What is tinnitus ?
Tinnitus or phantom sound, sometimes called tinnitus, is a disorder of the acoustic system, accompanied by hearing hissing, whistling, humming or beeps in one or both ears. This observation is done by the sufferer, but not by others (95%). The sound is observed especially when there is no or less ambient noise and can be so loud that the hearing is impaired.
The name comes from the Latin aurium tinnitus, which means' ringing in the ears "means. A term used in the entertainment world is tiny stress.
Tinnitus sometimes occurs in combination with hyperacusis.
Tinnitus causes
Originally, it was assumed that the cause of tinnitus lay in the auditory organ. However, the cause of tinnitus is probably in the brains. Overactive give parts of the brains in the auditory area continuous signals, while the sound is gone ("phantom sound"). For this reason, tinnitus is also compared with phantom pain. About the activity of the brains can be demonstrated by positron emission tomography or functional MRI techniques.
List of possible causes
-Hearing damage from loud sounds is considered very important cause. Tinnitus is a sign of early hearing loss and can occur immediately after a visit to a nightclub. Tinnitus or "ringing stress" is common among young people who go out one evening. At music venues, festivals and clubs often run on a volume of around 100 dB; a volume that can cause after ten minutes already acute hearing loss. Over 15% of young people between 16 and 30 already suffers from a form of permanent hearing damage. Also at high volume listening to music through portable personal audio devices (such as MP3 players) is suspect in this regard. It is important to move to a physician as soon as possible in the case of an audio trauma. If the tinnitus lasts longer than a few days it is necessary to be examined.
-Great emotional stress: traumatic noise (noise associated with trauma), burnout, stress and fatigue, posttraumatic stress disorder, panic disorder and anxiety disorder and depression
-Hearing loss by age
-Trauma to the head (skull fracture), neck, or barotrauma
-Trigger points: A study in 2007 found that in 56% of patients with tinnitus and Myofascial Trigger Points, tinnitus can be modulated by the application of digital compression of these points, especially those of the jaw muscles. The researchers found a strong correlation between tinnitus and the presence of trigger points in the head, neck and shoulder girdle. From: Prog Brain Res. 2007.
-Some ototoxic drugs: acetylsalicylic acid, in particular, containing analgesics (aspirin) are associated with tinnitus. Tinnitus is also a well-known side effect of the antibiotic kanamycin. It reduces the stiffness of the hairs on the hair cells (stereocilia), and thus promotes tinnitus. Diuretics, aminoglycosides, quinine, calcium channel blockers, antihistamines, anticonvulsants and statins can cause damage to the ear.
-After long-term use of benzodiazepines (especially after discontinuation of use, this may occur when withdrawal syndrome)
-Cerebrovascular cause high blood pressure, diabetes and atherosclerosis
-Neurodegenerative causes: Alzheimer's Disease
-Chronic otitis media with fluid behind the eardrum
-Otosclerosis
-Closure of the ear canal by an ear wax, for example, gag, water, or a cotton ball
-Meniere's disease
-Lyme disease
-Inflammation of a wisdom tooth
-A neurinoma
-Surgery on the ear
However, an underlying cause for the occurrence of the tinnitus in 40% of cases can not be found.
Tinnitus prevention
Hearing damage, possibly leading to tinnitus, can be prevented by roughly three measures:
-By an appropriate distance (at least two meters) away from the speakers to continue.
-By the time the ears to be exposed to loud noise as short as possible, for example by regularly taking a oorpauze.
-Most effectively: by using hearing protection. There are eartips with music filter, and customized otoplastics that protect the ear and hearing.
Tinnitus treatment
To date, there is no treatment that is effective for the majority of tinnitus patients. Treatment options are medical, audiological and psychological basis.
-Neuromodulation. Neuromodulatieve noninvasive techniques such as Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (TDCS) seem a promising way to reduce tinnitus. These techniques can modulate the activity of brain cells, thereby over active areas, which cause the tinnitus, can be slowed down. These techniques are safe.
-Tinnitus retraining therapy. This therapy attempts to train the brains so that they ignore the tinnitus. It makes use of sound enrichment and an understanding of the neurophysiological model of Jastreboff to work in habituation to tinnitus hand. For all types of tinnitus masking and habituation can give a positive contribution.
-Infusion Therapy. In Germany, Austria and Switzerland it is customary for decades in acute tinnitus to apply an infusion treatment. The active ingredients of the infusion is an anti-inflammatory drug (prednisolone) and a means to allow blood to flow better through the small blood vessels in the organ of hearing (pentoxifylline). This treatment should be applied as soon as possible after the occurrence of tinnitus, preferably within 14 days. The chance of improvement is greatest and can reach 80%. Tinnitus may disappear by this treatment or reduce. Rest is important during this infusion therapy. Is tinnitus for more than 2 or 3 months ago started then it is called tinnitus and chronic infusion therapy is no longer meaningful.
Hyperbaric oxygen therapy.
Sound Therapy. This external sound is used to divert attention from the tinnitus. Some forms of tinnitus can be treated while other forms untreatable and are permanent. In order to be able to sleep in such cases it may sometimes be necessary in order to prevent silence and to fall asleep with music. Also, a tinnitusmaskeerapparaat can be worn; this is a type of hearing aid that produces a masking sound that diverts attention from the ringing or beeping.
-At auditory stimulation therapy (also called "notched music" therapy) are from the favorite music of the patient the frequencies are filtered out in an octave around the show that as a result of the tinnitus is observed. The assumption is that tinnitusveroorzakende neurons that while playing the edited music get no signal, are muted by neighbouring neurons that are stimulated.
-Medication: at nearly all shapes can some antidepressants, such as amitriptyline (Elavil) and nortriptyline (Pamelor), certain tranquilizers such as alprazolam (Xanax) and light beta blockers like propranolol (Inderal) give peace and outcome.
-Psychotherapy: tinnitus caused by traumatic sound, stress, panic, exhaustion, anxiety and depression can solve the emotional causes through effective psychotherapy work. In the event of damage to the cochlea by ototoxic medications (can be recognised because it temporarily stops at intake of aspirin) is the effect of therapy the least.
-Cortical implants: in different clinics include in Detroit and in Belgium cortical implant performed as a new treatment. It is implanted under the skull an electrode. This gives electric shocks to the over active part of the brains that plays an important role in the development of tinnitus. The intention is that it protects the hyperactivity is suppressed in the brains, so that the tinnitus can reduce or disappear. This form of treatment is for the time being only suitable for people with severe tinnitus which can not be dealt with in a different way, but seems to be especially effective when the tinnitus does not yet exist a long time.
-Pulse Generator: experimental study at the University of Groningen around 2003 showed that treatment of the relevant parts of the brain using a pulse generator (a type of pacemaker) can be successful.
Dietary supplements:
*Zinc: four out of five small-scale studies that have been conducted in this field shows that it has a number of tinnitus patients benefit from a dietary supplement containing zinc.
*Ginkgo biloba: the standardized Ginkgo biloba extract EGb 761 (standardized to 24% ginkgo flavone glycosides and 6% terpene lactones) is effective in the treatment of tinnitus.
*Magnesium: noise exposure causes a magnesium deficiency in the body. Supplementation with magnesium can prevent hearing loss after exposure to noise, but may also improve the research audience of people with hearing loss. Magnesium is an antagonist of the neurotransmitter glutamate, which may play a role in the development of tinnitus.
-Nerve Stimulation: in February 2011 failed Navzer Engineer from the University of Texas in the US and his colleagues managed to cure rats of their tinnitus. After ten days of therapy, nerve stimulation while playing certain notes, the animals showed no signs of tinnitus more. The effects appear to be long-lasting or even permanent. Because of these positive results, the researchers have already begun testing the treatment on humans. These results were published in an article in the influential journal Nature. In a first clinical trial with 10 patients in Antwerp showed this therapy for 4 people to make a significant improvement.
The effects of tinnitus seem to be a patient in some cases eventually to be able to drive suicide; partly because the feeling of powerlessness on the continuous ringing has a paralyzing and strong depressing effect. Evidence for a relationship between suicide and tinnitus was never delivered; other (mental) disorders would appear to underlie the recorded suicide (attempt) and tinnitus patients.