Tinnitus is a symptom, not a disease, and is the hearing of sound in the ear even though there is no audible stimulus in the environment. Patients may describe this sound as ringing sound, machine sound, humming etc. The exact cause is not clear, and many possible reasons can cause ringing in the ears.
Tinnitus is divided into two groups as objective and subjective:
In objective tinnitus, there is a real sound that can sometimes be heard from the ear through a stethoscope or microphone. The source of this sound is the organs or tissues adjacent to the ear. For example, the sounds that occur in the presence of vascular diseases are rhythmic with heartbeats. Vascular diseases that can cause tinnitus; vascular tumors, carotid artery occlusive diseases, aneurysm and hypertension. Some nerve-muscle diseases are also the reason for objective tinnitus. These are diseases such as involuntary rhythmic contractions of the muscles around the middle ear or the eustachian tube (myoclonus), abnormal opening of the eustachian tube, and malfunction of the jaw joint (temporomandibular joint). Subjective tinnitus constitutes the largest group among the causes of tinnitus. Sound from the ear is a state of hearing even though there is no sound originating from the environment or the body. Source; It may be related to the inner ear, auditory nerve, or central auditory pathways. The most common reasons are;
- Ear related reasons; Aging-related hearing loss (presbycusis), noise-induced hearing loss, Meniere’s disease, otosclerosis, middle ear infections, external auditory canal diseases, etc.
- Metabolic diseases; Less or more thyroid hormones secretion, Diabetes, high cholesterol in the blood
- Neurological diseases; Multiple Sclerosis, head injury
- Medications; Aspirin, aminoglycoside antibiotics
- Tumors; Acoustic neurinoma, temporal lobe tumors, facial nerve neuroma
- Psychological factors; depression, anxiety
What is required for the diagnosis of tinnitus?
Initially, a detailed history should be taken from the patient and then a complete ear, nose and throat examination should be performed. In addition to these, routine hearing tests, advanced hearing tests, blood biochemical tests and, if necessary, tomography or MR imaging of the patient are necessary to reveal the reason for tinnitus.
How is tinnitus treated?
Drugs that increase the blood flow to the inner ear and / or regulate the activity of the inner ear hearing cells are used, especially in tinnitus that is thought to be of ear origin. Adrenergic, antiadrenergic, parasympathomimetic, parasympatholytic, smooth muscle relaxant drugs, vitamins, IV lidocaine were used for this purpose. Hearing aids or tinnitus masking devices are other alternative methods. If the tinnitus is severe enough to affect the daily life of the patient or the drugs used have not been effective, devices called tinnitus maskers and similar to hearing aids may be useful. With these devices, it is aimed to reduce the sensitivity of the regions that cause tinnitus by giving a sound at the same frequency as the ringing in the inner ear. Especially in cases where tinnitus is present along with hearing loss, patients can benefit greatly from hearing aids with tinnitus suppression feature.
Transcranial magnetic stimulation method is also a tinnitus treatment that has been used in recent years. In this method; The magnetic field created transmits a current to the ear area and brain cells. This current stimulates the neurons and normalizes the electrical activity of the disrupted neurons. The success rate varies from person to person and is applied in sessions. There are different application methods according to the severity, cause and duration of tinnitus.
Psychotherapy and antidepressant medication use can be effective when there are some psychological problems. In the presence of ossicular calcification such as otosclerosis or in the presence of tumors such as acoustic norinoma, performing a surgery may be a solution.
For patients who have trouble falling asleep due to tinnitus, listening to music before sleep can be a practical method.
