What is Tinnitus, and What Does it Cause?

Tinnitus is a constant or occasional ringing of varying volume. It is often best felt in silence. Rarely, the noise in the ear is synchronised with the heartbeat and becomes pulsating. This disorder can be triggered by an ENT organ or brain abnormality and should be diagnosed and treated by a specialist. It is the perception of sound in the absence of an external acoustic source. It is not an illness but can be a symptom of one.

Tinnitus is most often caused by disorders of the auditory analyzer; it can indicate various pathologies and  can also occur in short episodes for no apparent reason. Tinnitus or random ringing in the ears is a widespread pathology that affects approximately one in five adults. It is usually only uncomfortable but can sometimes interfere with the ability to concentrate and get adequate sleep. As a result, the patient experiences constant stress, negatively impacting personal relationships and work.

Why Do Ears Ring? 

There are several causes of tinnitus to explain what happens in the body when this pathology occurs:

• Spontaneous electro acousticemission
• Cortical organ damage
• Normal aging process
• Too much external noise
• Cochlear damage
• Tumour or haemorrhage
• Lesions of the nerves
• Hypersensitivity

Causes for ringing in ears include damage to parts of the auditory system – outer ear, middle ear, inner ear or brain. 

• Spontaneous electroacoustic emission, i.e., spontaneous generation of electrical signals in the cochlea of the inner ear, which are perceived as tinnitus;
• Cortical organ damage with impaired cochlear auditory cell function;
• Dissonance between healthy and damaged cochlea cells, which may be caused by the normal aging process;
• Increased activity of the posterior cochlear nuclei of the brain, caused by exposure to too much external noise;
• Auditory plasticity, that is, activation of the nerve centers in response to hearing loss due to cochlear damage;
• The formation of new connections between neurons of the auditory nerves when these are damaged, compressed by a tumor or haemorrhage, and the generation of impulses in them in the absence of external sound;
• Lesions of the trigeminal, facial, lingual-pharyngeal and other cranial nerves, activating the so-called otosomatic interaction;
• Increased limbic and autonomic nervous system activity due to hypersensitivity to the first episode of tinnitus.

What Are the Most Common Causes of Tinnitus?

The most common causes of ringing in the ears are usually related to some kind of hearing or nervous system disorder. Still, also it can be due to age changes, medicators or physical trauma. These are described in more detail below:

• The most common cause of humming in the ears is loss of hearing. Due to age-related changes, injury or medication, the cochlea’s sensitive cells are damaged. The cochlea cells stop sending electrical signals to the brain, and the brain begins to generate its impulses to compensate for the lack of external stimuli.
• Constantly ringing ears can be caused by illnesses in the outer or middle ear, such as earwax plugs, otitis media, narrowing of the ear canal and swelling of the tympanic cavity.
• Exposure to loud noise is a very common cause not only of hearing loss but also noise in the ear. Everyone should be aware of the damaging effects of loud music, and machinery noise and protect themselves from such exposure. Barotrauma is another cause of hearing loss.
• More than 200 medications can cause this symptom, most commonly aspirin, aminoglycoside antibiotics (gentamicin, kanamycin) and quinine derivatives. Non-steroidal anti-inflammatory drugs, etacrynic acid, platinum derivatives, ACE inhibitors and other medications can cause the noise. Exposure to methyl alcohol and benzene is also dangerous.
• Meniere’s disease is a condition accompanied by transient dizziness, random ringing and congestion in the ears, and temporary hearing loss.
• Acoustic neuroma – a tumour affecting the nerve pathway from the cochlea to the brain centres, causing noise and hearing loss on one side.
• Pulsating noise is usually associated with circulatory system abnormalities. It is seen in pregnancy, anemia, thyrotoxicosis, arteritis, and elevated intracranial pressure; vascular murmurs also occur in heart defects, vascular anomalies, and stenosis of the ear arteries.
• Objective constantly ringing ears may be caused by diseases of the temporomandibular joint, soft palate muscle pathology, middle ear, and a gaping orifice of the eustachian tube in the nasopharynx.
• Diseases that may cause humming in ears: hepatitis, diabetes mellitus, atherosclerosis, cervical spine instability or osteochondrosis, and various hereditary anomalies (Chiari, Klippel-Feil, Pence, Hunt, Konigsmark-Hollander-Berlin syndromes).

The causes and treatment for ringing in the ears are complex, and only a highly qualified otolaryngologist can fully understand the problem.

How to Understand if You Have Tinnitus?

Noise manifestations in the ear include a variety of sounds heard by the patient. 

It can be: 

• humming in ears; 
• buzzing; 
• the sound of a roaring aircraft engine;
• hissing;
• whistling or clicking.

It may be constant or occur only occasionally. If noise in the ear occurs, it is essential to see a doctor. It may not only be due to hearing loss but may also be a symptom of hypertension, hyperthyroidism, anemia or other complaints. In infectious ear diseases, noise may be accompanied by pain and discharge from the ear canal. If the noise is combined with dizziness, urgent medical attention is required, as it may be a manifestation of Meniere’s disease or cerebral circulation disorder.

In the case of brain tumours, this complaint increases at headache attacks. With a tumour in the posterior fossa, the noise increases with changes in body position.

Who Can Diagnose Tinnitus?

When you have answered the question, “What is tinnitus?” You should consult an otolaryngologist, who will diagnose it and may refer you to other specialists for diagnosis if you suspect a condition unrelated to your hearing analyzer.

The following diagnostic tests are used to identify the cause of the tinnitus:

• a complete physical examination, history, head, and neck examination and determination of cranial nerve function;
• hearing test (subjective audiography);
• objective audiological examination: brainstem auditory response (BCAR) and extratympanic electrocochleography;
• computerized tomography or magnetic resonance imaging of the skull;
• endoscopic nasopharyngoscopy to identify the cause of the muscle murmur;
• microtoscopy;
• in some cases, diagnosis of hypertension, hyperthyroidism and other therapeutic diseases;
• spinal tap with the determination of intracranial pressure if indicated.

How Can You Treat Tinnitus?

The disease can be treated with physical therapy, different types of medications, and mechanotherapy. Once the diagnosis is made and you clearly understand why your ears ring, the doctor will prescribe the necessary treatment to eliminate the cause of the noise in your head. The patient should be examined by an otorhinolaryngologist and a neurologist. The treatment of tinnitus depends on its cause. Different techniques are used for this purpose, e.g:

• medication, including sedatives and sedatives as well as tranquillisers and neuroleptics;
• drugs that improve blood flow to the hearing organ: Vinpocetine, Cinnarizine, ergot preparations, Predictal, Ginkgo biloba; Betahistine, B vitamins;
• physiotherapy: light therapy, UHF, diathermy, ionophoresis, ultrasound;
• mechanotherapy – Politzer balloon blowing, pneumomassage, auricular massage, cervical collar zone massage, vibro- and acoustic massage;
• biofeedback and reflexotherapy;
• use of hearing aids;
• auditory nerve stimulation.

Schedule a Consultation with Lone Star Neurology

In summary, tinnitus is a complex process that requires accurate diagnosis with modern equipment and competent treatment. Treatment of humming in ears  at an early stage of the disease is much more effective. The Lone Star Neurology provides medical services to diagnose and select therapeutic techniques for tinnitus and the conditions that cause it. 

• Any patient with tinnitus requires an individualized approach. The causes for ringing in ears have to be established, and the accompanying diseases, the emotional background, and the adverse domestic and occupational factors have to be assessed.
• The doctor must find out about the use of ototoxic drugs or persistent intoxication. Often, the patient requires further consultation with a cardiologist, haematologist, allergist, or endocrinologist. 
• Only a comprehensive examination and treatment can eliminate or reduce the patient’s discomfort. It is advisable to consult a qualified physician if you experience constantly ringing ears. They are our competent doctors from Lone Star Neurology who can help you with these problems!

FAQ

• What is the main cause of tinnitus?

The causes of tinnitus are usually related to some kind of hearing or nervous system disorder. The most common cause of tinnitus is hearing loss. Due to age-related changes, injury or medication, the sensitive cells in the cochlea become damaged.

• What helps tinnitus go away?

Tinnitus or ringing in the ears or head is often untreatable, but the good news is that tinnitus can be controlled. The latest technological solutions in audiology and surdology can help.

• What are the first signs of tinnitus?

Tinnitus is characterised by prolonged, chronic tinnitus. Ringing is not the only sound that indicates tinnitus. Some people can hear buzzing, humming, hissing and even murmuring. The depth, pitch and tone of the sound can vary.

• Is tinnitus serious?

The main danger of constantly ringing ears  is that it can signify another condition that needs to be identified and treated. Therefore, it is best to see a doctor if you have any noise in your ears.