Ringing in the ears (tinnitus)


What is it about ?

Tinnitus is the medical term for “ringing in the ears”. The auditory organ signals to the brain that there is sound when in reality there is not.

Usually the cause is exposure to excessive noise (e.g. at work, too loud music, explosion or fireworks, gunshot, etc.) But sometimes a condition is the root cause problem, such as otosclerosis (abnormal thickening of the bone in the inner ear that transmits sound in the form of vibrations in the eardrum to the auditory nerve), Ménière’s disease, or an acoustic neuroma (tumor not cancerous hearing nerve). Deafness due to aging can also be associated with ringing in the ears.

In most cases, tinnitus is the result of an injury to the inner ear; the auditory nerve is overstimulated and thus transmits erroneous information to the brain. The brain interprets it as “noise”.

What is their frequency?

Almost everyone in their life experiences a fleeting period of ringing in the ears (eg the ringing in the ears after a concert). In the general population, 1 in 10 people suffer from it permanently. One in 100 people suffer from severe ringing in the ears which affects their quality of life.

How to recognize them?

Ringing in the ears may sound like ringing or hissing, crackling, buzzing, or buzzing. They can go up and down in intensity. Sometimes the buzzing sounds are only heard in a quiet environment. It can therefore be very disturbing when falling asleep, and lead to loss of concentration, increased irritability, depression and reduced quality of life. We also often have the impression that we hear less well.

How is the diagnosis made?

The doctor will check for any other symptoms associated with the ringing (such as dizziness or hearing loss). He will also ask when it started, what are the characteristics of ringing in the ears (what pitch, if they coincide with the heartbeat, how disturbing they are in your daily life, etc.) and what are they? ‘there was a possible exposure to excessive noise. He will also check whether you are taking or have taken any medicines which may affect your hearing.

Then the doctor will examine you: with a otoscope he will inspect the ear canal and eardrum. If you can hear less well, he will try to determine with a tuning fork what type of hearing loss it is and where the problem might be (in the middle or inner ear, left or right). Tuning fork tests are not enough to confirm that you hear “well”. a audiogram lets you know if you can hear all frequencies in both ears. You will be played sounds at different pitches through headphones. The doctor can thus realize the state of hearing.

What can you do ?

Exposure to noise is usually the most common cause of tinnitus; it is therefore important to protect your ears against excessive noise. Use earplugs or some other type of hearing protection when you have to go to extremely noisy environments.
If the risk of noise exposure is too high at work, you can contact the occupational physician to find out what measures can help you prevent hearing damage.

It is often useful to have background noise like, for example, the radio so that the hissing sound is less noticeable. If you wear a hearing aid, you can increase the amplification of the sound in order to mask the buzzing noise.

Support groups for tinnitus patients can give you a lot of support and information.

What can your doctor do?

If you have hearing loss on one side and the origin of this problem is in the inner ear, the doctor will refer you to an otolaryngologist (ENT) to rule out a possible neuroma of the acoustic. Hearing loss due to a problem with the middle ear may indicate otosclerosis. If otosclerosis is suspected, you will also be referred to an ENT doctor. If there is no hearing loss or if this loss is on both sides, there is usually no need to refer to the specialist.

Usually, tinnitus does not get better. The main role of the doctor is therefore to reassure you. It is an annoying condition, but it is harmless. Sometimes certain drugs are offered, although their value has not been sufficiently proven.

If, in addition to ringing in the ears, you suffer from a depressed mood or want to improve your quality of life, your doctor may suggest antidepressants, desensitization training, rehabilitative treatment for tinnitus, or treatment for tinnitus. magnetic stimulation.

In the rare event that tinnitus is the result of middle ear ossification, acoustic neuroma, or vascular abnormality, surgery may be considered.

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Source

Foreign clinical practice guide ‘Tinnitus’ (2000), updated on 06.09.2017 and adapted to the Belgian context on 20.05.2018 – ebpracticenet