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Tinnitus, or noise in the ears is classically described as high pitched ringing or buzzing sound, which is only audible to the affected individual.
Most tinnitus is subjective, meaning the examiner cannot hear it.
The sound may be soft or loud, low or high pitched, and often affects both ears.
Tinnitus is common problem. It significantly affects 1-2 % of general population and much more common in light forms.
The most common causes of tinnitus is noise-induced hearing loss.
For example, an employee who works in a noisy industry loses hearing at the 4000 Hz tone.
Military personnel have a high incidence of tinnitus due to loud explosions and gunfire.
Musicians who are exposed to loud noise get tinnitus also.
Prolonged noise exposure accounts around 22 % of tinnitus. Hearing loss can also be caused other factors like age, age-associated hearing loss is called presbycusis.
another common cause of tinnitus is head and or neck injury. Accounts around 17% of cases.
Around 10 % is caused by infections.
Various drugs are ototoxic to some individuals or at sufficient doses. For example, high doses of aspirin cause tinnitus, and the issue resolves when aspirin is stopped.
Ear diseases cause tinnitus including Meniere disease.
Meniere disease is also associated with dizzy spells, vertigo attacks and balance problems.
Other causes include disease of the heart or blood vessels, brain tumors, acoustic neuromas (tumors on the auditory nerves of the ear), migraines, temporomandibular joint disorders, exposure to certain medications, a previous head injury and earwax.
There is no drug which can treat tinnitus.
current treatment strategy is aimed at controlling underlying disorders and symptomatically suppressing the perception of tinnitus.
Stress Reduction: This includes using biofeedback, measured breathing, etc. Although stress itself is not a cause of tinnitus, as in any condition, stress and anxiety can make the condition worse.
Cognitive Therapy: The more the patient understands what tinnitus is and is not the less negative effect. Once the patient fully cognizes – understands that tinnitus is similar to itching, the symptoms are reduced.
Masking: When the body hears the same sound from the cell phone or sound device, this reduces the symptoms. There are various forms of masking. Essentially these masking sounds take the attention away from the internal tinnitus sound and replace it with relaxing sounds.
Comprehensive management of tinnitus includes assessment of hypertension, blood lipids, thyroid function, allergies and informing patients of factors that aggravate tinnitus, such as stress, caffeine, nicotine, and aspirin.
Hearing aids for presbycusis, cochlear implants for sensorineural hearing loss and cessation of any offending medications are also important components of management.
Neramexane can have some effectiveness against tinnitus. It have nootropic effect also.
Some medications can have small improvements include: combinations of magnesium, alpha-lipoic acid, N-acetyl cysteine.
Medication such as alprazolam can reduce symptoms, but can have adverse effects including habituation.
A hearing aid is always of benefit when tinnitus is associated with hearing loss. Some aids come with built-in soothing or masking sounds.
Anti-depressants may be indicated for patients who do not respond to protocol therapy.
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