Causes of tinnitus
Tinnitus is a kind of sound that people feel subjectively without external sound or electrical stimulation. It is worth noting that tinnitus is an illusion that occurs in the auditory system, a symptom rather than a disease. Some people often feel that there are some special sounds in their ears, such as buzzing, hissing or sharp whistling, but there is no corresponding sound source around them. This condition is tinnitus. Tinnitus makes people upset and fidgety. In severe cases, it may affect their normal life and work.
Tinnitus can occur in many diseases, and almost any cause that can cause ear diseases will lead to tinnitus symptoms, but the relationship with hearing is more complicated. Tinnitus may be caused by a small eyeball touching the eardrum, but it may also be caused by a tumor located in the auditory nerve. Others such as otosclerosis (a disease that occurs in the ossicles of the middle ear), ototoxic drug poisoning, noise, etc. , can cause different degrees of tinnitus. Tinnitus has many manifestations, some on one side and some on both sides. Some appear intermittently, and some continue; Light tinnitus when quiet, heavy noisy when downtown.
The main causes of tinnitus are ear diseases, such as otitis externa, cerumen embolism, foreign body in external ear, acute and chronic inflammation of middle ear, perforation of tympanic membrane, otosclerosis, Meniere's syndrome, acoustic neuroma in inner ear, etc., which can all cause tinnitus.
Tinnitus can also occur in vascular diseases, such as glomus tumor of jugular vein, small blood vessel dilatation of ear, vascular malformation, hemangioma and so on. Venous tinnitus is mostly murmur, while arterial tinnitus is consistent with pulse.
People have such a consensus on the causes of noise. If you suddenly hear firecrackers, there will be a long echo in your ears and it will weaken for a long time. This is that external noise temporarily damages people's auditory nerves. People who have been working in a noisy environment for a long time, such as tractors and car drivers, traffic police, armed police, soldiers, disco staff, mahjong artists, long-term participants in meetings and operators of various equipment, are all victims of noise. Long-term noise stimulation has caused nerve damage in the inner ear most of the time. Tinnitus caused by noise is mainly manifested as the disorder of spontaneous activity of auditory nerve fibers. Generally speaking, noise exceeding the safe noise standard (85-90 dB) may cause tinnitus and deafness. However, there are individual differences in sensitivity to noise with the same intensity, and only sensitive person is hurt or the most serious.
Other systemic diseases can also cause tinnitus: autonomic nervous system disorder, insufficient cerebral blood supply, pre-stroke, hypertension, hypotension, anemia, diabetes and malnutrition. The incidence of tinnitus in people over 60 years old is as high as 30%. The main reason is that the auditory nervous system degenerates with age.
In addition, excessive use of toxic drugs such as gentamicin, streptomycin or kanamycin can also cause tinnitus and hearing loss, and tinnitus occurs earlier than hearing loss.
Excessive fatigue, lack of sleep and emotional tension can also lead to tinnitus. Meniere's disease is caused by acoustic neuroma and sclerosis, which is a disease in which the dense lamellar bone of bone labyrinth is partially replaced by spongy new bone rich in cells and blood vessels. Causes of head trauma, muscle clonus, systemic diseases, such as anemia, hypertension, diabetic hypothyroidism, hypoglycemia, autoimmune diseases, vasospasm diseases, etc. , can be accompanied by tinnitus, tinnitus of unknown cause accounts for about 40% of the tinnitus population. Tinnitus is caused by membrane permeability disorder or changes of hair cells inside and outside the cochlea, or synaptic metabolism disorder of hair cells, or short circuit between auditory nerve fibers.
Tinnitus can be divided into subjective and objective categories.
Objective Tinnitus is also called non-uniform tinnitus. It is a kind of tinnitus that you and others can hear. This situation is rare. Tinnitus can be rhythmic horseshoe, pendulum or other rhythmic noise. The causes of heterogenous tinnitus are: abnormal arteriovenous fistula or aneurysm in head and neck produces pulsating tinnitus consistent with pulse; Spasm of soft palate and ossicles; Abnormal opening of eustachian tube can not stop sound, and tinnitus consistent with respiratory rhythm can often be heard.
Subjective tinnitus is also called conscious tinnitus. Only the patient can feel tinnitus, which can be unilateral or bilateral. It has many properties, such as bell, buzz, whistle, air flute, insect sound and so on. There are many reasons for subjective tinnitus, and the common reasons are: inflammation of external auditory canal, foreign body in cerumen and tumor obstruction; Various types of middle ear diseases, such as middle ear diseases, tympanic diseases and otosclerosis; Meniere's disease, ototoxic drug poisoning, senile inner ear degeneration, inflammation of inner ear canal and intracranial, tumor and vascular abnormality; Craniocerebral trauma, skull base fracture, etc. Some medical diseases such as anemia, hypertension, hyperthyroidism or hypothyroidism, and kidney diseases may be the causes of tinnitus. In addition, mental stress will cause changes in blood circulation, affect the blood supply to the inner ear, lead to tinnitus attacks, and stress will also aggravate tinnitus.
Treatment of tinnitus
Patients with tinnitus should go to the hospital for a detailed examination and try to find out the cause of tinnitus. Take special treatment or symptomatic treatment according to the cause. Symptomatic treatment methods include:
① Drug therapy: vasodilators are commonly used to improve blood circulation in the inner ear, such as low molecular dextran and Danshen tablets; Or drugs that improve the energy metabolism of inner ear tissue, such as ATP and coenzyme A; Anticonvulsants, such as carbamazepine, sibelium and lidocaine, can inhibit abnormal excitement of auditory system.
② Masking therapy: Tinnitus is treated with tinnitus masking device, and the spontaneous excitation of inner ear or auditory nerve is inhibited by external sound stimulation, and hearing AIDS can also be used instead of masking device.
③ Psychotherapy, such as biofeedback therapy, uses different biofeedback signals to train patients to relax and restore the relative balance in the body, so as to achieve the purpose of treating tinnitus.
In short, tinnitus is generally not harmful to health, but it will be disturbing. At present, the treatment is difficult. If tinnitus symptoms appear, you should actively go to the hospital for corresponding examination and treatment to avoid delaying the diagnosis and treatment of some important diseases. If there is no special disease, don't be nervous. You should keep a happy mood and divert your attention. Tinnitus may be relieved.