ear health

Ringing in the Ears

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Key points

Ringing in the ears are annoying, continuous or intermittent noises, perceived in the absence of external sound sources: the ringing in the ears can regress in a short time or constantly torment those affected.

Causes

  • Temporary ringing in the ears → caused by gunshot, loud music
  • Pathological ringing in the ears → can be caused by: neurological alterations (eg multiple sclerosis, head tumor), infections, excessive drug intake, muscle spasms of the ear, otological changes (eg Meniere's disease, otitis, otosclerosis, earwax cap), allergies, hypertension, anemia.

Symptoms

Tinnitus is always symptomatic; what changes is the intensity with which they manifest.

The perceived buzz can indeed be described as: dull, crisp, roaring, pulsating, penetrating, hissing, rustling, tinnitus or whistling noise. Complications → depression, anxiety, sleep disorder

Diagnosis

Although numerous diagnostic tests exist to ascertain the ringing in the ears, it is rather complex to go back to the cause of origin. The most used diagnostic tests are: audiometric examination, movement tests, imaging tests.

Remedies and drugs

The cure for ringing in the ears is possible only when the cause is identified. If this is not the case, the drugs aim exclusively to alleviate the ringing: antihypertensives, antibiotics (in case of infection), antidepressants. Even the careful cleaning of the ears, aimed at removing the cerumen plugs, can alleviate the buzzing.


Definition

The ringing in the ears is the perception of an annoying acoustic noise in the absence of external sound sources. Defined precisely as tinnitus or tinnitus, the ringing in the ears can be continuous or intermittent, penetrating or mild, temporary or permanent; sometimes, the perceived buzz is so intense that it creates a real social unease. Many patients, in fact, harassed by continuous ringing in their ears, describe the disorder with strong and exaggerated similarities: "as if a train were running at full speed in the head". This expression, clearly hyperbolic, best expresses the concept of ringing in the ears in patients constantly tormented by this disorder. In this sense, tinnitus should be considered - albeit improperly - a disease.

In reality, more than a disease, the buzzing in the ears is a common symptom of many diseases: it is a particularly annoying and irritating disorder, which can heavily affect normal daily activities. Despite what has been said, according to the thought of many researchers, the ringing in the ears is "simply" the result of a fantasy, of an abstract image of the brain.

Incidence

Ringing in the ears is a rather frequent disorder, found mainly in males. The British Tinnitus Association estimates that 1 subject out of every 10 suffers from this discomfort: this fact makes us understand how buzzing in the ears is a common problem.

It is observed that 22% of patients suffer ringing complaints in their ears on one side only (unilateral tinnitus); 34% perceive instead a buzz of equal magnitude in both ears (bilateral tinnitus). The remaining 44% report a buzz in both ears, although on one side the noise is more annoying (generally in the left one).

Globally, 10-15% of the population are believed to be whining in their ears.

Among patients with ear disorders in general, it seems that as many as 85% of them also report ringing in their ears.

Older males are the category most exposed to tinnitus risk.

Classification

There is no single form of ringing in the ears; based on the characteristics of the tinnitus, it is possible to distinguish:

  • Subjective tinnitus: only the patient perceives an "imaginary" ringing in the ears. Other individuals do not perceive any noise or buzz, since there is no external acoustic stimulus. The subjective tinnitus is the properly called form of tinnitus.
  • Tinnitus objective: the ringing in the ears is also perceived by other subjects. In this case, there is actually an external source from which a noise, a sound or a hissing originates: the objective tinnitus cannot be defined as a tinnitus proper.

Causes

As evidenced several times, ringing in the ears is not really a disease, rather it should be considered a symptom that reflects an underlying pathology.

In some patients, ringing in the ears is reduced in a short time to disappear completely after a few hours: this is the case of tinnitus caused by a gunshot fired near the ear. Even the resounding music of concerts and discos can cause ringing in the ears, soon reversible.

For other patients, however, ringing in the ears is a permanent discomfort, independent of strong external noise. In similar situations, the cause must be sought more accurately.

What are the causes most involved in tinnitus of pathological interest?

The ringing in the ears of NEUROLOGICAL ORIGIN are due to:

  • multiple sclerosis
  • head trauma
  • ear tumors (eg acoustic neuroma)
  • head and neck cancer

The buzzing in the ears of INFECTIOUS ORIGIN is an expression of:

  • meningitis (infection sustained by meningococcus, pneumococcus or Haemophilus influenzae )
  • syphilis (infection supported by Treponema pallidum )

Ringing in the ears can result from the excessive / prolonged administration of some MEDICINES or substances:

  • alcohol
  • Aminoglycosides
  • Caffeine (abuse)
  • Loop diuretics
  • NSAIDs
  • Cytotoxic drugs
  • Salicylates

The ringing in the ears of MUSCULAR ORIGIN are due to:

  • Ear muscle spasms
  • Muscle spasms with common innervation (masticatory muscles, palate vault muscles)
  • Tension of the spine muscles

Ringing in the ears may depend on OTOLOGICAL ALTERATIONS:

  • Hearing changes
  • Meniere's disease: pathological disorder due to increased fluid pressure in the labyrinth, responsible for deafness, ringing in the ears, nausea, vomiting and dizziness.
  • Acute catarrhal otitis
  • Otosclerosis: hereditary disease involving the ear (often both), characterized by progressive hearing loss due to stiffening of the bone in the middle ear
  • Presbycusis: progressive hearing loss due to inexorable age advancement
  • Ear wax cap: ear wax accumulation in the external auditory canal

OTHER CAUSES

In some patients, the cause of ringing in the ears is to be found in changes in blood circulation (hypertension, atherosclerosis). Only rarely, ringing in the ears is due to allergies or anemic states.