Tinnitus aurium is the medical term for hearing sounds in the ears when no external sound stimulus is present. These sounds come in various forms and are only heard by the patient suffering from tinnitus. Numerous conditions and external factors increase the risk of developing tinnitus. The patient learns to deal with this tinnitus through various self-care measures. But the doctor also treats the possible underlying cause of this symptom. Both physical and mental complications are possible from hearing these sounds all the time. The outlook depends on the cause of tinnitus. In some cases the condition can be prevented.
- Synonyms tinnitus aurium
- Epidemiology tinnitus
- Causes: Due to diseases or external factors
- Types of tinnitus
- Symptoms of hearing sounds
- Diagnosis and examinations
- Therapy
- Complications
- Prognosis
- Prevention
Synonyms tinnitus aurium
Tinnitus aurium is also known by these synonyms
- tinnitus
- tinnitus
- sonitus
- susurrus aurium
- tinnitus
Epidemiology tinnitus
Tinnitus is quite common. Almost everyone occasionally experiences a mild form of tinnitus that lasts only a few minutes. About one in ten people suffer from tinnitus to some extent. This is more common in patients with a hearing disorder than those without a concomitant disease. Furthermore, men are affected more often than women. Finally, the disease becomes more common as patients age.
Causes: Due to diseases or external factors
Anatomy
Tinnitus is mainly due to the spontaneous activity in high-frequency neurons (nerve cells) in the auditory cerebral cortex. When the inner ear no longer works (sufficiently) (due to, for example, a condition or medication use), external sound is missing, which results in spontaneous activity of the neurons. As a result, parts of the auditory pathways in the brain can no longer process sound information. Due to the spontaneous activity of the nerve cells, the brain picks up these signals as sound.Tinnitus is also a symptom of some (ear) conditions and other external factors.
Diseases
The following conditions or syndromes may cause tinnitus aurium:
- abnormalities of the cervical vertebrae
- anemia (anemia)
- atherosclerosis (arteriosclerosis: a narrowing of the arteries)
- blood vessel disorders
- Ménière’s disease: an inner ear disorder that causes hearing loss and dizziness
- Paget’s disease (chronic inflammation of the bone)
- diabetes mellitus
- an acoustic trauma: hearing damage due to excessive noise in the ear
- an allergie
- an aneurysm (bulge of part of an artery) (rare)
- a bridge angle tumor (acoustic neuroma: benign tumor in the cranial nerve)
- an infection
- glue ear: an accumulation of fluid in the middle ear
- a middle ear infection (otitis media)
- an overactive thyroid (hyperthyroidism) or underactive thyroid (hypothyroidism)
- a trauma/injury
- epilepsy
- dental granulomas
- hearing loss from loud sounds
- Costen’s syndrome
- head and neck tumors
- hypertension (high blood pressure)
- labyrinthitis (inflammation of the labyrinth, part of the inner ear) and adjacent foci of inflammation
- nephropathy (medical term: kidney disease)
- acoustic neuritis
- ear infections
- Otosclerosis: An inherited condition in which abnormal bone growth in the middle ear causes hearing loss
- presbycusis (age-related hearing loss)
- sinusitis
- foreign objects or earwax in the ear
External factors
Alcohol, caffeine and smoking are triggers for tinnitus. Also the use of certain medications such as antibiotics (drugs against a bacterial infection), aspirin (in high doses), certain antidepressants, chemotherapy, diuretics (drugs), quinine medications (to treat malaria) and non-steroidal anti-inflammatory drugs. -inflammatory drugs (NSAIDs) (relieve pain and inflammation and reduce fever) increase the risk of tinnitus. This also applies to loud music or other loud noises that usually cause a high-pitched beep or a loud noise. In addition, a sudden explosion or a firefight leads to an acoustic trauma, causing the patient to suffer from tinnitus. Barotrauma (ear condition due to rapid pressure change in the ear) is sometimes also accompanied by tinnitus. Finally, patients may develop tinnitus aurium as a result of stress.
Types of tinnitus
Subjective tinnitus
Subjective tinnitus is tinnitus that only the patient hears. This is the most common form of tinnitus resulting from ear problems in the outer ear, middle ear or inner ear. In addition, subjective tinnitus is sometimes due to problems with the auditory nerves or the part of the brain that interprets nerve signals as sound (auditory pathways).
Objective tinnitus
Objective tinnitus is tinnitus that the doctor also hears when examining the patient. This rare form of tinnitus is the result of a problem with a blood vessel, a bone disorder of the middle ear or muscle contractions. One form of this is pulsating tinnitus (ringing in the ears with knocking sounds in the ear).
Symptoms of hearing sounds
The sounds of tinnitus can be described as:
- blowing
- pounding
- grumbling
- roaring
- booming
- whistling
- screaming
- clicking
- throbbing
- grinding
- humming
- squeaky
- rattling
- ringing
- hissing
- whooshing
- ticking
- buzzing
Even escaping air, running water, the inside of a shell or musical notes are possible sounds that the patient with tinnitus aurium hears. Some patients hear one sound, but combinations of these sounds also exist. These sounds sound quiet or loud, which is sometimes variable depending on the patient. The pitch is occasionally different. A wheezing and ringing sound is most common in patients who normally do not suffer from tinnitus but have spent an evening in a very loud environment. Constant or recurring tinnitus is stressful and makes it difficult for the patient to concentrate or sleep well. About one in three patients with tinnitus also suffer from hyperacusis (increased sensitivity to hearing sounds).
Diagnosis and examinations
Physical examination
The doctor asks the patient about the tinnitus: the type of sound, the time when these sounds started, one or both ears are affected, additional complaints (hearing loss, balance problems or numbness of parts of the face, etc.), similar symptoms in the family, etc. Other medical information is of course important for the doctor, such as whether the patient has elevated blood pressure or trauma to the head.
Diagnostic research
The doctor carries out the following examinations:
- An angiography to visualize the blood vessels
- An audiometry (hearing test) to determine the hearing loss
- A BERA test (test to detect nerve or hearing damage)
- A CT scan of the head
- An MRI scan of the head
Therapy
Self-care
Other sounds mask the sounds of tinnitus, such as soft music or a ticking clock. Tinnitus is often noticeable when the patient goes to bed at night because the environment is quieter. Therefore, the patient should provide a sound in the room or just outside the room, such as a humidifier, the hum of a freezer or the sound of a dishwasher. Sufficient rest is also important. The patient does this by sleeping with the head in an elevated position so that the sounds are less noticeable. Relaxation techniques such as yoga or tai chi are helpful. Stress or anxiety worsens the symptoms. Caffeine, alcohol and smoking are triggers that the patient avoids. Furthermore, it is important to protect the ears from further damage by avoiding noisy places and using earplugs when necessary. Hearing protection is important to prevent tinnitus as much as possible.
Professional medical care
For (ear) disorders For some patients, a hearing aid helps to mask the sounds of tinnitus. There is also a tinnitus marker, a kind of device to place behind the hearing aid. This makes a continuous rushing sound that drowns out the tinnitus sounds. In practice, however, few patients appear to experience positive effects, but for a number of patients this is a solution.With external factors Treating the cause of tinnitus sometimes resolves tinnitus, such as excess earwax that the doctor can remove. Adjustments in medication use are also sometimes possible. The patient never does this spontaneously, but always in consultation with the doctor. There are several medicines available on the market that relieve the symptoms of tinnitus, but these medicines are not equally effective for everyone.Other tips Tinnitus Retraining Therapy (TRT) is a long-term (years-long) form of cognitive behavioral therapy (form of psychotherapy) in which the patient gains insight into the origins of tinnitus and tips on how to deal with it. Another treatment method is neurostimulation. The doctor places an electrode around the auditory nerve. This emits electrical pulses and restores disturbed brain activity. In March 2017, a Chinese study found that the use of acupuncture is effective for treating tinnitus aurium. The results of the study showed significant improvement in patients with the use of electrical stimulation of acupuncture points.
Complications
Tinnitus itself is sometimes due to stress, but the tinnitus itself can also cause stress. The feeling of powerlessness and hopelessness is very strong in some patients. This vicious circle may result in sadness and depression. Insomnia, fatigue and exhaustion are other symptoms that tinnitus can lead to. Some patients experience personality changes resulting in anxiety, concentration problems, irritability and memory problems. Further complications depend on the underlying cause of tinnitus aurium.
Prognosis
When the cause of tinnitus can be resolved, the symptoms of tinnitus disappear or are greatly reduced. Permanent tinnitus occurs, for example, in the case of a bridge angle tumor, age-related hearing loss, noise hearing loss or Ménière’s disease. Sometimes the underlying cause of tinnitus is not known and this is often permanent. When tinnitus is the result of stress, it is often permanent, although symptoms often diminish when the patient is more relaxed.
Prevention
The cause of tinnitus can sometimes be prevented, for example by removing stress, avoiding triggering factors (alcohol, smoking, caffeine) and maintaining a healthy lifestyle so that blood pressure is healthy. Earmuffs or earplugs are other protective measures to prevent hyperacusis.
read more
- Ménière’s disease: Dizziness, tinnitus and hearing loss
- Cracking, popping noise in ears: Causes of ear noises
- Acoustic trauma: Hearing damage due to excessive noise in the ear
- Pulsating tinnitus: Ringing in the ears with knocking sounds in the ear
- Ear plug: Remove excess earwax, including with water