Tinnitus (Ringing or Humming in Ears) - Definition, Causes, Treatment

A Singing in The Ears

Tinnitus (Ringing or Humming in Ears)

What is Tinnitus?

Tinnitus or tinnitus is the perception of sound without sound in the external environment. It may be due to a metabolic cause such as hearing loss, side effects of drugs, high tanning or high cholesterol, as well as due to inner ear tumors. Often at night, it is noticed after the outside sound has ceased. It is a very common subjective symptom, seen in approximately 1 in 5 people over the age of 65.

Tinnitus can be detected in one or both ears. Often described as a ringing noise, but in some patients, this may be perceived as a "rattle" or "roaring sound, clicking sound, electric buzzing sound, humming, buzzing sound, wind sound or whistling sound". In some individuals, the intensity of the ringing sound may change with shoulder, head, tongue, jaw or eye movements. Generally, it is perceived more at night when masking external sounds decrease.

Pulsatile tinnitus or Vascular Tinnitus is called the stroke or muscle contraction related to the blood flow in the ear, neck and veins. If the ringing sound heard in the ear of the patient can be heard by the people around, it is called "Objective Tinnitus", if it can only be heard by the patient, it is called "Subjective Tinnitus".

Do You Want to Listen Tinnitus Sounds?

You can find many different ringing sounds on the website of the American Tinnitus Association (ATA) on the link named “Sounds of Tinnitus” (http://www.ata.org/sounds-of-tinnitus).

Another link where you can find sounds similar to pulsatile tinnitus: http://whooshers.com/whooshersounds.html

Another link where you can find different tinnitus sounds: http://whooshers.com/whooshersounds.html

Causes of Tinnitus

There are many causes of tinnitus in industrialized societies that can be seen as a natural consequence of noise trauma in employees.

Objective Tinnitus Causes

In the month when the amount of blood flowing in the veins around the ear can increase, the amount of turbulent in the vein may increase, such as atherosclerosis, venous hum, carotid artery aneurysm, carotid artery dissection, vasculitis (vascular inflammation, especially giant cell arteritis), idiopathic intracranial hypertension. audible pulsatile tinnitus may occur. Muscle spasms around the ear can also cause tinnitus that can be heard from the outside in the form of "clicking" or "crackling".

Subjective Tinnitus Causes

Subjective tinnitus has many possible causes. The most common cause is hearing loss due to noise, as a result of exposure to excessive or loud sounds. Tinnitus can also occur with sudden onset hearing loss. Even ototoxic drugs can cause secondary subjective tinnitus without hearing loss, at doses that are not themselves ototoxic.

Some ototoxic drugs such as aspirin can cause subjective tinnitus (damage to the nerves in the inner ear).

Link to the list of drugs that can cause tinnitus >> List of Drugs That Can Cause Tinnitus

Tinnitus may occur as a result of discontinuation of benzodiazepines in therapeutic doses.

Subjective tinnitus causes can be summarized as follows:

Ear-related diseases and conditions that cause hearing loss:

- conductive hearing loss
- external ear infection
- acoustic trauma
- earwax
- middle ear effusion
- superior semicircular rupture
- sensorineural (neural type) hearing loss
- presbycusis (age-related hearing loss)
- Meniere's disease
- acoustic neuroma
- mercury or lead poisoning
- ototoxic drugs (link to the ototoxic drug list >> Ototoxicity and Ototoxic Drugs)

Neurological disorders:

- Chiari malformation
- multiple sclerosis
- head injury
- skull fracture
- closed head injury
- spinal injury
- temporomandibular joint disorder
- giant cell arteritis

Metabolic disorders:

- thyroid disease
- hyperlipidemia
- Vitamin B 12 deficiency
- iron deficiency anemia
- diabetes

Psychiatric disorders:

- depression
- anxiety

Other reasons:

- tension myositis syndrome
- fibromyalgia
- vasculitis
- hypertonia (muscle tension)
- thoracic outlet syndrome
- Lyme disease
- hypnagogia
- migraine
- sleep paralysis
- Glomus tympanicum tumor
- anthrax vaccine containing protective antigens against anthrax
- some drugs can produce temporary tinnitus-like symptoms as a side effect
    . 5-MeO-DET
    . diisopropyltryptamine (DiPT)
- Benzodiazepine withdrawal period
- nasal congestion
- intracranial hypertension or hypotension (such as encephalitis and a leak of cerebrospinal fluid)

Tinnitus Treatment

Tinnitus and hearing loss can be permanent conditions. Treatment of tinnitus is directed towards the underlying disease and condition that causes tinnitus. When these diseases and conditions are treatable, tinnitus can also disappear. Tinnitus can be permanent, mostly because the inner ear cells are damaged. Although there are various drugs that can increase the nourishment or blood supply of the inner ear cells; Its effects are limited in neural damage. Sometimes there may be several underlying causes at the same time (such as high blood pressure, diabetes and hypercholesterolaemia with the death of the auditory nerves in elderly patients ...). When some of these reasons can be treated, tinnitus severity may decrease.

Precautions to Reduce Tinnitus

The following measures may be helpful for patients with tinnitus:

- Avoiding exposure to loud noises and noise
- Keeping blood pressure under control
- Reducing the use of salt
- Avoiding the use of caffeine-containing coffee and cola, and nicotine-containing tobacco (or cigarette)
- Reducing anxiety
- Allowing adequate rest time and avoiding fatigue.
- Exercising regularly
- Biofeedback can help or reduce tinnitus in some patients.
- Avoiding the use of large amounts of aspirin or other drugs that can cause inner ear damage

Laser Applications in Tinnitus

In the treatment of tinnitus, it is advocated that low-level laser application to the affected ear can stimulate the inner ear and cause changes in the inner ear. These theories have not been scientifically proven. There is insufficient evidence in the medical literature to support the use of low-level laser used in the ear canal for the treatment of tinnitus.

Tinnitus Mesmerizing Sounds

Some patients with tinnitus state that they cannot fall asleep due to the sound they perceive in their ears and that they are more disturbed at night. For these patients, it may be beneficial to listen to the sounds found in nature (such as the sound of birds, streams, waterfalls) when they lie on the bed. Timed radios or ringing pads are available for this.

There are many links on the internet where you can find ringing voices masking sounds. You can start listening to these sounds when you go to bed Some of these sounds can be listened to by clicking on them available below or you can download them to your computer.

(Source websites for sounds:

Tinnitus Masking Sounds

Air Heater Sound

Autumn Winds

Beach Walk

Forest Birds

Forest Campfire

Mountain Meadow

Niagara Waterfall Pink Noise

Pink Noise

Purple Noise 1

Purple Noise 2

Rainy Day

Soapy Shower

Tropical Beach

Vibrating Virtual Fan

Virtual Shower

White Noise 1

White Noise 2

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
E-Mail: muratenoz@gmail.com 
Mobile phone: +90 533 6550199
Fax: +90 212 542 74 47