[National Ear Care Day] How much do you know about the incessant tinnitus?

What is tinnitus?

Tinnitus is a subjective sensation, which refers to the sound of cicadas, hissing or electric current produced in the ear or brain without external sound or electrical stimulation. The incidence of tinnitus is high worldwide, and the prevalence of tinnitus in mainland China is consistent with the global data (about 16%). It is one of the important health problems in the world, and it is trending towards younger people.

What are the symptoms associated with tinnitus?

Research shows that mood is closely related to the occurrence and development of tinnitus. When tinnitus persists and does not ease or worsens, some patients show negative emotions such as panic and anxiety, part of the brain's nervous system is activated, and negative emotions are further strengthened, forming a vicious cycle of tinnitus-negative emotions-intensified tinnitus. Among them, anxiety and depression are the most common causes of tinnitus.

Sleep is closely related to tinnitus and is an important factor affecting tinnitus. When sleep disorders occur, metabolic waste will accumulate in the brain, affecting brain function and causing tinnitus compensatory disorders. The more severe the sleep disorder, the greater the impact of tinnitus on the patient. Other factors such as hyperacusis, stuffy ears, headaches, personality, stress, social support, etc. may also play a role in the occurrence and development of chronic tinnitus (tinnitus lasting more than 1 year).

How does tinnitus occur?

The occurrence and development of tinnitus is a very complex process, and the specific cause is still unclear, but acute tinnitus is clearly caused by ear damage, and more and more studies have shown that the brain plays an important role in the occurrence of tinnitus.

Classification of tinnitus

The classification of tinnitus is relatively complex, including objective tinnitus and subjective tinnitus. Objective tinnitus is tinnitus that can be perceived by others or recorded by instruments. Because there are specific causes of tinnitus and it can be treated, it is a relatively good type of tinnitus and needs to be distinguished from subjective tinnitus. Subjective tinnitus, which is what we usually call tinnitus, is a subjective feeling. There is no objective sound source and the sound has no meaning. It accounts for the vast majority of tinnitus patients. Subjective tinnitus can be divided into three categories according to the length of the course of the disease: acute tinnitus (tinnitus lasts for less than 3 months), subacute tinnitus, and chronic tinnitus. Sometimes subacute tinnitus and chronic tinnitus are collectively referred to as non-acute tinnitus. It is also necessary to clarify several concepts related to tinnitus. The first is auditory hallucination. This perceptible sound currently belongs to the category of psychiatry and is not discussed, but it should be identified first in clinical practice. The second is noise in the ear, which is a normal physiological phenomenon.

Treatment of tinnitus

There are many treatment methods in modern medicine, including drug therapy, sound therapy, cognitive behavioral therapy and Chinese medicine therapy, acupuncture, massage, acupoint injection, etc. Drug therapy is mainly aimed at acute and subacute tinnitus. Neurotrophic drugs, vasodilators, hormone drugs, anticonvulsants, antianxiety, and antidepressants are commonly used. There are many methods, but there is no specific drug to cure tinnitus. For some subacute tinnitus and chronic tinnitus, comprehensive treatment is also required. Sound therapy is the use of instruments to train sounds, including masking therapy and habituation therapy. Masking therapy refers to the use of methods to improve tinnitus and enhance the adaptability of the human ear to tinnitus by increasing the sound of the surrounding environment; habituation therapy is to use smaller stimulating sounds to patients so that both tinnitus and stimulating sounds can be heard. After long-term contact, patients get used to the sound and then adapt to the tinnitus sound. These two types of sound therapy are the mainstream treatments for chronic tinnitus.

So how do we deal with tinnitus when it occurs?

The complex etiology and unknown mechanism of tinnitus make it difficult to treat. In fact, we can change our thinking. The occurrence of tinnitus is an early warning signal of physical abnormalities. It is an early benign warning: reminding patients to adjust their sleep (whether the time is long enough, whether the depth is enough, whether the mind is clear after waking up), whether they are in a state of anxiety or depression (this can be treated with drugs or psychological adjustments), whether there is acid reflux, heartburn, and otolaryngology diseases, etc., and pay attention to whether there are cranial diseases, malignant tumors, etc. At the same time, pay attention to regulating blood sugar, blood pressure, blood lipids and diet, and reduce menopausal symptoms. Therefore, when tinnitus occurs, a specialist examination should be conducted to understand whether there is any abnormality in the auditory conduction pathway. Of course, all diagnoses and judgments are layered and graded. Some can be solved through consultation, some require specialist examinations to answer, and some require multidisciplinary collaboration. In other words, if you want to significantly solve the problem of tinnitus, there is still a long way to go. It requires the joint efforts of doctors and patients, and the participation of families and society.

(Pictures from the Internet)

About the Author

Zhao Liheng, deputy chief physician of the Department of Otolaryngology , is proficient in the prevention and diagnosis of common and frequently occurring diseases in the Department of Otolaryngology, and can provide corresponding conservative or surgical treatment plans. He has done some research on rare diseases, difficult diseases, and language development.

Visiting department: Otolaryngology

Clinic hours: Thursday all day