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19.05.2015

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Constant noise in the head -- such as ringing in the ears -- rarely indicates a serious health problem, but it sure can be annoying. Almost everyone has had tinnitus for a short time after being exposed to extremely loud noise. Sound waves travel through the ear canal to the middle and inner ear, where hair cells in part of the cochlea help transform sound waves into electrical signals that then travel to the brain's auditory cortex via the auditory nerve.
Tinnitus can arise anywhere along the auditory pathway, from the outer ear through the middle and inner ear to the brain's auditory cortex, where it's thought to be encoded (in a sense, imprinted). Musculoskeletal factors — jaw clenching, tooth grinding, prior injury, or muscle tension in the neck — sometimes make tinnitus more noticeable, so your clinician may ask you to tighten muscles or move the jaw or neck in certain ways to see if the sound changes. If you're often exposed to loud noises at work or at home, it's important to reduce the risk of hearing loss (or further hearing loss) by using protectors such as earplugs or earmuff-like or custom-fitted devices.
In addition to treating associated problems (such as depression or insomnia), there are several strategies that can help make tinnitus less bothersome. The most common types of tinnitus are ringing or hissing ringing and roaring (low-pitched hissing). Tinnitus is usually static noise in the auditory system that is associated with loss of sound from the external environment. If a specific cause for tinnitus is determined, it is possible that treating the cause will eliminate the noise.
The American Hearing Research Foundation is a non-profit foundation that funds research into hearing loss and balance disorders related to the inner ear, and to educating the public about these health issues.
For many, it's a ringing sound, while for others, it's whistling, buzzing, chirping, hissing, humming, roaring, or even shrieking.
When hair cells are damaged — by loud noise or ototoxic drugs, for example — the circuits in the brain don't receive the signals they're expecting.


Things that cause hearing loss (and tinnitus) include loud noise, medications that damage the nerves in the ear (ototoxic drugs), impacted earwax, middle ear problems (such as infections and vascular tumors), and aging.
Pulsatile tinnitus calls for a thorough evaluation by an otolaryngologist (commonly called an ear, nose, and throat specialist, or ENT) or neurotologist, especially if the noise is frequent or constant.
Masking devices, worn like hearing aids, generate low-level white noise (a high-pitched hiss, for example) that can reduce the perception of tinnitus and sometimes also produce residual inhibition — less noticeable tinnitus for a short time after the masker is turned off. Other treatments that have been studied for tinnitus include transcutaneous electrical stimulation of parts of the inner ear by way of electrodes placed on the skin or acupuncture needles, and stimulation of the brain using a powerful magnetic field (a technique called repetitive transcranial magnetic stimulation, or rTMS).
Persons who experience tinnitus should be seen by a physician expert in ear disease, typically an otolaryngologist. For many people with tinnitus, the sound is usually masked, or covered up, when there is a usual level of noise in the environment.
A review by Smith (2005) concluded that high quality clinical trials do not support the use of ginko, although earlier trials found it beneficial. Tinnitus can also be a symptom of Mnire's disease, a disorder of the balance mechanism in the inner ear. She or he will also ask you to describe the noise you're hearing (including its pitch and sound quality, and whether it's constant or periodic, steady or pulsatile) and the times and places in which you hear it. If you have age-related hearing loss, a hearing aid can often make tinnitus less noticeable by amplifying outside sounds. The aim is to habituate the auditory system to the tinnitus signals, making them less noticeable or less bothersome. Today, the term TRT is being used to describe modified versions of this therapy, and the variations make accurate assessment of its effectiveness difficult.
The most common causes of tinnitus are damage to the high frequency hearing by exposure to loud noise or elevated levels of common drugs that can be toxic to the inner ear in high doses.


Your clinician will review your medical history, your current and past exposure to noise, and any medications or supplements you're taking. A blood vessel may be close to the eardrum, a vascular tumor such as a glomus tumor may fill the middle ear, or a vein similar to a varicose vein may make enough noise to be heard. Tinnitus may be heard when there is a temporary conductive hearing loss due to ear infection or due to blockage of the ear with wax, or may be associated with any other cause of conductive hearing loss.
Transelectrical nerve stimulation (TENS) is the application of a small electrical force to the skin near the ear, in an effort to affect the cochlear nerve. The resulting electrical noise takes the form of tinnitus — a sound that is high-pitched if hearing loss is in the high-frequency range and low-pitched if it's in the low-frequency range. A device is inserted in the ear to generate low-level noise and environmental sounds that match the pitch, volume, and quality of the patient's tinnitus. Masking of the sound by providing noise from the outside was a popular area of focus in the treatment of tinnitus for several years, but has not proven long-term to be the solution to cure that was hoped. Some permanent damage to the delicate hair cells in the inner ear has probably occurred from the noise trauma, so it is important that you prevent further injury from noise exposure. For example, the carotid artery (the main supply of blood to our brains) runs right next to the inner ear and yet we usually do not hear the pulse or heart sounds that are carried in the artery.



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