Noise in head / Tinnitus
It is an annoying symptom met frequently. May be intermittant or persistant. May be low or hig pitch. May be heard by other people or by the patient alone. May be with or without hearing loss.
Tinnitus is not a disease alone, it is a result of a problem, disesase. There are many causes of tinnitus.
Hearing mechanism: There are 5 parts in hearing process. Outer, middle, inner ears, hearing nerve pathway and brain.
External ear: Between auricle and tympanic membrane. These structures collect and transmits the sound waves.
Middle ear: Between tympanic membrane and internal ear. Tympanic membrane and three little ossicles take a role here. They transmit and augment the vibrations to the inner ear. Fluid in the inner ear canal is effected by these vibrations.
Inner ear: It is a bony place in which liquid is circulating surrounded by membranes. Movement of this fluid triggers the nerve endings to producing nerve stimulus.
Nervous pathway: Stimulated nerves in the inner ear carries these signals to the hearing centers of the brain.
Brain: Brain evaluates these stimulations and we hear them as different sounds.
Outer ear tinnitus: Earwax, foreign body, swelling of the canal may obstruct the canal. These may effect the membrane also and can cause tinnitus. Venous dilatations around external ear canal may cause pulsative tinnitus.
Middle ear tinnitus: Any kind of problem in middle ear function may cause tinnitus. Any kind of scar tissue can stimulate nerve endings and can cause tinnitus, also venous tissue can cause pulsatile tinnitus.
Inner ear tinnitus: Factors effecting inner ear fluid pressure can cause tinnitus. Allergy, circulatory problems, infection can effect both fluid and membrane surrounding it.
Nerve pathway tinnitus: Nerve pathways are the most delicate organs of the hearing mechanism. A little problem in these nerves effect the hearing. Local infections, allergic edema, toxic effect of systemic diseases, very loud sounds, some drugs and chemicals may effect them.
Brain tinnitus: Any kind of swelling, circulatory problem may cause tinnitus. Mostly these are one sided tinnitus.
Hearing problem: Tinnitus can be with or without hearing problem. This is normal because they are in the same place and related to each other. People with tinnitus are afraid of being deaf, this is an unnecessary fear. Many hearing defficient people do not have tinnitus.
Treatment: If a certain disease is diagnosed as a cause of tinnitus, it is treated accordingly. The followings are adviced if there is no reason found for tinnitus.
1-Since stres can cause and trigger tinnitus try to do your best to get rid of it.
2-Try to find time to to rest.
3-Avoid alcohol, smoking and caffeine intake.
4-Learn that tinnitus is an annoying symptom and try to ignore it.
5-Your tinnitus will not cause you to die or be deaf. Get rid of these thoughts.
6-If you are in a very silent place try to put something around producing sound to feel tinnitus fewer like a clock, music.
7-Place your head above your heart level while sleeping.
8-Some relaxing medicine may help for a short time.
Result: Hearing is a very delicate mechanism. It is related with feelings, anxiety very much.
To be treated, patient should understand the mechanism of tinnitus exactly.