Tinnitus

Under Tinnitus one understands pathological ones Ringing in the earsthat are either recurring or even occur continuously, i.e. chronically. Those affected hear an unpleasant tone or noise, which can usually be perceived as whistling, ringing or humming. The main reasons for tinnitus can be psychological as well as pathological and physical causes.

What is tinnitus?

Under a Tinnitus (tinnitus auriumfg) one understands Ringing in the ears of the most varied types. These can be persistent or also recurring noises and tones, which, without external acoustic stimulation, can only be perceived subjectively by the person concerned. The triggers for tinnitus can be in the ear or in the brain.

There are three different types. With acute tinnitus, the symptoms last for up to three months. If the tinnitus is subacute, the symptoms last for three months to twelve months. Chronic tinnitus is when the noises in the ears have been present for more than twelve months.

There is also a classification into four different degrees of severity. Compensated tinnitus grades I and II. This type does not yet cause any health problems. Grades III and IV are called decompensated tinnitus. It already has serious health effects.

causes

The causes for one Tinnitus can be in a wide variety of areas. In the ear canal, blockages caused by wax, protruding bones (exostoxes) or foreign bodies can lead to tinnitus. In the area of ​​the middle ear, this can be caused by a defect in the eardrum. However, a tube dysfunction, a tympanic effusion, immobility of the eardrum or an otitis media can lead to tinnitus.

The inner ear can be a trigger for tinnitus due to a noise- or age-related hearing disorder, medication or a sharp drop in blood pressure. Meningitis, anemia, incorrect blood pressure, multiple sclerosis or a brain tumor can also lead to tinnitus. Noises in the ears or tinnitus can also occur as a symptom of a sudden hearing loss.

Typical symptoms & signs

The main symptom of tinnitus are sound sensations in the ear. These can sound like hissing, humming, humming, crackling, ringing, hissing or whistling. Depending on the severity and intensity, tinnitus symptoms can be very stressful.

Only with objective tinnitus can another person hear the noises in the person's ears. In most cases, it is ringing in the ears, which is described as subjective tinnitus. Only the person concerned is burdened with it. Others cannot hear the noises in the ears, even if they are perceived as loud and disturbing.

However, the tinnitus noises are not conceited. They can be caused by tense neck muscles, constant stress, hearing damage or other triggers and are therefore real. With a corresponding level of intensity, they can burden those affected so that they suffer from secondary symptoms.

Often times, the causes of tinnitus are not identified, so symptoms persist. This can lead to secondary symptoms such as depression, irritability, difficulty concentrating, headaches, dizziness, jitteriness with high pitched tones, sleep disorders or inability to work. Participation in social activities is disturbed if the symptoms are severe. There is sometimes social withdrawal because the tinnitus makes hearing difficult.

Doctors also call the accompanying symptoms mentioned secondary symptoms. These can lead to a veritable tinnitus cycle. This culminates in depression, social withdrawal and inability to work.

Complications

The complications associated with tinnitus can be divided into two categories: on the one hand, complications related to an underlying medical condition and, on the other hand, complications that can be triggered due to tinnitus itself.

The former complications range from consequential damage due to nerve damage to the complications that can occur with inflammation, Menière's disease, vasoconstriction or thrombosis in the relevant area. It is in cases where the underlying medical condition is known to look at it.

In most cases, however, tinnitus remains uncomplicated, even if left untreated. Only a few percent of all those affected experience serious or permanent complaints. Rarely, the tinnitus itself (the narrowing of the blood vessels that triggers it) can lead to decreased hearing and deafness.

Overstimulation of the sense of hearing (hyperacusis) is possible: those affected suffer from an enormously increased perception of noises that cause pain. Chronic tinnitus can also establish itself and lead to permanent stress for those affected. Chronic tinnitus is often accompanied by psychological problems that can range from depression to suicide. However, adequate tinnitus therapy can prevent this.

When should you go to the doctor?

If the typical ringing in the ears or beeping occurs, a doctor should be consulted. Constant or repeated noises in the ears indicate tinnitus, which must be examined by a doctor. A doctor should be seen within a week if the symptoms have not subsided in the meantime. In 50 percent of cases, the tinnitus only lasts a few hours or days. If it disappears by itself, no medical evaluation is necessary. In the event of repeated complaints, the ear specialist should be consulted. Accompanying symptoms such as headache, dizziness, or fever suggest a serious cause.

The person concerned must quickly see a specialist and have the complaints clarified. Otherwise, the tinnitus may increase or even persist. In the worst case, there is a risk of hearing loss. Patients who suffer from chronic tinnitus should inform the doctor about increasing symptoms. Tinnitus is treated by an ear specialist. The family doctor can usually also make an initial suspected diagnosis. With stress-related tinnitus, the patient may need to see a therapist so that the causes of the stress can be broken down and remedied. The earlier the tinnitus is treated, the better the chances of recovery.

Treatment & Therapy

A successful therapy for Tinnitus is based on the causes as well as on the duration of the illness, therefore there is also the classification already mentioned. The earlier the treatment is started, the more likely it will be successful. In acute tinnitus in the inner ear or for an unknown cause, a sugar solution infusion or a combination of saline and glucocorticoids is given. This should lead to a renewed activation of the sensory cells.

Hyperbaric oxygen therapy can also be used. This eliminates an oxygen deficiency in the inner ear. If the cause of the tinnitus is an occlusion of the ear canal, the cause can often be removed without any problems. With subacute or chronic tinnitus, the chances of treatment are much lower. The infusions already mentioned are also administered here. This is done in conjunction with psychotherapy. By learning relaxation techniques such as yoga, autogenic training or progressive muscle relaxation, the symptoms of tinnitus are alleviated.

If none of this leads to an improvement in the symptoms, a tinnitus retraining therapy according to Jastreboff is applied. Here the tinnitus should be suppressed from consciousness.

Aftercare

Follow-up care is about maintaining the patient's quality of life and showing ways to deal with the tinnitus. Since tinnitus in many cases becomes chronic and cannot be cured, once the diagnosis and treatment have been completed, it is a question of patient acceptance. If you are depressed, it is advisable to consult a psychotherapist.

In therapy, patients can learn to live with the noise in their ears and to concentrate on other areas of life again. A visit to the hearing aid acoustician should also take place. Since tinnitus is often associated with hearing loss, hearing aids can help improve hearing and at the same time draw attention away from the tinnitus.

If there is no hearing impairment, there is the possibility of a so-called noiser or masker. This is a hearing aid that produces an adapted noise. This is supposed to cover up the tinnitus and helps many sufferers in everyday life. However, some do not need such noise permanently. For many, the tinnitus only bothers in quiet situations.

Here it can be helpful to switch on a counter noise, such as soft relaxation music or the sound of the sea. Last but not least, those affected should take care to avoid stress and to listen better to their bodies. If the cause of the development of the tinnitus is known, it should be avoided in the future.

You can do that yourself

Tinnitus is a hearing disorder in which patience and stress reduction are very important. Patients can therefore do a lot for themselves and their health in everyday life. First of all, it helps to think that tinitus can heal spontaneously or at least improve significantly. Since tinnitus is often a warning signal from the body to pay more attention to one's own health and, above all, to the needs of the psyche, relaxation is particularly important. This can be done using methods such as Jacobsen's progressive muscle relaxation (PMR) or autogenic training. Yoga with a mixture of physical exercises, breathing exercises, meditation and relaxation can also reduce stress and restore inner balance.

Rest is helpful with tinnitus, but in no way should be confused with social withdrawal. The request for sick leave is certainly helpful, especially in a stress-intensive job, and loud music should also be avoided, at least in the acute phase. Maintaining social contacts is important to prevent the tinnitus from causing isolation. Nicotine and alcohol, including coffee, should ideally be significantly restricted. However, it is important to drink enough. It is best to cover it with water or herbal teas. Self-help groups specializing in the topic of tinnitus offer a helpful exchange of experiences and have valuable tips ready for those affected.