Tinnitus Signs and Symptoms | UCSF Health

Signs & Symptoms
Audiology

Tinnitus is one of the most elusive conditions that health care professionals face. It is an auditory perception not directly produced externally.

It is commonly described as a hissing, roaring, ringing or whooshing sound in one or both ears, called tinnitus aurium, or in the head, called tinnitus cranii.

The sound ranges from high to low pitch and can be a single tone, multi-tonal, or noise-like, having no tonal quality. Tinnitus may be constant, pulsing or intermittent. It may begin suddenly or progress gradually.

Tinnitus can be broadly classified into two categories: objective and subjective.

Objective Tinnitus

This form is audible to an observer either with a stethoscope or simply by listening in close proximity to the ear. Objective tinnitus accounts for less than 5 percent of overall tinnitus cases and is often associated with vascular or muscular disorders. The tinnitus is frequently described as pulsatile, or synchronous with the patient’s heartbeat. In many instances, the cause of objective tinnitus can be determined and treatment, either medical or surgical, may be prescribed.

Subjective Tinnitus

This form is audible only to the patient and is much more common, accounting for 95 percent of tinnitus cases. Subjective tinnitus is a symptom that is associated with practically every known ear disorder and is reported to be present in over 80 percent of individuals with sensorineural hearing loss, which is caused by nerve and/or hair cell damage.

Because tinnitus, like pain, is subjective, two individuals may demonstrate identical tinnitus loudness and pitch matches yet be affected in significantly different ways. The severity of the tinnitus is largely a function of the individual’s reaction to the condition. That said, many tinnitus sufferers:

• Have difficulty sleeping or concentrating
• Feel depressed or anxious
• Report additional problems at work or at home that may contribute to the distress caused by tinnitus
• Describe a correlation of tinnitus perception with stress
• It is often difficult to determine whether a patient’s emotional state pre-existed, or is a result of the tinnitus.

Causes

Although the exact mechanism underlying tinnitus is unknown, it is likely that there are many related factors. Tinnitus usually, but not always, has to do with an abnormality of the hearing or neural system.

There are a number of causes linked with tinnitus including:

• Disorders in the outer ear, such as ear wax, a hair touching the eardrum, a foreign body or a perforated eardrum
• Disorders in the middle ear, such as negative pressure from eustachian tube dysfunction, fluid, infection, otosclerosis, allergies or benign tumors
• Disorders in the inner ear, such as sensorineural hearing loss due to noise exposure, aging, inner ear infection or Meniere’s disease often accompanied by hearing loss and dizziness

Tinnitus also can temporarily result from certain medications, such as:

• Anti-inflammatories such as aspirin, ibuprofen, nonsteroidal anti-inflammatories and quinine
• Sedatives
• Antidepressants
• Certain antibiotics and chemotherapeutic agents

Other causes include:

• Systemic disorders such as high or low blood pressure, anemia, diabetes, thyroid dysfunction, glucose metabolism abnormalities, vascular disorders, growth on jugular vein, acoustic tumors and head or neck aneurysms
• Non-auditory disorders such as trauma to the head or neck, temporomandibular (jaw joint) disorders and neck misalignment

Current research suggests that even though tinnitus may initially be caused by an injury to the ear, ultimately an auditory pattern is established in the brain. Therefore, many treatment approaches are directed at the brain, not the ear.

Although the majority of tinnitus sufferers also have hearing loss, the presence of tinnitus does not indicate that one is losing hearing.

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.

Pulsatile Tinnitus FAQ | Northwestern Medicine

What is tinnitus?

Tinnitus is a ringing, buzzing, hissing, whistling or clicking in one or both ears. It occurs in the absence of external sound. This sound may or may not be present at all times. When it occurs, it is steady, without changes in loudness or pitch. Tinnitus interferes with everyday life for 20 million people in the U.S. For 2 million of them, it can be debilitating. Learn more about tinnitus.

What is pulsatile tinnitus?

Pulsatile tinnitus (pulse synchronous) is a rhythmic pulsing noise in one or both ears. It occurs in the absence of external sound. It tends to be synced with the heartbeat. The noise is often described as a “whooshing,” sound heard when the heart beats. Pulsatile tinnitus symptoms can increase or decrease when you lie down or turn your head. Symptoms can also change when you put pressure on the jugular vein.

What causes pulsatile tinnitus?

Pulsatile tinnitus has many causes. It often occurs due to issues in the blood vessels, or the vascular system, in the head and neck.

Vascular causes include:

• Venous hum. This benign condition occurs when blood flow is abnormal in the jugular veins. This causes a vibration you can hear.
• Idiopathic intracranial hypertension (increased pressure in the skull). This condition is marked by headaches, vision issues and pulsatile tinnitus. The two large veins that bring blood out of the brain (transverse sinuses) are narrowed. This narrowing causes the “whooshing” tinnitus. It is like how a whistle works (it pushes air through a narrowed space). In most cases, this condition is treated with medication. In severe cases, it may be treated with minimally invasive methods to relieve the narrowing of the veins.
• Sigmoid or jugular sinus diverticulum. This is a rare condition. It occurs when the veins at the base of the skull protrude and extend close to the inner ear structures. This condition is not dangerous. It is treatable with endovascular (minimally invasive) techniques.
• Dural arteriovenous shunts. These abnormal connections develop between arteries and veins in the lining around the brain. This abnormal connection forms in the walls of the large veins that return blood from the brain to the heart. The noise occurs due to the flow of high-pressure blood from the arteries to the veins at the base of the skull. These lesions can be low-grade (no danger of stroke) or high-grade. Low-grade lesions may be treated if symptoms affect your quality of life. High-grade lesions must be treated. If left untreated, there is a high risk of brain injury. In most cases, treatment for both types is minimally invasive.
• Arterial stenosis. This is narrowing of the blood vessels (arteries) in the neck that carry blood to the brain. It can be a risk factor for stroke.

Other factors may increase your awareness of the sound of blood pumping through your blood vessels. These can include:

• Conductive hearing loss. This can be caused by a ruptured ear drum. You may be more aware of internal sounds because you cannot hear external ones.
• Neurological issues. You may hear sounds more intensely than normal.

How is pulsatile tinnitus diagnosed?

First, your multidisciplinary care team will ask about your medical history. Then they will thoroughly check the blood vessels in your head, neck and ear canal. You may also have hearing and blood tests.

You will also likely have imaging tests. They will show what is happening inside your skull. These may include:

• Ultrasound checks the arteries in the neck. This test can exclude a narrowing.
• MRI shows details of the brain and the inner ear.
• Magnetic resonance angiography (MRA), magnetic resonance venography (MRV), computerized tomographic angiography (CTA) and computerized tomographic venography (CTV) can check the arteries and veins inside the head. These tests can detect abnormal narrowing or short circuit connections.
• CT scan to check the brain and skull base.
• Conventional angiography is a minimally invasive, high-resolution evaluation of the arteries and veins. This is done to check or rule out high-grade dural arteriovenous shunts. It is also used to plan treatment. If your healthcare provider suspects high pressures in the head, they may use this technique to measure direct pressure of the veins.

How is pulsatile tinnitus treated?

Pulsatile tinnitus can often be cured once your healthcare provider finds and treats the underlying cause. Your treatment will depend on the cause of your condition. Treatment options may involve:

• Medication is used to treat some underlying conditions. These include hyperthyroidism, anemia, elevated intracranial hypertension or high blood pressure.
• Endovascular minimally invasive surgery, such as stenting, can correct certain underlying conditions, including an aneurysm.
• Self-management techniques may help ease your symptoms if you do not have an underlying cause. These may include sound therapy, cognitive behavioral therapy and tinnitus retraining therapy.

Causes and treatment of noise and whistling in the head

25
Oct
2017

25 Oct 2017 Types of Tinnitus, Causes Types of tinnitus, Dizziness, hearing loss, Tinnitus

Any noise sensation that lasts for several days is a reason to visit an otolaryngologist. If the symptom lasts more than a week, it is necessary to be examined by a doctor – causes and treatment of noise and whistling in the head are set individually.

Delay in contacting a specialist can lead to deterioration of the body and irreversible consequences, such as hearing loss, severe neurological deficit. In order to restore it, you will have to spend a lot of time and effort.

Article content:

• 1 Etiology
  • 1.1 Symptoms
  • 1.2 Diagnosis
  • 1.3 Treatment
    • 1.3.1 Treatment by highly qualified specialists

Common non-dangerous causes of noise effects in the head include:

• Minor stress.
• A busy day at work.
• Flight, long distance trip.
• Prolonged stay in a noisy place with loud music, harsh banging, rattling construction equipment, etc.
• Overwork.
• Hormonal changes in the body (typical for women).

The most common causes of whistling in the head region:

1. Wax plug, foreign body, small insect in the ear canal.
2. Inflammatory process of the middle ear – otitis.
3. Damage to the auditory nerve – neuritis.
4. Ear and head injuries – contusion and rupture of the eardrum, blow to the head, concussion of the brain.
5. Hypertension.
6. Tumor formations of the neck, head.
7. Stroke
8. Diseases of the thyroid gland.
9. Physiological changes associated with age.

There are reasons that belong to the low risk group:

• Use of a hearing aid.
• Permanent work in a noisy place – in a factory, factory ..
• Turbulent air movement
• Decreased level of serotonin.

Medicines of certain groups – gentamicin, quinidine, etc.

You cannot figure out the etiology on your own, you doubt the stability of your body’s health? Contact the experts – they will conduct the necessary examination and help to find out how dangerous the case is.

Symptoms

The main precursor of whistling in the head is an atherosclerotic lesion of the vascular basin of the carotid arteries, more often this phenomenon is seen in the left hemisphere. The patient’s condition becomes critical when the arteries are blocked by plaques formed in their cavity.

Atherosclerosis is the most common cause of impaired blood flow and supply of oxygen and necessary substances to organs. As a result, there are:

1. Strong dizziness .
2. Pain in the head.
3. Disturbed functioning of the vestibular apparatus.
4. With sudden movements, the patient easily loses balance, may faint.

The terrible consequence of these manifestations is stroke or cerebral infarction: the death of a group of cells in the brain. The phenomenon is irreversible, so you need to carefully listen to the symptoms that arise and start treatment as early as possible – at the stage when the vessels can return to normal flexibility and patency.

Whistling in the ears may remain after a previous stroke. This is due to the fact that the head vessels work inconsistently, the functionality of auditory analyzers is impaired. After the crisis, the patient’s speech becomes loud and unintelligible – because he does not hear himself well. Whistling and ringing occur due to increased pressure in the brain and ears.

Diagnosis

Since most cases of wheezing in the head are due to vascular disorders, the main procedure will be their hardware check, as well as an examination of the head:

• Computed tomography.
• X-ray of the skull.
• Examination of the auditory analyzer for tumors and other anomalies.
• Audiogram.

In general, the doctor will prescribe tests for basic blood and urine tests. The procedure is mandatory in order to identify or confirm the presence of inflammatory processes.

Treatment

Therapeutic measures against whistling in the ears are not aimed at eliminating its cause. Complete elimination of discomfort is impossible only in one case – if the pathology is age-related. This is due to the gradual destruction of the auditory nerve, so that the doctor’s actions will be aimed at adapting the patient to new auditory manifestations.

If the noise effect is due to medication, then:

• Report the situation to your doctor.
• Stop taking the drug.
• Replace it with an equivalent with the knowledge and consent of a specialist.
• If replacement is not possible, take tricyclic antidepressants.

With cervical osteochondrosis, the patient needs to do preventive physical education – its complex will be prescribed by the attending physician, and also – to take chondoprotectors. Atherosclerosis requires a special diet, taking special medications – statins. With increased pressure, complex continuous therapy is prescribed. The pathology of the heart is corrected with the help of glycosides.

If there is a danger to the life of the patient and a conservative approach does not have the desired effect, a surgical operation is performed.

Treatment by highly qualified specialists

For a guaranteed result, contact the Tinnitus Neuro clinic. We are pleased to offer each client low price conditions, high-class professional services and an individual program. Our specialists have experience sufficient to treat the most complex diseases. Give yourself the joy of a full-fledged perception of the world – come to us for treatment!

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Rapper Mak Sima Mgla writes songs when he is almost deaf. Read an interview with him

An interview with rapper Mak Sima Mgla from Kirovo-Chepetsk was published on the Max Headroom Incident telegram channel. The musician hears almost nothing, extraneous sounds constantly sound in his head, and the disease progresses. How he lives with this and how he writes music at the same time – read the full version of the interview. It’s worth it. Below are a few quotes.

How hearing problems started

I was awakened at night by noise. I thought my parents didn’t turn off the TV. I went and checked, but this noise was in my head.

That’s when it broke me. Thought it was a dream; that I wake up and everything is calm. But no, this whistle has become even stronger. And from that moment I still wake up and fall asleep to this whistle, hum, noise, gnashing in my head – in such a kind of my own disco.

How I went to shamans for treatment

Look, the first time it was my parents’ initiative, when the doctors said that my illness could not be cured. My mother is a believer. There was a village two hundred kilometers from our city, and they brought me there. An old man lived there – he did not take money, he took food. I remember that his right eye was white. He led me into a room, I sat down, and he began to move the book over my head. I was shaking a little, there was a shiver, maybe a childish self-hypnosis. I liked the old man as a person, but somehow he did not succeed.

And the second time I went across the river to another grandfather, not far from the city. They say people come to him from all over Russia. It was two years ago. I found his address, I go in like this – and he looks at me from the doorway and says: “You have something with your head.” “Such a colorful man. He put an amulet around my neck and began to move his hands. I was shaking even there… He says: they jinxed you, look for the answer in the past and go to confession.

How he lives with the disease

Now I have a hearing aid in one ear, but I try to use it only at home. The sound in it is terrible, the whole body irritates. Especially when the package rustles, it’s like skin is being removed from you. I’ll release an album, ha ha, I’ll buy myself a cool device for two hundred thousand. The rumor settles quickly. And when I am completely slammed, then the hearing aid will not be needed.

It seems that I am teaching myself to listen with my eyes, to give sound to some elements of life. Now I’m writing to you, on the windowsill. Outside the window there is a courtyard, in the room on the bed there is a girl, and all I hear is a squeak in my head, the melody of my world.

How he writes music at the same time

This is a dreary process, there is no algorithm. I always have some kind of melody in my head, and I read something under it, hum. In general, I should be inspired by the word, directly hit me. I don’t write verse-chorus-verse songs, that’s old fashioned. I like to play with the beat. When I choose the beats that are sent to me, it should capture my mood. It’s like he’s whistling to me that the game has started. If I don’t hear this whistle in a beat or in any other music, then this music is not mine.

About plans for the future

If I catch on, then yes (about possible concerts). I would like to try to speak with someone at the beginning. I often imagine how I perform: turn on the “Black Record”, close my eyes and start stirring up the room. I hope I will hear the beat on stage – I’m worried about it. In any case, I will perform with a plus, leave some of my choruses, ad-libs on the minus, so that they help me not to go off the beat.

How does he perceive reality now

Everything has changed.

It’s like sitting in a wheelchair, only inside yourself. Or vice versa – got up from a wheelchair. The world has changed. I used to hear the teapot whistle, now I don’t; and when it boils, I remember that sound. When I walk past the highway, where there is a large flow of cars, I do not hear them, but I feel the vibration. My ear hears some sharp sounds, a monotonous sound passes me by.

What is his creative goal

I want to achieve the form of sound that sits in my head. All I have is a word, so I want to own this word even without a beat, so that it is melodic and cool.