Tinkle - ear noise

Ringing of the ears / tinnitus

The ear noises referred to as ringing in the ears can be traced back to a variety of causes. For example, ear noise occurs as an accompanying symptom of circulatory diseases, blood pressure abnormalities, injuries to the eardrum, inner ear defects, inflammation, Ménière's disease (inner ear disease), metabolic disorders or tumors. Too much mental stress and stress can trigger the subjectively perceived noise. In addition, ringing in the ear can be caused by acute noise, such as during disco or concert visits.

contents

Individual symptoms
Causes of ringing and tinnitus
Causes of subjective tinnitus
Ototoxic substances as the cause of subjective tinnitus
Acute and chronic tinnitus
diagnostic procedures
treatment methods
Treatment in conventional medicine
Tinnitus retraining therapy
Tinnitus treatment with the help of behavioral therapy
Alternative treatments
Massages, excretory procedures and herbal medicine
Nutritional therapies as part of tinnitus treatment
Anthroposophic Medicine, Ayurveda and Aromatherapy
Biofeedback in the context of naturopathic tinnitus therapy
Ozone therapy and orthomolecular medicine
Bach flower therapy

Individual symptoms

Tinnitus is the medical generic term for all ear noises as well as the so-called tinnitus. Since the acoustic perceptions can be side effects of serious illnesses, a regular visit to the doctor is recommended. The focus of the investigation should be on the identification and treatment of possible causes of the ringing of the ears, although many treatments promise to resolve the symptoms without further exploring the causes of tinnitus.

Otolaryngology usually occurs as a subjectively perceived recurrent ear noise, which locates the affected person in one or both ears. However, ringing in the ears can also be perceived more diffusely in the head without a clear assignment to the ears being possible. Relatively often appear as concomitants on a reduction in hearing and dizziness and dizziness. However, the duration and intensity of the ear noises is highly variable, so that the individual burden for tinnitus patients extremely different. A distinction is made in the medical world between a so-called compensated tinnitus and a decompensated tinnitus. In compensated tinnitus, the ear noises are indeed perceived, but those affected can live with them without personal interference - the acoustic perceptions are virtually ignored. By contrast, decompensated tinnitus is perceived as a significant burden by patients, and it threatens far-reaching consequences such as depression, sleep disorders, anxiety and concentration disorders, with effects on numerous areas of life. The trend is that the longer the ear noises stop and the higher the intensity of the acoustic disturbances is perceived, the greater the strain on the person concerned and the risk of further health problems.

Causes of subjective tinnitus

In a subjective tinnitus, the ear noises arise according to current research in the auditory system without the actual acoustic stimuli are present. There are numerous causes for the subjectively perceived rapture of the ears. For example, foreign bodies in the ear canal, inflammation of the ear, diseases of the middle ear (eg ossification of the ossicles, otosclerosis) as well as viral and bacterial infections are responsible for the occurrence of unpleasant ear noises. Also a so-called sound trauma, triggered by massive noise effects, is often accompanied by subjectively perceived tearing of the ears or ear whistles. In addition, a sudden loss of hearing as a possible cause of the burdensome ear noises such as diving accidents or the more rare diseases of the inner ear Meniere's disease, Hydrops cochleae and Endolymphschwankungen. In addition, autoimmune diseases of the inner ear as well as so-called semicircular dehensities, which cause a hypersensitivity to noise and balance disorders, cause the subjectively perceived tinnitus. Tumors of the auditory nerves are also possible causes of the subjective ringing of the ears and in case of deafness (hypacusis) subjective tinnitus can occur as a kind of phantom pain. Tension in the cervical and temporomandibular muscles occasionally causes ear noises, whereby the lack of movement associated with working on the PC significantly increases the risk of corresponding symptoms. In addition, psychological problems and stress are considered significant risk factors for tinnitus.

Causes of ringing and tinnitus

Numerous causes may cause ringing in the ears, but a distinction must be made between the relatively common subjective and the rare objective tinnitus. While the subjective ear noises are registered only by those affected, objective tinnitus noises are based on an externally perceptible or at least measurable body-own sound source. The possible causes of objective tinnitus are relatively manageable. Vascular malformations, soft palate tympanitis (soft palate disorder) and tube dysfunction are the most common cause of the actual ear noise.

Ototoxic substances as cause

Tinnitus can also be caused by numerous so-called ototoxic drugs and substances (ototoxicity = "ear toxicity"), which have a destructive effect on the inner ear. Above all, the sensory cells of the hearing and balance organ and the associated nerve in the brain are attacked by the ototoxic substances. The ototoxic substances include some antibiotics, cytostatics, diuretics, quinine (also contained in "bitter lemon" and "tonic water"), salicylates such as the active ingredient in aspirin (acetylsalicylic acid) and proton pump inhibitors (omeprazole). Various solvents also contain ototoxic chemicals. In addition, lead, cadmium, mercury, arsenic, carbon disulphide, carbon monoxide and cyanides are harmful to hearing.

Acute and chronic tinnitus

In addition to distinguishing the buzz from the ears according to objective and subjective perception, tinnitus in Germany is subdivided on the basis of experience in acute and chronic tinnitus. From acute tinnitus is therefore the speech when the ear noises occur for a maximum of three months. If the symptoms persist for more than three months, there is chronic tinnitus. While in the acute phase the tinnitus recedes relatively often without further treatment, the chances of recovery after a transition into the chronic phase are considerably worse. Without appropriate therapy, the unpleasant ear noises can accompany patients for years and become a significant psychological burden, which brings with it further health problems. Since the treatment prospects are higher the sooner the therapy is started, an ear, nose and throat doctor (ENT specialist) should be consulted no later than one to two days after the onset of the ear whistle in order to obtain a first diagnosis.

diagnostic procedures

First, a detailed examination of the ear, nose and throat should be done, which is used to exclude possible pre-existing conditions such as ear infections, sinusitis or snuff-related ventilation disorders of the Eustachian tube as causes of the ringing of the ears. The ENT specialist then tests the patients' sense of balance and uses a tuning fork to check their hearing. When checking the hearing, it is also possible to determine which tones are perceptible for the tinnitus patients. In addition, the so-called audiometric examination provides clues about the perceived volume of the buzz and the severity of the disease. It may be followed by blood tests, X-rays, Doppler sonography or magnetic resonance imaging to rule out further diseases as a tinnitus causer. A psychoanalytical evaluation of the symptoms also makes sense, in order to determine possible psychological reasons of the tinnitus. Because tinnitus can be caused by countless factors and often a causally oriented treatment that addresses the causes of the disease and not the symptoms, promises better healing prospects, the exact diagnosis of tinnitus is particularly important.

Treatment methods for tinnitus

According to the possible causes of tinnitus there are many promising treatment methods. However, very few of them are clearly scientifically proven and there is no universally valid therapy for correcting the acoustic perceptions. The treatment methods should not only be adapted to the individual causes but also to the clinical picture (acute / chronic). Thus, acoustic stimulation methods, behavioral therapies, drug therapies, physiotherapy and even surgical procedures for the treatment of tinnitus are used. However, the chances of success are extremely different and are directly related to the possible causes of the tinnitus.

Conventional treatment

The conventional medical approach to the treatment of acute tinnitus in this country usually provides a medication with glucocorticoids (eg cortisone), magnesium, vitamin E supplements, intravenously administered local anesthetics and circulation-promoting agents. This is primarily intended to ensure a better circulation and oxygenation of the ear, since it is assumed that the acute tinnitus is a result of circulatory disorders of the small inner ear vessels. With this drug treatment can be achieved relatively often in the acute phase of tinnitus treatment success, but so far there are no scientific studies that confirm the success of tinnitus therapies, taking into account possible placebo effects. Thus, the treatment success could also be attributed to the placebo effect.

If oysters occur as a chronic disease, however, the drug treatment are usually ineffective anyway. Earlier, conventional medicine therefore resorted to such drastic measures in severe chronic tinnitus as the transection of the auditory nerve, but due to the low success rate such interventions are no longer performed today. Instead, physicians, for example, rely on hearing aids that cover the ears around and make it imperceptible to patients. In addition, various studies are currently investigating whether transcranial magnetic stimulation of certain brain areas can bring about relief of tinnitus. Thus, the brain areas that are altered in activity in tinnitus patients are stimulated by magnetic impulses to correct the acoustic perceptions. In addition, the use of brain pacemakers for the treatment of severe chronic tinnitus is in the testing phase.

Tinnitus retraining therapy

In addition, conventional medicine uses methods such as tinnitus retraining therapy, behavioral therapies or relaxation exercises to treat chronic tinnitus. In the case of tinnitus retraining therapy, for example, patients should learn to no longer perceive the noises as unpleasant. The processing of tinnitus in the central nervous system and conscious perception form the center of therapy. The actual causes of the ringing of the ears, however, are not examined further in the retraining method. At the beginning of the Tinnitus Retrainig are in this country advice and information, with the patients should learn everything about the disease. Thereafter, hearing therapies are used in which the persons affected are regularly exposed to acoustic signals and train their brains in their handling of the perception of noise. In addition, there is an accompanying psychotherapeutic care of tinnitus patients, which also aims to facilitate the handling of the acoustic perceptions. As part of psychotherapeutic accompaniment, patients should also acquire tinnitus-preventive behavior such as exercise or relaxation exercises (eg, autogenic training).

Tinnitus treatment with behavioral therapy

The cognitive behavioral therapies are mainly used in patients with severe chronic tinnitus; Several representative studies show clear treatment success. However, even in cognitive behavioral therapy tinnitus per se is not resolved, but merely influences the perception of the unpleasant ear noises. Cognitive-behavioral therapy was initially used primarily for the treatment of depression, but later transferred to other diseases where cognition is considered to be of major importance. Cognition means mental processes of information processing, of cognition, comprehension, judgment and perception. In the treatment of tinnitus with cognitive behavioral therapies, the mental perception and processing of the ear noises is specifically altered, so that the patients ideally no longer feel that they are unpleasant or disturbing and that the impairments in everyday life can be minimized.

Alternative treatments

As alternatives to the often costly conventional medical treatment methods, there are numerous therapeutic options in the field of natural remedies and homeopathy, which promise similar success with significantly lower costs and side effects. Many of these methods are now also taken over by the health insurance companies. Before the actual treatment can begin, however, in the context of amnesia, to determine possible causes of the outer ringing. Subsequently, appropriate treatment methods are initiated, whereby in case of doubt, a referral to specialists of the respective field is necessary. Psychotherapeutic treatments, which on the one hand serve to work through existing mental health problems and on the other hand avoid stress and coping, are relatively often part of tinnitus therapy. In particular, stress-related tinnitus should be significantly reduced or completely avoided by relaxation methods such as yoga, tai chi or autogenic training.

Massages, excretory procedures and plants

If muscle tensions or back pain in the area of ​​the cervical spine cause tinnitus, naturopathy also uses massages, physiotherapy and acupuncture for treatment, but with extremely different degrees of success. The same applies to homeopathy, which often plays a significant role in naturopathic tinnitus therapy and in the administration directly on the various forms of tinnitus (unilateral, bilateral / acute, subacute, chronic / pitch and Tonintervalle) and the possible causes (stress , Noise, diseases).

The humoral therapy or the so-called Ausleitenden procedures are also used for the naturopathic treatment of the outer ringing. The detoxification and detoxification therapies are designed to purify the blood and cleanse the body of harmful substances. In addition to the classic bloodletting, the use of leeches, the Baunscheidtherapie (not uncontroversial irritation of the skin with a needle device), wrap, sweat cures and cupping (glass jars, which are placed with the opening on the skin and heated) in question.

Also, the herbal medicine (phytotherapy) is attributed special importance in the naturopathic tinnitus treatment. Thus, for example, the substances contained in the Ginko cause a relief of the Ohrensausens, but also the concomitant administration of melissa, hops and valerian preparations is often part of the holistic treatment approach of naturopathy. The same applies to the metabolism-promoting plants such as artichokes, nettles, dandelion or milk thistle, which are used in herbal medicine for the detoxification of the body.

nutrition therapies

The diet is also attributed in natural medicine a significant importance in the development of the Ohrensausens. Since it is assumed that a hyperacidity of the organism may be the cause of the louse, non-medical practitioners use appropriate nutritional therapies to regulate the acid-base balance in the body. In the context of tinnitus therapy, a vegetarian diet is also prescribed more frequently. Furthermore, various nutritional therapies recommend a significant reduction in the intake of acidifying foods such as animal proteins (meat, sausage, fish and eggs), milk and dairy products, soy products, dough and pastry, sweets and carbonated beverages. Caffeine (coffee, cola), alcohol and nicotine are also to be avoided as much as possible. In addition, in natural medicine is often a renunciation of synthetic food additives such as preservatives, dyes and flavor enhancers (glutamate) recommended to avoid acidification of the organism. Since stress can also upset the acid-base balance, the nutritional therapies in naturopathic treatment are often coupled with appropriate behavioral therapies and relaxation exercises. As part of the nutritional therapies is usually recommended a full-fledged, vitamin, mineral, antioxidant-rich diet with high fluid intake - ideally as herbal tea or carbonated mineral water.

Anthroposophic medicine, Ayurveda, Aromatherapy

In addition to the comprehensive catalog of treatments used by naturopathy in tinnitus therapy are methods of anthroposophic medicine and the traditional Indian healing art Ayurveda. The treatment methods focus not only on possible physical causes of the tinnitus, but also consider mental, emotional and spiritual factors.

Furthermore, some naturopaths recommend aromatherapy for tinnitus treatment. The therapists use essential oils, which are assumed to have a health-promoting effect, usually for external use in massages. However, the oils can also be used at home for inhalation or application to certain parts of the body (eg pulse, elbow, temples). However, the chances of success of the aromatherapy in the treatment of the Ohrensausens are rather low compared to the other naturopathic treatment methods.

Biofeedback in the context of naturopathy therapy

Another method that is used relatively frequently in naturopathy for tinnitus therapy is biofeedback. In this case, the patient with image or tone-giving process feedback on presumed intentionally uncontrollable physiological parameters - such as heart rate, respiratory rate, temperature, skin resistance, muscle relaxation or brain function (neurofeedback) - reimbursed. As part of the therapeutic support, the patients learn to independently regulate the decisive parameters through appropriate exercises or to counteract possible derailments. With the help of the therapist's instructions the influence of behavior, thoughts and feelings on the various parameters as well as a beneficial reaction to it is learned very quickly, so the basic idea of ​​biofeedback. In the end, the learned reactions should integrate as an automatic physiological reaction. Naturopaths report that in patients with tinnitus biofeedback - in addition to the general health-promoting effect of regulating the physiological parameters presented - also produces a kind of distraction effect, which can contribute to a significant relief of symptoms. Because those affected focus on the body functions shown and try to influence them specifically, so they pay less attention to the tinnitus.

Ozone therapy and orthomolecular medicine

If inner ear diseases are suspected as the cause of the tinnitus, lymphatic drainages are also used in natural healing in order to eliminate possible lymphatic blockages (lymphostases) through the gentle massage of the lymphatic drainage tubes of the ear, thus avoiding the unpleasant acoustic sensations. In addition, measures of orthomolecular medicine in tinnitus therapy are used to this day, although the treatment of the tinnitus with the high-dose administration of vitamins and minerals is highly controversial among medical professionals. Because the reports of experience, which describe a relief of symptoms, are facing scientific studies, which prove that the excessive intake of vitamins and minerals used can lead to significant health problems. Tinnitus treatment using ozone therapy is also controversial, with up to 200 milliliters of blood usually being taken from patients as part of their own blood therapy, then enriched with an ozone-oxygen mixture and injected back into the patient. The ozone is said to kill off bacteria, fungi and viruses and improve blood circulation, but there are serious side effects that can cause serious health problems.

Bach flower therapy

Occasionally, the Bach flower therapy is used in the treatment of the outer ringing, but so far there is no scientific evidence for a possible therapeutic success. According to the principles of the British physician Edward Bach are in the context of therapy, the negative mental states, which are to be the cause of all diseases and diseases, determined and used various flower essences to correct the mental balance disorders. In the 1930s, Edward Bach contrasted a total of 38 disharmonic states of mind with 37 different flower essences and a tincture of rock spring water, which were intended to harmonize. Although in several scientific studies no effect of Bach flower therapy could be demonstrated, which went beyond a possible placebo effect, there is little against the use of flower essences for the treatment of tinnitus, as no potentially harmful side effects are known.

All in all, naturopathy offers numerous methods for the treatment of the outer ringing, the effect of which could not yet be proven clearly scientifically. But in the end, the outcome counts for the patient, and whether this is due to a placebo effect or the treatment method used is of secondary importance. (Fp)

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