How much do you know about tinnitus?

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The word "tinnitus" comes from Latin, which refers to the subjective feeling of hearing a buzzing or sound in the absence of any external sounds. It can affect one or both ears or cause a person to hear sounds inside the skull. It may be continuous or intermittent. Tinnitus can have different tones and can have one or more types of noises (such as buzzing or ringing). Tinnitus can affect people of all ages. It is a symptom of auditory system dysfunction, which may occur from lesions in the outer ear, middle ear, inner ear, auditory nerve, central auditory pathway to the auditory cortex of the brain.


How much do you know about tinnitus?


What is tinnitus?

Tinnitus refers to the subjective feeling of sound in the ears or head when there is no sound source in the outside world. Tinnitus has various manifestations, such as buzzing, hissing, electric current, cicada chirping, telephone ringing, etc. It can be unilateral tinnitus, bilateral tinnitus or cranial ringing. Tinnitus can be continuous, intermittent or pulsatile. According to whether there is a sound source, it can be divided into subjective tinnitus and objective tinnitus. Objectivity refers to the true sound of internal biological origin, which is transmitted to the ear through the body's own tissues. Sources include: blood vessel pulsation, pulse sound, middle ear muscle spasm, Eustachian tube or soft palate movement sounds. Tinnitus can sometimes be heard when the examiner puts the stethoscope to the ear, which is also called other-aware tinnitus. In contrast, subjective tinnitus is an hallucination of auditory perception in which objective sounds cannot be recognized and only the patient can hear the tinnitus. This type of tinnitus is the most common. The tinnitus mentioned in this article mainly refers to subjective tinnitus.


What are the common causes of tinnitus?
①External ear lesions: common in external auditory canal cerumen embolism, foreign bodies, boils and tumors;
②Middle ear lesions: Eustachian tube lesions, acute and chronic otitis media, tumors, etc., can also be seen with tympanosclerosis and Intratympanic vascular lesions, etc.;
③Inner ear lesions: Meniere's disease, sudden deafness, otosclerosis, inner ear damage caused by ototoxic drugs, noise, infection, etc.;
④Retrocochlear hearing Systemic lesions: such as acoustic neuroma, cerebellopontine angle lesions, etc.;
⑤Other system lesions: such as hypothyroidism, diabetes, and inner ear concussion caused by head trauma;
⑥For unknown reasons, most patients with tinnitus have No clear cause can be found, and triggering factors related to tinnitus such as mental stress, poor sleep, bad living habits, noise stimulation, diet, etc. may be related to the occurrence of tinnitus.

What are the treatment principles for tinnitus?

Treatment of tinnitusTreatment is divided into etiological treatment and symptomatic treatment. Etiological treatment refers to the treatment of the primary disease causing tinnitus (such as sudden deafness, Meniere's disease, acoustic neuroma, nasopharyngeal cancer, etc.). If tinnitus persists after treating the primary disease and the cause cannot be found, symptomatic treatment is required. The purpose of idiopathic tinnitus treatment is not to eliminate the tinnitus sound. There is currently no specific drug for the treatment of tinnitus because the causes of tinnitus are different and it is impossible to treat all different causes of tinnitus with one drug.
The treatment plan adopts the principle of individualization, and the corresponding preferred plan is selected according to the patient's specific conditions such as the severity of tinnitus.
① It consists of external ear diseases (such as cerumen embolism, foreign body in the external auditory canal, cholesteatoma of the external auditory canal, etc.), middle ear diseases (secretory otitis media, middle ear cholesteatoma, adhesive otitis media, otosclerosis, etc.), inner ear diseases For tinnitus caused by (such as Meniere's disease, auditory neuropathy, sudden deafness, ototoxic drugs, etc.) and retrocochlear diseases (acoustic neuroma, cerebellopontine angle tumor, etc.), active treatment of the primary disease is required.
② For tinnitus caused by diseases other than the auditory system (such as hypertension, thyroid dysfunction, anemia, nasopharyngeal cancer, etc.), attention should be paid to controlling the primary disease.
③ For patients whose tinnitus has seriously disturbed the patient’s normal work, life, and sleep, and who cannot tolerate it, and who develops a series of psychoneurological symptoms, the patient’s neurasthenia or anxiety symptoms must first be treated, and the patient must also be taught Learn the correct psychological understanding of tinnitus. Most tinnitus is characterized by worsening in quiet situations, especially at night. During the day it is mainly ambient noise that acts as a mask. Therefore, tinnitus patients should try to avoid quiet environments and create appropriate background noises such as soft music, the sound of water flowing in a goldfish tank, etc.
④ Most tinnitus patients have mild symptoms and short duration, and are often ignored. The patients do not feel the interference or pain of tinnitus. These people become "tinnitus people" rather than "tinnitus patients". Some patients with tinnitus have a long history and initially feel the tinnitus is severe, but as time goes by, they feel that the tinnitus does not worsen or the tinnitus decreases, and does not affect work, life, and sleep. For these patients, after examination, if no organic disease is found, that is, it is not dangerous tinnitus, tinnitus consultation can be given to the patient, telling the patient that tinnitus is a kind reminder from the body and a sound that does not need to be eliminated, so that the patient can correctly understand it. tinnitus. This is cognitive behavioral therapy, which does not require special treatment.

What should tinnitus patients pay attention to in their daily lives?
Tinnitus is affected by many factors. Tinnitus patients should pay attention to the following issues:
① Have an optimistic and open-minded attitude towards life: Once you suffer from tinnitus, you must first pay attention to it and go to the hospital for examination. Determine whether it is dangerous tinnitus or non-dangerous tinnitus. If it is non-dangerous tinnitus, tinnitus patients should pay less attention to tinnitus, develop hobbies, adjust the rhythm of life, pay attention to regular sleep and healthy diet;
②Avoid noise stimulation, disable ototoxic drugs, smoke less and drink less, etc. ;

③It is necessary to have a correct understanding of tinnitus.Tinnitus is a kind reminder from the body. It does not need to eliminate the tinnitus sound. Eliminate the patient's fear of tinnitus and establish a correct understanding of tinnitus.


The current situation of tinnitus in China

Most epidemiological surveys of tinnitus in China use the diagnostic criteria of tinnitus lasting for 5 minutes or more. A random cluster sample of 1,434 elderly people aged ≥60 years in Beijing was conducted. The prevalence rate of tinnitus was 34%, and the main type was high-pitched tinnitus, accounting for 71.9%. An epidemiological survey of tinnitus was conducted on 28,000 people from nearly 300 natural villages in 12 counties and cities in northern Shaanxi using random cluster sampling and questionnaires. The prevalence of tinnitus was 7.8%, 8.5% for men and 7.0% for women. Among patients with tinnitus, 35.3% had mild tinnitus, 44.2% had moderate tinnitus, and 20.5% had severe tinnitus.

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