The ringing in the ears can be due to a variety of
causes. Noise in the ears occurs, for example, as an accompanying symptom
of circulatory diseases, blood pressure deviations, injuries to the eardrum,
inner ear defects, inflammation, Ménière's disease (disease of the inner ear),
metabolic disorders or tumors. Excessive psychological stress and stress can also trigger the subjectively perceived
noises. In addition, ringing in the ears can be caused by acute noise
exposure, for example when going to a disco or concert.
Individual
symptoms
Tinnitus is the medical generic term for all noises
in the ears as well as the so-called ringing in the ears. Since the
acoustic perceptions can be side effects of serious illnesses, a visit to a
doctor is urgently recommended if they occur regularly. The focus of the
investigate should be on determining and treating possible causes of the
ringing in the ears, although numerous treatment methods promise to remedy the
symptoms without investigating the causes of the tinnitus in more detail.
Ringing in the ears usually occur as a subjectively
perceived recurring noise in the ear that those affected localize in one or
both ears. However, ringing in the ears can also be perceived more
diffusely in the head without a clear assignment to the ears being
possible. Relatively often, accompanying symptoms are reduced hearing as
well as dizziness and drowsiness. The duration and
intensity of the noises in the ears is highly variable, so that the individual
stress for tinnitus patients is extremely different. The medical world
differentiates between so-called compensated tinnitus and decompensated
tinnitus .
With compensated tinnitus, the noises in the ears
are perceived, but those affected can live with them without any personal
impairment - the acoustic perceptions are virtually ignored. Decompensated
tinnitus, on the other hand, is perceived by patients as a considerable burden
and there is a threat of far-reaching consequences such as depression, sleep
disorders, anxiety and
concentration disorders , with effects on numerous areas of
life. There is a tendency to determine: the longer the noises in the ears
and the higher the intensity of the acoustic disturbance is perceived, the
greater the burden for those affected and the greater the risk of further
health problems.
Causes of
Subjective Tinnitus
In the case of subjective tinnitus, the noises in
the ears arise according to the current state of research in the auditory
system - without any actual acoustic stimuli. There are numerous possible
causes for the subjectively perceived ringing in the ears. Among other
things, the following are mentioned here:
- Foreign bodies in the ear canal,
- Inflammation of the ear,
- Diseases of the middle ear (e.g. ossification of the auditory
ossicles, otosclerosis),
- viral and bacterial infections.
So-called acoustic trauma, triggered by the effects of massive noise, is
often accompanied by subjectively perceived ringing in the ears or whistling in
the ears. In addition, a sudden hearing loss is also a possible cause of
the annoying noises in the ear, such as diving accidents or the rare diseases
of the inner ear, Menière's disease, hydrops cochleae and endolymphatic
fluctuations. In addition, autoimmune diseases of the inner ear as well as
so-called semicircular canal dehiscences, which cause hypersensitivity to noise
and disturbances of balance, can cause the subjectively perceived ringing in
the ears.
Tumors of the auditory nerves are also possible
causes of subjective ringing in the ears and in the case of hearing loss
(hypacusis), subjective tinnitus can occur as a kind of phantom
pain. Tension in the cervical spine and the temporomandibular joint
muscles occasionally cause noises in the ears, whereby the lack of exercise
associated with working on the PC significantly increases the risk of
corresponding symptoms. In addition, mental health problems and stress are considered significant risk factors for
ringing in the ears.
Objective
causes of ringing in the ears and tinnitus
Numerous causes can cause ringing in the ears,
although a distinction must be made between the relatively common subjective
and the rare objective tinnitus. While the subjective noises in the ears
are only registered by those affected, objective tinnitus noises are based on
an externally perceptible or at least measurable body's own sound
source. The possible causes for an objective tinnitus are relatively
manageable. The most common triggers are:
- Vascular malformations,
- Soft palate nystagmus (disease of the soft palate)
- and tubal dysfunction.
Ototoxic
substances as the cause
Ringing in the ear can also be cause by numerous
so-called ototoxic drugs and substances (ototoxicity = "ear
toxicity") that have a destructive effect on the inner ear. Above
all, the sensory cells of the auditory and equilibrium organs and the associated
nerve in the brain are attacked by the ototoxic substances. The ototoxic
substances include some antibiotics, cytostatics, diuretics, quinine (also
contained in "Bitter Lemon" and "Tonic Water"), salicylates
such as the active ingredient in aspirin (acetylsalicylic acid) and proton pump
inhibitors (omeprazole). Various solvents also contain ototoxic
chemicals. Lead, cadmium, mercury, arsenic, carbon disulfide, carbon
monoxide and cyanide are also considered to be harmful to hearing.
Acute and
chronic ringing in the ears
In addition to differentiating the ringing in the
ears according to objective and subjective perception, tinnitus in Germany is
divided into acute and chronic tinnitus on the basis of empirical
values. Acute ringing in the ears is therefore when the noises in the ears
occur for a maximum of three months. Chronic tinnitus is present if the
symptoms persist for more than three months.
While in the acute phase the tinnitus declines
relatively often without further treatment, the chances of recovery are
considerably worse after a transition into the chronic phase. Without
appropriate therapy, the unpleasant noises in the ears can accompany patients
for years and become a considerable psychological burden, which brings further
health problems with it. Since the treatment prospects are higher, the
sooner the therapy is started, an ear, nose and throat doctor (ENT doctor)
should be consulted at the latest one to two days after the onset of the
ringing in the ears in order to obtain an initial diagnosis.
Diagnostic
procedures
First of all, a detail examination of the ear, nose
and ears should be carried out, which serves to rule out possible
pre-existing diseases such as ear infections, sinus infections or
rhinitis-related ventilation disorders of the ear trumpet as causes of the
ringing in the ears. The ENT doctor then tests the patient's sense of
balance and checks their hearing with a tuning fork. When checking their
hearing, it is also possible to determine which tones can be heard by the
tinnitus patient. In addition, the so-called audiometric examination
provides clues about the perceived loudness of the ringing in the ears and the
severity of the disease.
Blood tests, x-rays, Doppler sonographies or
magnetic resonance tomographies can follow in order to rule out other diseases
that may cause tinnitus. A psychoanalytical evaluation of the symptoms
also appears to be useful in order to determine possible psychological reasons
for the ringing in the ears. Because tinnitus can be caused by countless
factors and often a causally oriented treatment that addresses the causes of
the disease and not the symptoms promises better healing prospects, the exact
diagnosis of ringing in the ears is of particular importance.
Treatment
methods for ringing in the ears
There are numerous promising treatment methods,
depending on the possible causes of tinnitus. However, very few of them
have been clearly scientifically proven and there is no generally applicable
therapy for eliminating acoustic perceptions. In addition to the
individual causes, the treatment methods should also be adapted to the clinical
picture (acute / chronic). Acoustic stimulation methods, behavioral
therapies, drug therapies, physiotherapy and even surgical interventions are
used to treat tinnitus. However, the chances of success are extremely
different and are directly related to the possible causes of the ringing in the
ears.
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