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Ringing in the ear symptoms, causes and treatment
contents
- Trigger of ringing in the ears
- Subjective and objective tinnitus
- Causes of subjective tinnitus
- Causes of Objective Tinnitus
- What does brain research say??
- What happens with tinnitus in the brain??
- Psychic episodes of earbuds
- Which doctor is responsible?
- Treatment with ringing in the ear
- Which medications are suitable?
- Earbuds stop by relaxation
- music therapy
- Coping
- prevention
- Self-help with ringing in the ear
Trigger of ringing in the ears
Many sufferers notice that their mood affects the course. Stress, a mental crisis or tension cause the sounds to be stronger. If they are fine, the noise level will decrease. In some cases, sports amplify the ringing in the ear, while in others it is weakened by movement.
Ringing in the ears can be very uncomfortable for those affected and considerably limit the quality of life. (Picture: Picture-Factory / fotolia.com) Subjective and objective tinnitus
Scientists distinguish between an objective and a subjective tinnitus. An objective tinnitus is an actual sound in the body, for example flowing blood. There is no real noise in subjective tinnitus.
99% of those affected suffer from subjective tinnitus. The neuroscientists agree that such a ringing in the ear does not occur in the ear, but by a disruption of nerve cells in the brain. An ENT specialist determines what type of tinnitus is present.
Causes of subjective tinnitus
Subjective tinnitus is a collective term for a symptom that can have multiple causes. These include:
- Sudden Hearing Loss
- Sonic trauma, for example, by noise at a concert, an explosion or a bang
- Foreign body in the ear canal
- ear infections
- Viruses and bacteria
- chronic middle ear infection
- Diseases of the cardiovascular system
- Diseases of the central nervous system
- decompression sickness
- kidney disease
- Autoimmune disorder in the inner ear
- muscle disorders
- Disorders of the cervical spine or temporomandibular joint
Causes of Objective Tinnitus
The much rarer objective tinnitus has causes in malformations of the vessels, blood sponges, disorders of the soft palate and the tube functions, tumors in the middle ear and changes in the blood flow of the jugular veins.
What does brain research say??
Traditionally, subjective tinnitus was considered a problem of the inner ear. But it turned out that this remains even when the auditory nerve is severed. The ear ringing has nothing to do with "false hearing", even if those affected "hear" something that is not there.
The human brain is extremely complex. In tinnitus sufferers, the events of the nerves in different regions of the brain are now changing. The normal balance between excitement and braking in the nerve centers that control the hearing is disturbed. Thus, these centers activate the nerve cells even without real sound sources.
Tinnitus is thus the hearing variant of phantom sensations and phantom pain, in which the nerves also become active without real stimuli existing.
Although the trigger of a subjective tinnitus is often a hearing loss, but the cause of disturbed perception lies in the brain.
If some of the fine cells of the cochlea are damaged, the transmission of sound signals to the brain no longer works properly. (Image: Henrie / fotolia.com) What happens with tinnitus in the brain??
Our inner ear has different sensory cells. Those at the beginning of the cochlea perceive the high frequencies, those at the end of the cochlea the deep ones. Now if the cells at a certain place in the snail damage, then send these weaker or no signals to the primary auditory cortex.
The brain responds when the nerve cells of the auditory cortex receive too weak signals and restructures the connections between the nerves. The tinnitus without real noises arises because this "repair" fails. The affected nerve cells change their connection to the neighboring cells faulty: they are now acting too high and firing synchronously. Thereby we hear sounds that do not exist in the outside world.
With such overactivity, it becomes clear that psyche and body can not be separated in humans. An anxiety disorder, stress and inner restlessness can lead to subjective tinnitus, or reinforce an existing ringing in the ear. The latter happens much more often.
Tinnitus sufferers are aware of the vicious circle that ringing in the ear causes them mental problems, and that the psychological problems in turn amplify the ringing sounds. Many suffer from sleep disorders, can concentrate poorly and have symptoms of depression.
Sleep disorders are particularly common: while we concentrate (in the wake of everyday life) on the outside world, we are thrown back to falling asleep on our body and the semi-as well as unconscious activity of our brains. Everyone knows the feeling of toothache or headache, that the pain torments us now "unfiltered". It is similar in subjective tinnitus. During the day we more or less ignore the noise, because we constantly deal with other things, in bed, when we close our eyes, the ear ringing beats us pure and disturbs us so that we can not fall asleep.
Those affected are prevented from falling asleep by ringing their ears. (Image: bmf-foto.de/fotolia.com) Psychic episodes of earbuds
Specialists have extra questionnaires to record the severity of the psychological effects of ear noises. One problem is the social environment. Tinnitus is not visible like migraine or depression. Non-Hispanic people, who also have no medical knowledge, often see those affected as simulants.
In addition, the (first) trigger for ringing in the ear is often an acute psychological burden, a relationship crisis, chronic stress or a burnout syndrome. Since those affected are psychologically struck anyway, little sensitive contemporaries quickly come to the verdict "the (or) yowls around again, this is nothing serious, the (or) tries again to attract attention ..."
Or they put tinnitus in the existing mental health problems. For example, if the sufferer suffers from an anxiety disorder, borderline syndrome, or bipolar disorder, it is likely that the patients will feel the ringing just as much as the perceived threats to the outside world that their fear fantasies have plotted against them. However, those affected really hear the sounds, even if they are not real, just as someone who sees double images actually sees them.
The majority of tinnitus patients develop no psychosocial disorder due to the annoying sounds. However, every twentieth person affected receives significant psychosocial problems during and through the disorder, which extend into all areas of life. These range from incapacitation to the failure of love relationships.
Some sufferers withdraw socially. In social relationships, they can not concentrate on the other person's ears and react irritably without wanting to do so. Tinnitus itself limits the ability to talk. The sounds are often associated with deafness, those affected can hear worse, making it harder for family, friends and acquaintances to support them. The ringing in the ear hinders social contacts, which in turn would be necessary to psychologically stabilize the patients.
The danger of subjective tinnitus is that it not only presents itself as a disorder, but can also cause other disorders, from uncontrolled mood swings to increased anxiety, malaise and fatigue and the associated consequences of chronic sleep deprivation.
Which doctor is responsible?
First contact point is an ENT doctor. You should visit it especially when the sounds are first heard and stop for more than 24 hours. If you suffer from hearing loss or even dizziness, you should go to a doctor immediately.
The ENT specialist determines the cause of the ear noises through a patient interview, in which he informs himself about possible triggers and examines the auditory canal. If there is a basic disease, it must be treated.
For ear noises that last for the first time and more than a day, you should definitely visit an ear, nose and throat doctor. (Image: Alexander Raths / fotolia.com) They should go to the doctor, because only this can recognize whether it is really a tinnitus. The cause can be harmless: Ringing in the ears can occur, for example, with a cold or a middle ear infection, even with a cold. Then they usually pass away with the infection.
For ENT examination comes a hearing test, the patient recognizes on an audiometer, how loud the noises are in the ear. With a tympanogram, the doctor checks how the muscles in the middle ear, the tapping pressure and the ossicles work. A high performance microphone shows if there is a disturbance of the inner ear.
You do not have to go to a doctor when the ringing in the ear for a specific trigger occurs and disappears quickly. Were you with a Motorhead cover band yesterday and not only blaring their skulls, but singing in their ears? If the ringing sound is over in the evening, you do not have to go into treatment, but next time you might think of not standing next to the speakers.
Treatment with ringing in the ear
Tinnitus can only be treated in combination. Medications are just as important as stress reduction exercises, relaxation techniques, and coping skills. In acute tinnitus, high-dose cortisone or blood circulation enhancing agents are the first choice to push nerve cell reorganization.
If the symptoms already last for months, on the other hand the coping training is in the foreground. As in the case of chronic migraine or chronic pain, the primary concern here is to live in the ear with the burdening ringing sounds.
This succeeds in many sufferers. They live with the background noise, just as people get used to the tram in front of their bedroom over time.
Which medications are suitable?
In addition to cortisone, antibiotics are required as the cause of inflammation. In an acute hearing loss, for example, there are funds that promote the blood circulation.
Earbuds stop by relaxation
Stress is one of the most important triggers for subjective tinnitus, stress additionally amplifies the perception of sounds, and these in turn trigger stress. Therefore, stress therapy is inseparable from tinnitus treatment.
Those affected are well advised to learn techniques to reduce stress. Massages, saunas and especially long walks in nature - especially in the forest - serve this purpose.
Regular forest walks are a good way to reduce stress. (Image: vvvita / fotolia.com) If the stress in turn with basic mental disorders such as general anxiety disorders, mood disorders, depression or bipolar tendencies or a borderline syndrome, then it is not done with self-treatment, but a psychotherapy is announced. In order to reduce stress, a behavioral therapy is particularly suitable. There you will learn to avoid the triggers that cause stress, and which are almost always only partially aware of those affected.
A classic, for example, are people who want to be perfect in every area and in any area, thereby permanently overburdening themselves, exposing themselves to stress because they can not satisfy these unattainable demands and then blame themselves for their tinnitus.
Targeted breaks, coupled with a passionate occupation, effectively prevents stress and keeps the ringing in your ears in check: For example, if you set up a rock garden or restore old bikes to new splendor, then do not concentrate on the sounds and her brain does not focus on them for a while.
Decisive is doing, it's less about what they do. When your thoughts revolve around tinnitus, you perceive it more consciously. An exciting novel, an unfinished work, washing dishes, sorting old letters - all that keeps them from concentrating on the ringing in their ears.
music therapy
In tinnitus, a music therapy helps. Because music sets itself above the frequencies of tinnitus, it does not even have to be "louder". Just as people whose apartment is located directly on a high street, let the radio run during the day, so as not to concentrate on the traffic noise, you can also push the internal noise aside.
If the symptoms are based on severe brain and nerve disorders, the music therapy is not very successful. However, with "ordinary" tinnitus ringing in the ear is the only nerve disorder. Our brains work selectively: when we listen to the couple's conversation in a cafe two tables further, then the brain fades out other sounds that are objectively louder.
An ENT doctor or an acoustician now determines the frequency of her tinnitus. You can search for music on an app that filters out certain frequencies, and they are no longer aware of the internal sounds. This not only helps in the acute situation, but the ringing in the ears generally relieves.
It is important that you like the respective music. Because a positive experience promotes the reprogramming of the brain to a better hearing.
Listen to the appropriate tracks regularly with headphones in an environment that does not bother anyone for four months.
The music is a learning therapy. Our brain is not a static organ but constantly changes its connections. The tinnitus itself is nothing more than such a connection, and this connection can also change the brain as it represses memories and brings others to consciousness.
Music can bring about a general relief of tinnitus. (Image: Syda Productions / fotolia.com) Coping
If tinnitus persists, then cognitive-behavioral therapy is required, either on an outpatient basis or in a clinic. In this you will learn which emotions amplify or weaken the ear ringing. They learn to redirect their attention through acoustic stimulation.
They learn practical techniques to move the sounds away. These include fantasy as well as dream travel as well as psychoactive role play and change of perspective. For example, imagine they were looking at their tinnitus from the outside, "knock it off," scold him, make fun of him, or put him in other contexts. Some patients even write narratives in which the ear noise plays a role.
They learn to fight for freedom when the ringing in the ears takes up a lot of space. Some patients literally hear the tormenting noise: they jog around the city park, or they sit on their bicycles and race across the fields. Protect your ears and do not expose them to loud noises or drafts.
prevention
The causes of subjective tinnitus can be manifold, and not all can be avoided. However, you can generally avoid a lot of noise and stress, in addition you can learn to handle stress.
Self-help with ringing in the ear
For most tinnitus disorders, you can not remedy the cause yourself, and often not even the doctor can because the center can not be treated directly. Keep your ear away from loud noises and avoid sudden breezes. If the symptoms persist, seek help. (Dr. Utz Anhalt)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)