flare-up, too, like high blood pressure. If introducing sound into your nighttime routine doesn’t help or you feel dizzy when the ringing is active, it’s time to see the doctor.
Whooshing sound in ear when bending over | Sandia Hearing Aid Center
Whooshing sound in ear when bending over is the type of ear noise that is perceived as a pulse rhythmic pulsation that is always in time. Whooshing sound in the ear typically originates within the blood vessels inside the area of the head or neck when blood flow is interrupted. It is either from decreased blood pressure or a narrowing of the blood vessel diameter, both of which contribute to turbulent blood flow that can be felt through the ears. The sound ranges in volume from a ring to a roar.
While distracting, whooshing sound in ear when bending is not typically a symptom of something serious. Though it may get worse with age, whooshing sound may improve with treatment for many people. Often, it helps to treat a known underlying cause. Many therapies minimize or block the noise, resulting in less apparent whooshing sound. What causes whooshing sound in ear when bending over in Colorado Springs? Let’s take a look.
Loud noise Exposure
Loud noises, especially those originating from chain saws, heavy vehicles, and weapons, are major sources of hearing loss due to noise. Portable musical devices like iPods or MP3 players can also cause hearing problem if they are played excessively for long periods of time. Whooshing sound through the ear caused by short-term exposure, such as the presence of a noisy concert, generally goes away; both short and long-term exposure to loud sound can cause permanent harm.
Ear bone changes
Bone tightening in the middle ear can affect your hearing and cause whooshing. The disease is caused by irregular growth of the bone and appears to occur in families.
Earwax trap dirt and slowing bacterial growth helping in protecting your ear canal. If too much earwax accumulates, it is too difficult to wash away naturally, causing the eardrum to lose hearing or become irritated, which may lead to whooshing sound.
Some health complications, like head injuries or neck injuries, are likely to cause whooshing sound. Blood vessel disorders such as blood pressure and neck or head tumor can also cause a whooshing noise.
A variety of medicines can cause tinnitus, or exacerbate it. Generally speaking, the higher the dosage of these drugs becomes, the greater the whooshing sound. The unwelcome noise always disappears when you stop using such medications. Such medications include; antibiotics, cancer medications, some antidepressants, and aspirin, among others.
In Colorado Springs, everyone can experience whooshing sound when bending over, but here are some people who are at a higher risk of experiencing whooshing sound.
Those exposed to loud noise
Prolonged loud noise Exposure will harm the tiny cells of sensory hair in your ear that transmit sound to your brain. Particularly at risk are those who work in noisy conditions such as factory and construction workers, musicians, and soldiers.
As one age, the number of nerve fibres functioning in one’s ears decreases, which causes hearing to lose. Due to loss of hearing ability, one is likely to experience whooshing sound.
Men are at a high risk of experiencing whooshing sound than women because they are more exposed to loud noise that women. However, there is no scientific evidence to support this claim, but it is better to be safe than sorry.
Cardiovascular problems patients
Whooshing sound in ear is mostly caused by unbalanced blood flow, which means conditions that have an impact on blood flow exposes one to the risk of experiencing whooshing sound. Such conditions include blood pressure and narrowed arteries.
Those with head or neck injuries
The head and neck are connected to the ear, and any damages can result in hearing problems that are associated with a whooshing sound.
Tackling whooshing sound is based on the underlying cause of the problem. This is caused, in most cases, by harm to the hearing organ. There is usually no need for any other care in such cases than reassurance that some treatable disease does not trigger the sounds. So what are the possible solutions? Let’s take a look.
Accumulated earwax makes one experience whooshing sounds, and they should be removed more often. It is essential to observe ear hygiene to make sure ears are in good and healthy condition.
Treating health conditions associated with a whooshing sound in ear when bending over
The best way to solve whooshing sound in ear when bending is to identify the cause. If health conditions like blood vessel disorders cause it, one should focus on treating these conditions to alleviate the symptoms of whooshing sound.
If the problem is caused by the type of drugs you are using, let your doctor know of the problem and help you change the medicine regime to one that will not cause whooshing sound.
This can be done using masking devices or hearing aid devices.
These devices, worn in the ear and similar to hearing aids, emit a constant, low-level white noise that suppresses symptoms of whooshing sound.
Hearing aid devices and Whooshing sound in ear when bending over
These are small electronic devices that help with a different type of hearing loss. Some people experience whooshing sound when it is quiet others when it is noisy. Hearing aid devices helps pick up sounds around one and makes them clear and louder for one to ear. Hearing aid devices are useful to those who experience whooshing sound that is associated with hearing loss.
Whooshing sound may not be a severe medical issue, but it is disturbing to those who experience it, especially to those the symptoms are long-term. Hearing loss is the major cause of whooshing sound, and such cases should be reported to a doctor for a further medical check-up. Ear hygiene is an essential factor that should be considered to ensure ears are in good condition. Everyone has a chance of experiencing whooshing sound in ear when bending, and everyone is advised to be keen on any symptoms, and if they persist, it’s vital to seek medical advice.
Is Pulsatile Tinnitus Common in Pregnancy?
Are you hearing a whooshing or pulsing noise in your ear during pregnancy? Pregnancy hormones can cause or make tinnitus worse. Here are some ways to help deal with the ringing in your ears when you’re pregnant.
Your lunch out with friends today became a battle to hear and understand over the persistent ringing in your ears. Your evening snuggled up on the couch with a good book was interrupted by that agonizing tone. You’re not even looking forward to going to bed tonight because you know that even getting a good night’s sleep has become dependent on whether you can get the white noise maker loud enough to drown it out.
Is the Ringing in the Ears Related to My Pregnancy?
Studies show that as many as 33% of pregnant women suffer from pulsatile tinnitus, which is the sound of a rhythmic noise like a whooshing sound, compared to only 10% of non-pregnant women. The onset is sudden for some people and then it goes away as soon as the pregnancy is over. For others, the symptoms persist long after. For those who already suffered from tinnitus before getting pregnant, two-thirds of them state that the tinnitus became so much worse. (Here are a few other things that can make tinnitus worse.)
Let’s explore why so many women get tinnitus during pregnancy and what you can do to find relief.
What Is Pulsatile Tinnitus?
Pulsatile tinnitus is a symptom caused by an underlying condition. Those with tinnitus will experience distracting internal sounds superimposed over the everyday sounds of their environment. The symptoms can be very distracting and are often constant. They make conversation, working, relaxing, and sleeping difficult.
Pulsatile tinnitus can increase anxiety levels and even contribute to depression, which pregnant women are already more susceptible to due to the changes in the body’s chemistry.
Pregnant women with tinnitus may hear:
- Ringing (common during pregnancy)
- Thumping (very common during pregnancy)
- Or other sounds
You may be wondering how someone could hear these things if they’re not “really there,” however, tinnitus is believed to be a function of the brain that may be generating the strange and persistent sounds, in addition to any health or hearing problems you may have that could also cause tinnitus, such as clogged ears or high blood pressure.
Most cases of tinnitus cannot be seen or heard by any professionals or their medical equipment. But it’s very real to those experiencing it, as you already know.
Pregnancy and Pulsatile Tinnitus
Pulsatile tinnitus is a very common form of tinnitus during pregnancy. This is when your ears become acutely aware of the blood moving through the vessels around your ears. You can hear it with each beat of your heart in a thumping sound.
This can also be a sign of elevated blood pressure and possibly preeclampsia, which can be very serious. For this reason, you should always share with your doctor that you’re hearing ringing in your ears while pregnant and describe in detail what it sounds like so any pre-existing problems can be addressed before they turn into something more serious.
Why Might Pulsatile Tinnitus Be Triggered During Pregnancy?
There are so many changes happening in the body during pregnancy that it becomes a perfect storm of factors that can lead to tinnitus:
Congestion Interfering with Hearing
Congestion is a common side effect during pregnancy. It can make your ears feel stuffy and full. That’s your Eustachian tubes filling up with fluid. This excess phlegm and fluid can impact how sound moves through the ear canal, which leads to tinnitus sounds in your ears. Before you take any congestion medicine, you should check with your doctor to find out what medications are safe during pregnancy.
Does Preeclampsia and Ringing in Your Ears?
Preeclampsia is a condition during pregnancy when your blood pressure is elevated to dangerous levels. It usually occurs after week 20 of your pregnancy and is detected by protein in urine and high blood pressure, the latter of which is a cause of pulsatile tinnitus. This condition often goes hand in hand with gestational hypertension, also known as pregnancy-induced hypertension, and affects 5-8% of all pregnancies. Your doctor will check for signs of preeclampsia during your routine visits, and if detected, will suggest changes to your diet and extra rest to treat the issue.
Can Pregnancy Hormones Cause Changes in Your Hearing?
Hormones are primarily regulated in the hypothalamus, a smaller part of your brain. During pregnancy, the hypothalamus works overtime. It communicates with your body regarding how much hormone to produce and when to stop production.
Hormone changes can lead to intense emotion, anxiety, fatigue, and even depression. These are well-known influencers of the severity of ringing in ears while pregnant.
In addition to pregnancy, UK studies have shown that women are more likely to develop tinnitus during menopause. They might also have it while receiving hormone replacement therapy (HTR) or as a symptom of PMS.
Each of these situations demonstrates a hormonal link, and all of them can have a severe impact on your hearing.
Can Pregnancy Cause Hearing Loss?
In some cases, pregnancy can also cause hearing loss. The most common cause of hearing loss during pregnancy is a condition known as otosclerosis. Otosclerosis describes a condition where there is abnormal bone growth in the small bones in the middle ear. For some women, pregnancy seems to escalate the process leading to hearing loss and women who have otosclerosis in both ears are 33 percent more likely to experience increased hearing loss after pregnancy. Hearing loss can lead to other health issues, so it’s important to get treated right away if you experience hearing loss. The most common treatment is a hearing aid, which poses no risk to pregnant women or to their fetuses.
In addition, there are rare cases of sudden sensorineural hearing loss in women. If you suddenly lose your hearing in one ear, see your physician immediately.
Can Pregnancy Cause Changes in Blood Pressure?
Problems with your blood pressure is one of the main causes of pulsatile tinnitus. Your elevated blood pressure can cause temporary ringing in ears while pregnant, which can become permanent even after pregnancy if left untreated. When the blood isn’t flowing freely through the vessels around your ear, it causes the ringing and whooshing sounds described earlier. You may also have an underlying problem with your blood vessels, such as atherosclerosis or malformation of your capillaries, which is exacerbated by your pregnancy.
Pregnancy Increases Your Environmental Awareness
This survival mechanism may go back to the days of the prehistoric humans or before. When you’re pregnant, your senses are often hyper-sensitive. Touch and hearing are often more pronounced. If you start hearing a ringing in your ears, it is possible that you may have always had tinnitus and only became aware of it because the sound got louder. If this is the case, then there is an underlying issue unrelated to pregnancy which is causing your hearing problems, so you may want to speak with a hearing specialist either during or after your pregnancy.
Can Antidepressants and Other Medication During Pregnancy or After Pregnancy Cause Tinnitus?
If pre- or post-partum depression is severe, your doctor may prescribe antidepressants. Tinnitus is a known side effect of some of these drugs. In addition, if you become sick or have an infection during pregnancy, your doctor may prescribe antibiotics – be aware that some of these medications can also lead to tinnitus.
If you experience tinnitus problems while taking antidepressants, you may want to see a therapist who is experienced in cognitive behavioral therapy (CBT), as this type of therapy has been shown to effectively treat tinnitus in many patients.
General Stress During Pregnancy
Tinnitus most often first appears in people who are under significant stress, which impacts functions like your blood pressure. Pregnancy can be a very stressful time, both emotionally and physically. The body is changing. It’s producing excess hormones as it tries to keep up. Stress has been shown to make tinnitus worse. If this is happening to you, consider meditation to help lower your blood pressure and stress hormones. You can look into mindfulness training, or as mentioned above, visit a CBT therapist to learn effective coping skills to deal with stress and your tinnitus.
The Effects of Pregnancy on Your Senses
It’s no surprise that pregnancy would have an effect on your ears. Pregnancy affects all your senses, often making you become hyper-alert. Here are just a few ways your senses may change or become more acute during pregnancy:
- Taste – Women often experience a “bad” taste in the mouth during the first trimester. Eating foods with vinegar or citrus can help.
- Smell – Strong scents you normally find pleasant like a specific shampoo may make you queasy. Some foods like garlic and onions may do the same. Avoid scents that make you feel sick and get some aromatherapy scents that you enjoy.
- Sight – Many women become slightly nearsighted during pregnancy. Hormone changes and fluid-retention may be the cause. If you have diabetes or have been diagnosed with gestational diabetes, speak with your doctor about this symptom.
- Touch – Your skin may become very sensitive, and parts of your body might swell or become extremely sore.
While these changes are all normal during pregnancy, you probably noticed that most of these changes typically go away after pregnancy – and you’re wondering how to stop or treat your pregnancy-related tinnitus.
Does the Ringing Stop After Pregnancy?
Many women say the tinnitus subsides after pregnancy as their hormone levels and other factors return to normal. However, it may persist in cases of postpartum depression or a very stressful parenting situation, either because of medication you’re taking, or high-blood pressure brought on by stress.
Others find that once they become aware of tinnitus, it never entirely goes away. If this happens, be sure to speak with a hearing specialist. There are ways to treat tinnitus, even when you are pregnant.
How to Get Tinnitus Relief and Reduce Pregnancy-Related Tinnitus
There is no cure for tinnitus. But some methods reduce tinnitus symptoms and their impact on your life. You should make sure to discuss any treatments with your doctor before attempting to address your tinnitus, and consult with your primary care physician, OB/GYN, and hearing specialist before trying any treatments.
Talk to Your OB/GYN
Your OB/GYN likely has a number of suggestions for treating or making your tinnitus more bearable. They’re here to help you with any symptoms you’re experiencing.
Ask your doctor to check your iron levels, especially if lightheadedness accompanies the ringing. You might have anemia (iron deficiency), which you can treat with changes to your diet. Your doctor may also help you better manage your blood pressure.
See a Hearing Specialist
If your OB/GYN’s suggestions aren’t helping, consider seeing a hearing expert. You may need a referral for insurance to cover it. Hearing specialists can help you find tinnitus relief during pregnancy that won’t affect the baby. They may be able to develop more custom solutions for your specific condition.
Relaxing, Meditating and Clearing Your Mind Helps Relieve Tinnitus
This heading may have you screaming at the top of your lungs, “How can I relax with this ringing in my ears?” We get it, it’s not easy. But remember, stress makes tinnitus louder. Even a small reduction in stressful feelings can help.
Relax any way you can safely do so while pregnant. Try exercise, meditation, reading, yoga, or doing things you enjoy, which studies show can help. Always talk to your doctor regarding exercise routines and supplements during pregnancy.
Focus on the positive and try to redirect your thoughts if they become negative to reduce stress spirals.
Try a Sound Machine
How about the sound of a peaceful creek running over a bed of rocks? Doesn’t that sound nice? Or you might like the constant chug-a-chug-a-chug of a train moving down the tracks. Sound machines typically produce 10 or more ambient sounds, so it’s easy to find one that helps drown out the noise so you can sleep or relax.
Sound machines can help distract the brain so that you are no longer aware of your tinnitus, which usually becomes worse at night since there aren’t any other sounds competing for your attention.
Speak with a Therapist
This is not to suggest that tinnitus is a mental illness. It’s much more complex than that. But stress, anxiety, and depression can make tinnitus worse. Speaking with someone helps you get tinnitus relief during pregnancy.
Get Sound Therapy
Sound therapy is a method where you train the brain not to hear the tinnitus. This kind of cognitive therapy has been shown to help tinnitus and has no adverse effects when you are pregnant.
Consider a Hearing Aid to Help with Tinnitus
In extreme cases, especially if the tinnitus persists after you have the baby, you can wear an ear device or a hearing aid, which cancels out the sound in the affected ear.
You don’t have to suffer from this condition. Talk to a hearing specialist about other treatment options.
90,000 Ringing or tinnitus, tinnitus – causes, examination and treatment | Symptoms
Acoustic trauma (noise-induced hearing impairment)
Exposure to noise is related to professional activities or hobbies. Loss of hearing.
Age-related changes (presbycusis)
Progressive hearing loss, often seen in other family members
Barotrauma (damage to the ear due to sudden changes in pressure)
Previous obvious ear injuries
Brain tumors (eg, auditory neuroma or meningioma) or diseases such as multiple sclerosis or stroke
Tinnitus, often hearing loss in only one ear.Sometimes other neurological disorders.
Medicines (especially aspirin, antibiotics-aminoglycosides, some diuretics)
Tinnitus occurs in both ears immediately after starting the drug.
Hearing loss is also possible (with the exception of aspirin). Dizziness and loss of balance may occur with aminoglycosides.
Eustachian tube dysfunction
Often, a gradual loss of hearing over a long time, as well as frequent colds.With a sharp change in pressure during an air flight or other activities, the feeling of congestion does not disappear. May be in one or both ears (often stronger in one ear than the other).
Infections (eg, otitis media, labyrinthitis, meningitis)
Previous cases of this infection
Recurrent attacks of hearing loss, tinnitus and / or a feeling of stuffiness in one ear, severe systemic dizziness.
Blockage of the ear canal (sulfur plug, foreign body or as a result of otitis externa)
Only one ear is affected.Visible pathologies during examination, including discharge with otitis externa.
Malformations of arteries and veins (arteriovenous) of the dura mater
Constant pulsating tinnitus in only one ear. Other symptoms are usually absent.
Spasm of the palate or middle ear muscles
Irregular clicks or mechanical noises. Other neurological symptoms are possible (when the spasm is caused by a neurological disorder, such as multiple sclerosis).When symptoms occur, palate and / or eardrum movement may be observed.
Turbulent blood flow in the carotid artery or jugular vein
During the examination, there may be a humming or pulsating noise around the neck.
The murmur may stop when the doctor presses on the jugular vein and / or when the head is turned to the side.
Vascular tumors of the middle ear (eg, glomus tumors)
Constant pulsating tinnitus in only one ear.During the exam, there may be a humming or pulsating noise around the affected ear.
90,000 causes and treatment – clinic in Moscow
Tinnitus is currently used to describe subjective tinnitus. Tinnitus includes not just noise or ringing in the ears or head, but a whole range of related problems – emotional, mental, social. Chronic tinnitus affects about 30% of the world’s population. Nervous strain caused by constant noise and inability to enjoy silence leads to insomnia, depression, irritability, impaired concentration and unexplained fears.
However, it should be noted that tinnitus itself is not an independent disease, but only a symptom. Tinnitus can be caused by various diseases (senile changes in the hearing aid, ear injuries, or pathology of the cardiovascular system). Most people with tinnitus find that when the underlying cause of tinnitus is treated, symptoms will diminish over time.
MANIFESTATION OF TINNITUS
Tinnitus is manifested by a sensation of persistent tinnitus.This noise may be characterized by patients as hum, hiss, hiss or ringing. In addition, hearing loss is noted. The characteristic of noise can range from a soft ringing to a loud whistle in one ear or in both. Sometimes the noise can be felt so loud that the patient cannot concentrate on his work and daily activities. Earwax build-up can worsen the appearance of tinnitus, as it can cause hearing loss. The patient does not hear external sounds, as a result of which the internal tinnitus is felt louder.Over time, tinnitus is less perceived and less likely to cause stress. The manifestations of depression are smoothed, sleep and general well-being improves.
CAUSES OF TINNITUS
Thousands of auditory cells in the inner ear use hairs to convert sound vibrations into electrical signals, which are then sent to the brain. Normally, the hairs of these cells move in accordance with sound vibrations. However, if these hairs are damaged or irritated, they begin to move chaotically.The result is a mixture of electrical signals, which the brain interprets as constant noise. The most common causes of this change in inner ear cells are:
- Age-related changes in the cells of the hearing aid (presbyacusion). This process starts from about 60 years old.
- Noise damage to the inner ear. Excessive exposure to noise for a long time can lead to hearing loss.
Tinnitus also occurs in metabolic diseases such as diabetes mellitus, kidney disease, diseases of the cervical spine, and pathology of the temporomandibular joint.
Other causes of tinnitus include:
- Long-term use of certain medications. Certain types of antibiotics (such as gentamicin) and high doses of aspirin can damage the cells of the inner ear.
- Changes in the structure of the auditory ossicles of the middle ear. A decrease in the mobility of the ossicles, for example, with otosclerosis, can also lead to hearing impairment.
- Injury. Injury to the head or ear can be accompanied by damage to the inner ear.
Hearing impairment can also be caused by some diseases of the cardiovascular system. In this case, a condition such as pulsating tinnitus occurs.
- Atherosclerosis. Atherosclerosis is manifested by the formation of cholesterol plaques on the walls of the arteries. As a result, the vessels lose their elasticity and cannot pulsate in time with the movement of blood. This leads to the fact that the blood flow in the vessels becomes turbulent (that is, with vortex) and a noise sensation with each pulsation of the vessels.
- High blood pressure. Hypertension and factors that increase blood pressure such as stress, caffeine and alcohol can increase the feeling of noise.
- Turbulent blood flow in the vessels. Narrowing of the carotid arteries or jugular veins leads to turbulent blood flow in them, which is manifested by a noise in the head.
- Capillary pathology. A pathology such as arterio-venous shunts (connections between arteries and veins) can be accompanied by a sensation of noise in the head.
- Tumors of the head and neck. Tinnitus is often a sign of head and neck tumors (eg, acoustic neuromas).
The search for the causes of the noise in the ear should be started as early as possible. Moreover, it should be conducted not only by an ENT doctor, but also by doctors of other specialties. In order to clarify the causes of the noise, the doctor asks the patient about the nature of the symptoms: when they first appeared, their severity and in which case they worsen.In addition, since tinnitus can be caused by various other diseases not directly related to hearing, the doctor examines the general condition of the patient. It is imperative to find out if the patient is taking any medications. Next, the doctor examines the ear and its lumen to identify the presence of sulfur plugs, which themselves can cause tinnitus. To identify vascular pathology, the doctor listens to them with a phonendoscope. If the cause of tinnitus is damage to the inner ear, then this condition is called subjective tinnitus, since the noise is felt only by the patient.If the doctor also detects the noise when examining the patient’s vessels, then this is pulsating tinnitus.
Treatment for tinnitus depends on the cause. If the cause of tinnitus is age-related changes in the inner ear or its damage due to noise trauma, then there is currently no treatment. For the most part, the patient can only adjust to the existing problem. A specialist from our Center will discuss with you tips for reducing the severity of the manifestation of tinnitus.In case of other causes of tinnitus, the specialists of the ENT Center will treat this or that disease, the symptom of which is tinnitus. If earwax has accumulated, your ear canal will be flushed. If the cause of tinnitus is head vascular disease, then the neurologist will prescribe the necessary therapy. If tinnitus is a manifestation of taking certain medications, you must stop taking them or replace them with other drugs that do not induce tinnitus.
symptoms, causes and what threatens
Noise or ringing in the ears is a common condition affecting about one in five adults and may be a manifestation of the condition.
This condition often accompanies hearing loss, although it does not in itself cause deafness. As a result, the patient experiences constant stress.
Tinnitus may indicate the presence of serious diseases such as heart disease, diabetes mellitus and others, neurologist Alexander Evdokimov told about this.
Tinnitus is ringing or tinnitus without external acoustic stimulus. This sensation can be characterized by patients as hum, hiss, whistle, ringing, noise of falling water, chirping of grasshoppers.
What can cause tinnitus?
Cardiovascular diseases, as well as inflammation or dysfunction of the temporomandibular joint, can provoke tinnitus.
Diabetes mellitus also contributes to the development of tinnitus. The fact is that this disease affects the auditory cells and hairs that form the nerve impulse.
The problem may be related to the cervical spine.Due to osteochondrosis, angiospasm or vascular tortuosity can also occur, which leads to an increase in blood turbulence.
A common cause of tinnitus is ENT pathology. Inflammatory diseases or damage to the auditory nerve, or damage to the centers of hearing in the cerebral cortex by various neoplasms lead to the development of tinnitus.
Blood pressure problems can also cause tinnitus.This symptom may be accompanied by an increase or decrease in pressure, and it can also be caused by taking medications.
Symptoms, Causes and Threats
Ear noise includes a variety of sounds heard by the patient. It can be ringing, buzzing, the sound of a roaring aircraft engine, hiss, whistles, clicks. It can be permanent or only appear occasionally.
If you experience noise in your ear, you should consult a doctor.This may be associated not only with the pathology of the hearing system, but also be a manifestation of various serious diseases.
With ear infections, noise can be accompanied by pain and discharge from the ear canal.
If noise is combined with dizziness, urgent medical attention is required, as this may be a manifestation of Meniere’s disease or cerebrovascular accident.
Early treatment is more effective.
Tinnitus – causes and what to do?
Often, patients observe such an unpleasant condition as tinnitus, which is not a physiological norm in some situations. Tinnitus or noise is a disturbance in the amplitude of vibrations of the hairs that are located in a person’s inner ear. These hairs are needed to transform sound vibrations into impulses that enter the cerebral cortex.
Tinnitus can be felt in patients in completely different ways.Someone hears it in the form of the sea surf, while others note noise phenomena similar to the intense squeak of a mosquito. In clinical otolarynology, tinnitus is abbreviated as tinnitus.
Why does tinnitus appear?
The perception of noise in each person has a purely individual character. There is an imaginary and true perception of noise. For example, imaginary perception is when only a person hears noises. And objective perception differs in that such noises can be heard by a stranger.
By the way sound vibrations appear and form, there are vibrational (sound sources emitted by the inner ear) and non-vibrational sources. There can be a great many reasons for the appearance of tinnitus, ranging from banal sulfur plugs to serious violations and malfunctions of the hearing aid.
What does noise look like in different pathological processes? With a sulfuric plug in the ear, the noise is usually mild and monotonous. It may resemble the sound of the surf. With a tumor neoplasm, the noise seems to flow around in several ranges.With such a disease as exudative otitis media, the noise can be distorted, diverse. Also, patients may experience periodic clicks in the ears when turning the head.
In otosclerosis, low-frequency monotonous noises are felt, and acoustic trauma is characterized by the presence of constant unpleasant low-frequency noise in the ears.
How to get rid of tinnitus?
It is almost impossible to eliminate ringing and tinnitus on your own. Moreover, improper treatment can significantly aggravate the course of the underlying problem.Therefore, for examination and instrumental examination, it is imperative to consult an otolaryngologist.
Treatment is prescribed to the patient after a thorough examination and collection of a complete history of the patient’s physiological state, during which not only the patient’s complaints, but also other possible manifestations of the disease are taken into account. The treatment regimen is selected strictly individually based on the analysis received. For example, if the presence of a sulfur plug is diagnosed, then the otolaryngologist should remove it as carefully and carefully as possible.After that, the noise usually disappears completely.
90,000 Tinnitus (tinnutus), symptoms, diagnosis, treatment
Tinnitus or subjective ear noise (tinnitus, ringing in the ears) is one of the most difficult to solve problems faced by otorhinolaryngologists, audiologists, otorhinolaryngologists, and neurologists. This is not an independent disease, but only a symptom. Tinnitus is understood as the auditory sensations that arise in a person in the absence of an external sound source.Most patients have a decrease in auditory function, but they describe their sensations differently – from a quiet whistle, ringing, noise to very loud and intrusive; melodies; buzzing, hissing, clicking, tingling. Tinnitus can be felt in one ear or both. Some patients, due to loud noise or ringing, lose concentration and are unable to perform their work duties and drive a car.
The causes of ringing in the ears or head are:
- Injury to the head or ear with damage to the inner ear.
- Structural change in the auditory ossicles of the middle ear due to a decrease in their mobility.
- Cardiovascular diseases accompanied by pulsating tinnitus.
- Atherosclerosis, in which, as a result of the formation of cholesterol plaques on the walls of the arteries, the vessels lose their elasticity, the blood movement is disturbed, it becomes turbulent, with each pulsation of the vessels, the patient feels tinnitus, his blood pressure rises, against which hypertension develops.
- Turbulent blood flow in the vessels, which appears due to the narrowing of the carotid arteries.
- Capillary pathology (connections between arteries and veins).
- Tumors of the head and neck.
- Long-term medication (some types of antibiotics, high doses of aspirin).
Tinnitus problems at the Federal State Budgetary Institution NCC otolaryngology FMBA of Russia are dealt with in the scientific and clinical department of vestibulology and otoneurology. With the help of the latest techniques, specialists successfully work in assessing subjective ear noise, using otoacoustic emission (OAE) and impedance measurements in the acoustic reflex decay mode with a deliberately low stimulus.With the help of psychoacoustic noise metering, using an audiometer, the height and “loudness” (intensity) of subjective ear noise is assessed. In addition, in our Center, it is mandatory for all patients with tinnitus to undergo a classical audiological examination: audiometry and ETF test, which allows to detect a violation of the function of the auditory / Eustachian tubes (tubular dysfunction). Various tinnitus questionnaires are used to objectively assess the severity of subjective tinnitus.
When prescribing individual drug and non-drug treatment in our Center, the timing of the onset of the disease, the causative factor, the peculiarities of the dysfunction of the inner and middle ear, the negative experience of previous treatment, as well as the data of psychological testing are taken into account – this allows you to achieve the desired positive result.
90,000 Tinnitus. When is tinnitus? How to get rid of tinnitus?
The most common complaint in temporomandibular joint dysfunction is jaw clicking, accompanying opening of the mouth, yawning, and eating. Clicks are so pronounced that others can hear them, and pain does not necessarily appear. Crunching, crackling, crepitus may also be present.
The range of sound phenomena heard by the patient is quite wide: it can be whistling, grinding, humming, ringing, chirping, squelching, clicking, and many other effects.People describe them based on their associations (for example, the sound of falling drops, the sound of the sea, the murmur of water, etc.). The noise can be felt all the time, or it can be interspersed with quiet periods. It is noteworthy that the slightest movement of the head, shoulders, tongue and even eyes can provoke sounds.
Usually, with TMJ dysfunction, there are disturbances in the work of the masticatory muscles: they are either spasmodic or are in hypertonicity. Together with changes in the pressure in the oral and ear cavities, this factor causes a narrowing or widening of the lumen of the Eustachian tubes (the canal that connects the pharynx and the middle ear).The air, passing through this constantly changing channel in size, trembles and generates sound of different frequencies and intensities. If the auditory ossicles move along with this, the sound becomes more pronounced and takes on the character of clicks, crackling and sometimes even rumbling. Particularly impressionable patients focus on sound effects and for this reason they cannot concentrate on other matters, work, irritability, fatigue appears, and sleep is disturbed.
Getting rid of tinnitus is possible only by treating the underlying problem, namely TMJ dysfunction.
- The neuromuscular approach is widely used here: electroneurostimulation is prescribed to relieve tension in various muscle groups, including the tympanic membrane tensors and muscles that lift the soft palate.
- Splinting helps to restore muscle tone and eliminate tinnitus, as the muscles relax and the pressure in the oral and ear cavities is equalized.
- An important factor is the presence of a narrowing of the upper jaw, because the muscle responsible for raising the soft palate will be tense in this case.This muscle is directly connected to the tensioner muscle of the tympanic membrane, and therefore can affect its tone as well, causing tinnitus. As a result, it may sometimes be necessary to wear orthodontic appliances to expand the upper jaw in order to normalize muscle tone and eliminate sound effects heard by the patient.
- Also, doctors recommend for the period of treatment to refrain from listening to loud music, in particular with headphones, to try to protect the hearing organs from excessive sound load, and the jaw from excessive chewing tension.
Thus, the normalization of muscle tone, occlusion and the creation of an optimal trajectory of movement of the lower jaw will restore the functions of the temporomandibular joint and get rid of unwanted sound and other effects associated with this pathology.
Therapy and hygiene
Why does tinnitus occur and how is it treated
The maestro’s hearing gradually deteriorated, and the constant tinnitus did not stop.However, at that time he began writing a new Third Symphony, which he later called the Heroic.
Until now, the disease, which also suffered from the German composer, remains partially investigated, although the disease is very common in people from 55 to 65 years old. At this age, tinnitus occurs in every fifth person.
More about tinnitus
American otolaryngologist Pavel Yastreboff, who invented the most successful method of treating tinnitus at the moment, calls the cause of tunnitus – the activity of the nervous system.
According to his definition, the disease is not mechanical in nature and is not a consequence of vibrations in the cochlea. Everything is caused by processes in the nervous system. If you have a noise in your left ear, treatment that has not yielded results on its own, this article will be useful to you.
Tinnitus can occur in the right ear, left, or both ears, synchronously and asynchronously. The disease is classified according to the duration of the course and secondary symptoms.
By the duration of the course:
- Acute – arose less than 3 months ago and does not stop
- Mild – arose from 3 to 12 months
- Chronic – arose more than 12 years ago and does not stop
Depending on Secondary symptoms are decompensated and compensated tinnitus, when noise is felt, but does not interfere with normal life, does not cause headaches and other side effects.Decompensated tinnitus is accompanied by migraines, insomnia, and significantly disrupts the usual way of life.
Sometimes pulsating tinnitus can have a different nature – for example, the most common cause is a blockage of the ear canal. This can happen when water, dust, insects, or a foreign object have entered the ear canal (as in children). Also, extraneous sounds can be felt due to diseases and injuries of the outer, middle ear, as well as diseases of the inner ear.As a rule, murmurs are just symptoms of the disease, which in most cases disappear after the disease is cured.
Tinnitus Treatment: Adaptive Therapy
Adaptive Therapy is the most effective treatment for tinnitus that exists today. The principle of adaptive therapy is based on sound therapy and one interesting phenomenon.
Its essence lies in a psychological phenomenon called residual compensation or inhibition.
A special intermittent sound of a certain volume suppresses or prevents ringing or irritation in the ears.
A similar principle of influence on the hearing system lies in the TRT module of Audifon hearing aids, which can be optionally integrated into any device of the brand. We will describe in detail how the module works and the German Audifon devices below.
Left ear noise and right ear noise eliminated with TRT module
TRT module works on the principle of adaptive therapy to help you get rid of chronic tinnitus and live a fulfilling life while enjoying all the benefits of hearing aids.
The extension generates noise on an ongoing basis and thus contributes to its translation as background noise. The noise will be compensated and over time you will not notice it. This will allow you to live fully again, not to be distracted, to be more collected and calm. It will also allow you to comfortably perceive sounds, communicate easily and enjoy peace of mind.
3 facts about the TRT module:
- It is adjusted for you in order to achieve the maximum therapy result depending on your feelings.
- It can be integrated with any Audifon hearing systems (choose the perfect model for your cost and lifestyle).
- The quality of the captured audio signals remains as high as possible, despite the presence of the module.
Want to know more about tinnitus therapy and audifon hearing aid extensions? We are waiting for you for a consultation at KIND Intersluh. We will conduct an audiometric examination, as well as tell you about the features of the hearing systems, we will select the device for you depending on your hearing impairment, and also we will carry out its adjustment and the TRT module.