tinnitus (TINNITUS) hearing noise in one’s ears or in one’s head without warning about hearing. This is especially felt in a quiet environment. Tinnitus is a symptom, not a disease. It can be heard as ringing, hissing, cicada sound, ringing, buzzing sound, wave sound, wind sound, water current sound or hum.
It is frequently seen in the society, and two out of three people are temporarily affected by this disorder at least once in their life. Persistent (chronic) tinnitus detection rate is reported to be 2-7%. It is more common over the age of thirty. Tinnitus is often associated with hearing loss, and as the degree of hearing loss increases, the incidence of tinnitus increases. 40% of patients with tinnitus have hyperacusis, which is called decreased tolerance to sound and discomfort from loud sounds. It has been determined that long-term exposure to noise increases the incidence of tinnitus. If it continues for more than six months, it is called chronic and these cases will be much more difficult to treat. As a result of long-term tinnitus, patients experience restlessness, stress, tension, anxiety disorder, irritability, trouble falling asleep or sleep disruption.
It is believed that tinnitus is the damage to the hair cells that provide hearing in the inner ear (cochlea), and the increased signals sent by the brain to cover the damage in these cells are perceived by the individual as an annoying sound. In the formation of tinnitus, deterioration in the functions of the inner and outer hair cells in the cochlea is held responsible. Prolonged exposure to noise, hypoxia and ischemia have been reported as the main causes of dysfunction of these cells.
Tinnitus is evaluated in two main groups as objective and subjective tinnitus; While the sound can be heard by both the patient and others in objective tinnitus, the sound can only be heard by the patient in subjective tinnitus.
Objective tinnitus causes; vascular (aneurysm, tumor, hypertension), neuromuscular causes such as muscle spasms and the Eustachian tube called patent tuba is constantly open.
Subjective tinnitus causes are caused by problems in the external ear canal, eardrum, middle ear and the ossicles and auditory organ (cochlea). These; ear plugs (plug), nerve and vascular tumors (especially acoustic neuroma), Meniere’s disease, Otosclerosis (ear calcification) and sound (acoustic) trauma, ototoxic drugs, smoking, long-term exposure to noise, ear infections. Tinnitus, especially when accompanied by dizziness and hearing loss, may be the result of a tumor in the inner ear. The first complaint of many patients with sudden hearing loss is usually tinnitus. In addition, some diseases outside the ear can cause subjective tinnitus: Vitamin deficiencies, trace element deficiencies (copper, iron, zinc), metabolic disorders (hypothyroidism, diabetes), tooth and jaw disorders, teeth grinding, cervical vertebra problems, anxiety-tension- Stress-depression, autoimmune diseases such as rheumatoid arthritis, multiple sclerosis, head trauma and finally old age can cause tinnitus to a great extent.
Evaluation of the patient with tinnitus starts with taking the patient’s history first. A detailed ear, nose and throat examination is then performed. Unfortunately, there is no objective diagnosis and test method for the evaluation of tinnitus. A complete audiological examination and tomography or magnetic resonance imaging examinations may be requested. Laboratory examination (whole blood, sugar, thyroid function tests, minerals, vitamins, etc.) is required if it is thought to be caused by extra-ear problems.
Tinnitus treatment begins with prophylaxis. Sound trauma (acoustic trauma), noise and ototoxic drugs (salicylates, nonsteroidal anti-inflammatory drugs, etc.) that may cause tinnitus should be avoided, and blood pressure and sugar should be kept under control. It is necessary to stay away from alcohol, cigarettes, excessive amounts of tea and coffee. Many drugs and various treatment methods, especially acupuncture, have been tried, but there is currently no specific treatment. In recent years, masking treatment has been applied, and although this application does not cure the tinnitus, the patients benefit to a certain extent as they get rid of the disturbing sound of the tinnitus to some extent. Only devices called tinnitus masking can be used for masking. When a hearing aid is used in patients with hearing loss, both masking and tinnitus and hearing loss are treated.
prof. Dr. Mustafa KAZKAYASI
