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Ear Disorders

Tinnitus: Causes and Symptoms

The word tinnitus tends to scare people. It is difficult for sufferers to describe this phenomenon precisely: a sort of strange parasitic noise in the ear, somewhere between a hissing and buzzing sound, which is sometimes very unpleasant. Very often, its symptoms fortunately stop over time, but it is better to have some information on the subject. Find out here what causes it, how to prevent it from happening and how it might affect your everyday life.

What is Tinnitus?

Tinnitus is a disturbing noise directly in your ear. Tinnitus can manifest itself as a chirping, screeching or buzzing noise that can vary in intensity. It is not a disease, but a symptom of another health problem. There are many ways to prevent or treat tinnitus, for example with the help of white noise.

While some tinnitus can last for months or even a lifetime, others disappear as quickly as they appeared. There are 3 different types of tinnitus:

  • Acute tinnitus lasting on average 3 months
  • Subacute tinnitus lasting from 3 to 12 months
  • Chronic tinnitus when it lasts more than a year

Tinnitus’ categories

This depends on the type of tinnitus. Whether the tinnitus is pulsatile or not, we tend to classify them into two broad categories, the second of which refers to tinnitus that is much more difficult to experience than the first.

  • Compensated tinnitus: compensated tinnitus is a buzzing sound inside the ear that is not very noticeable, as if it were distant or masked.
  • Decompensated tinnitus: more pronounced in its intensity, this type of tinnitus can cause real anguish if it is experienced over a long period of time. People who suffer from it are often afraid that it will get worse and this phenomenon tends to cut them off from their loved ones. Another result is what is known as hyperacusis, i.e. increased sensitivity to other everyday noises around them.

How long does Tinnitus last

While some tinnitus can last for months or even a lifetime, others disappear as quickly as they appeared. There are 3 different types of tinnitus:

  • Acute tinnitus lasting on average 3 months;
  • Subacute tinnitus lasting from 3 to 12 months;
  • Chronic tinnitus when it lasts more than a year.

Tinnitus Causes

Although it is impossible for a health professional to measure this phenomenon during a hearing test and its origins can be multiple, there are two main families:

Subjective Tinnitus

Subjective tinnitus is the term used for tinnitus that is not caused by external sound stimulation, which makes it more difficult to identify the triggering factors. Subjective tinnitus can therefore be caused by different parts of your ear, but also by your nerves or your brain. This type of tinnitus can also occur after a blockage in your ear canal (e.g. earwax plug).

  • It can be caused by a sound trauma, but also by a hearing impairment or so-called presbycusis, i.e. a progressive neuro-sensory loss of hearing. According to some scientists, damage to the inner ear may result in the transmission of sound to the brain being interrupted and the brain itself creating sound to compensate. This results in the patient feeling that he or she can hear a sound in one ear while being deaf.
  • In the middle ear, damage to the eardrum or inflammation could also be a factor.
  • Brain dysfunction caused by meningitis or tumours can also lead to tinnitus, and even if the auditory nerve is severed, the tinnitus persists.
  • Finally, tinnitus can be caused by psychological causes.
Objective Tinnitus

This term is used for tinnitus that is related to another disease identified as Meniere’s disease. This is characterised by dizziness, nausea, tinnitus and progressive hearing loss. This objective tinnitus is usually located in the inner ear. Unlike subjective tinnitus, it can be measured by an ENT doctor using special equipment and then treated or operated on.

  • Vasoconstriction (i.e. reduction in the diameter of blood vessels) of the inner ear usually causes a noise that follows the rhythm of your pulse.
  • Muscle cramps cause the patient to hear a rattling sound.
  • Obstruction of the eustachian tube (small duct from the ear to the nasal cavity) also often causes tinnitus.
  • Problems with the temporomandibular (jaw) joint can cause grinding or crushing noises.

Tinnitus Triggers

There are many potential triggers for tinnitus. Illness, stress or other factors are all possible. That is why it is essential to determine the cause in order to adopt the right treatment. A hearing aid can help.

Stress

Working too hard or having a painful experience can cause tinnitus, which is often one of the first S.O.S your body sends.

Medications

Some drugs can have the undesirable effect of causing tinnitus, in particular those used to combat rheumatism, pain and depression, but also more targeted drugs against malaria or hypertension (e.g. ACE inhibitors or beta-blockers).

Noise pollution

Too much exposure to noise can cause tinnitus. Hearing protection is therefore strongly recommended when working in the construction industry or in a discotheque.

Salt

For a person suffering from tinnitus, it is strongly recommended to watch his diet. Salt and spices in excessive quantities can indeed amplify the interfering noises felt. Although there is no proof, scientists are also looking at glutamate.

Alcohol, drugs, nicotine and caffeine

All of these can cause tinnitus.

Conclusion

As you can see, there are many potential causes of tinnitus and they can be very different. Knowing the source of the problem is therefore crucial if you want to be able to benefit from a suitable treatment. Among the solutions that can be recommended by a health professional are hearing aids, the different types of which we detail for you here.

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Ear Disorders

Which people are most at risk of developing Tinnitus?

Tinnitus can be described as a buzzing, ringing, humming, hissing or chirping sound and can be variable and complex. Objective tinnitus is typically pulsatile (synchronous with the heartbeat) or intermittent. Tinnitus is best perceived in a quiet environment and in the absence of competing stimuli, and thus often seems worse at bedtime.

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Tinnitus can be intermittent or continuous. Continuous tinnitus is at best annoying and often very distressing. Some patients adapt better to its presence than others; depression can sometimes result. Stress usually makes tinnitus worse.

Tinnitus’ risk factors

There are many risk factors for tinnitus: excessive exposure to noise, physical activity, use of certain medications, stress…

  • Excessive exposure to noise
    The inner ear is lined with several thousand hearing cells. These cells are fragile and, once destroyed, cannot regenerate. These cells are equipped with vibratory cilia, whose function is to transmit sound vibration. When loud sounds are perceived by the ear, these cilia lower and then straighten after a while. However, regular exposure to too many decibels (dB) eventually leads to permanent damage to the hearing cells and their vibrating cilia. It can also happen that a single exposure to a particularly violent sound (e.g. the detonation of a rifle or a firecracker) close to the ear causes irreversible damage to the hearing cells. This causes permanent hearing damage and can therefore lead to tinnitus.
  • Physical activity
    Physical activity and head movements increase pulsatile tinnitus.
  • Use of certain medications
    When taken for a long time, certain medications can cause tinnitus. These include: high doses of acetylsalicylic acid, anti-malarials such as quinine, some diuretics such as furosemide, various chemotherapy drugs and some antibiotics.

Note: resistance to the adverse effects of noise and drugs varies greatly from person to person.

  • Stress
    Stress is not a risk factor for tinnitus, but it can increase the perception of tinnitus and thus worsen its impact on quality of life.

People at risk of Tinnitus

  • Elderly people: ageing often causes a deterioration of the hearing mechanisms, which can lead to the appearance of tinnitus;
  • Men: they are more affected than women by this type of symptom;
  • People exposed to noise:
    • people working in an industrial environment;
    • truck drivers and all those whose profession requires them to use a car frequently;
    • car mechanics;
    • construction workers;
    • soldiers in conflict zones;
    • musicians;
    • residents of densely populated cities;
    • people who regularly go to discos, nightclubs, concert halls and raves, or who listen to music at high volume with their walkman or MP3 player.

How to prevent Tinnitus?

Beware of noise

Avoid unnecessary and frequent exposure to very high or even moderately high noise levels. If necessary, use earplugs, ear muffs or foam earplugs, whether at work, on a plane, during a rock concert, when using noisy tools, etc.

Beware of certain medications

Avoid taking high doses of non-steroidal anti-inflammatory drugs such as acetylsalicylic acid and ibuprofen for long periods. See above for a partial list of drugs that are potentially toxic to the ears. If in doubt, ask your pharmacist or doctor.

Identify aggravating factors

Alcohol, caffeine or smoking increase tinnitus in some people. Very sweet foods or drinks containing small amounts of quinine can have this effect on other individuals. These aggravating factors vary from person to person.

Reducing and managing stress

Practising relaxation, meditation, yoga, physical activity, etc., can reduce stress and anxiety, which are both consequences and aggravators of tinnitus.

Avoiding absolute silence in the case of hyperacusis

When suffering from this intolerance to loud noises, it is best not to seek silence at all costs or wear earplugs, as this can make the auditory system even more sensitive, thus lowering the discomfort threshold.

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Ear Disorders

What is Tinnitus?

Tinnitus is a “disturbing” noise that a person hears without it actually existing.

All about Tinnitus

They can be whistling, buzzing or clicking noises, for example. It can be heard in one or both ears, but it can also seem to be present inside the head, either in the front or the back. Tinnitus can be occasional, intermittent or continuous. It results from a dysfunction of the auditory nervous system. It is a symptom that can have many causes.

Temporary tinnitus can occur after exposure to very loud music, for example. It usually resolves without intervention.

This sheet focuses on chronic tinnitus, i.e. tinnitus that persists and can become extremely annoying to sufferers. However, in the vast majority of cases, tinnitus does not have a significant impact on quality of life.

Symptoms of tinnitus

There is a long list of types of noise heard by people with tinnitus. It seems that the most frequently mentioned noise is whistling, but patients also name the following sounds:

  • pulsing ;
  • clicking;
  • buzzing; ;
  • hissing;
  • tinkling sounds;
  • humming; buzzing;
  • rustling ;
    etc.

Depending on the cause, tinnitus may be accompanied by hearing loss, nausea, drowsiness, dizziness, pain or a persistent feeling of having a plug in the ears.

Many sufferers also experience intolerance to loud noises or have loud or painful perception of sounds perceived as normal or soft by healthy people. This condition is called hyperacusis.

Tinnitus is usually less annoying during the day because it is “masked” by other noises in the workplace or home. However, it is more noticeable in the evening and can cause sleep disturbances for many people.

The different types of Tinnitus

There are 2 main categories of tinnitus.

  • Objective tinnitus
    Some of these can be heard by the doctor or specialist consulted, as they are caused by disorders that, for example, make the blood flow more audible. They can also sometimes be manifested by repeated “clicks”, sometimes related to abnormal movements of the ear muscles, which can be heard by those around. They are rare, but usually the cause can be identified and the patient can be intervened and treated.
  • Subjective tinnitus
    Subjective tinnitus is when the sound is audible only to the person affected. This is the most common form of tinnitus, accounting for 95% of cases. The causes and physiological symptoms of subjective tinnitus are not yet well understood and are therefore much more difficult to treat than objective tinnitus. However, it is possible to improve the patient’s tolerance to these internal noises.

The intensity of tinnitus varies from person to person. Some people have little tinnitus and do not seek help. Others hear noises all the time, which can affect their quality of life.

Note: if voices or music are heard, this is another disorder, called auditory hallucination.

Prevalence of Tinnitus

In general, it is estimated that 10% to 18% of the population suffers from tinnitus. The proportion is 30% in adults. Between 1% and 2% of the population is severely affected.

The widespread use of personal stereos and MP3 players among young people leads to fears that the prevalence will increase in the medium term.

Causes of Tinnitus

Hearing tinnitus is not a disease in itself. Rather, it is a symptom that is very often linked to hearing loss. One hypothesis is that it is a “phantom signal” generated by the brain in response to damage to the cells of the inner ear. Another hypothesis is that the central auditory system is dysfunctional. Genetic factors may be involved in some cases.

The most common factors associated with the onset of tinnitus are:

  • in adults, excessive exposure to noise;
  • in older people, hearing loss due to ageing.

Other possible causes include:

  • an injury to the head (such as a head injury) or neck (whiplash, etc.);
  • long-term use of certain medications that can damage the cells of the inner ear (see Risk factors section);
  • spasm of a small muscle in the inner ear (stapedial muscle);
  • blockage of the ear canal by an earwax plug.

Some diseases can also cause tinnitus:

  • Otosclerosis, a disease that reduces the mobility of a small bone in the middle ear (the stapes) and can cause progressive deafness (see diagram);
  • Meniere’s disease and sometimes Paget’s disease;
  • ear or sinus infections (e.g. recurrent ear infections);
  • a tumour in the head, neck or on the auditory nerve;
  • misalignment of the temporomandibular joint (which allows jaw movement);
  • diseases affecting the blood vessels; these can cause so-called pulsatile tinnitus (about 3% of cases).

These diseases, such as atherosclerosis, hypertension or abnormalities of the capillaries, carotid artery or jugular vein, can make the blood flow more audible. This tinnitus is of the objective type: objective non-pulsatile tinnitus may be caused by an abnormality of the eustachian tube, by neurological disorders or by abnormal contractions of the muscles of the throat or middle ear.

Course and possible complications

Some tinnitus occurs very gradually: before becoming permanent, it is heard intermittently and only in quiet places. Others appear suddenly, following a particular event, such as a sound trauma.

Tinnitus is not dangerous, but when it is intense and continuous, it can become very disturbing. In addition to causing insomnia, irritability and concentration problems, it is sometimes associated with depression.

Tinnitus Treatments

Treatment of the condition can reduce the tinnitus. Correcting the hearing loss (e.g. with a hearing aid) relieves tinnitus in up to 50% of patients.

Stress and other psychological factors (e.g. depression) can exacerbate symptoms, so efforts to recognise and treat these factors can lead to improvement. Many patients are reassured that their tinnitus is not a serious medical problem. Tinnitus can also be made worse by caffeine and other stimulants, so patients should try to stop taking these substances.

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Although no specific medical or surgical treatment is available, many patients are relieved by background noise that masks the tinnitus and allows them to fall asleep. Some patients benefit from a tinnitus masker, a device worn as an external hearing aid that emits a low tone that can suppress the tinnitus. Guided habituation tinnitus treatment, offered by specialised tinnitus treatment programmes, is useful for some patients. Electrical stimulation of the inner ear, e.g. by a cochlear implant, can reduce tinnitus but is only indicated in cases of profound deafness.

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Ear Disorders

How do you clean your ears properly?

Everyone knows that regular ear cleaning is essential. But don’t do it just any old way! To preserve the integrity of the eardrum, cleaning the ear canal must follow certain rules. Here are a few things you should do carefully to clean your ears and those of your child in complete safety.

For good ear hygiene, regular cleaning is essential. Should you use a cotton swab? Every day or once a week? We still have questions about a banal daily hygiene gesture.

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Regular ear cleaning: why is it necessary?

Regular ear hygiene allows earwax to be removed from the ear canal.

What flows out of the ear, earwax, is a mixture of fatty substances, minerals naturally produced by glands located in the first third of the ear canal, and dust. This earwax is useful: it lubricates the canal, protects it and rids it of impurities, and then it is supposed to evacuate itself without any external help. A self-cleaning system that sometimes leaves unsightly wax crumbs. You remove them according to your own rhythm of wax secretion, but not more than once a week.

Cleaning your ears keeps them healthy and prevents ear problems. But you need to know how to do it.

Ban the cotton swab, which can cause blockages and injuries

Most people use a cotton bud to clean their ears. However, it is often misused and is an inappropriate accessory: it is not designed to be inserted into the ear canal at all, but rather to clean the ridges of the ear.

Misuse of the cotton swab can lead to damage and injury to the eardrum, earwax build-up, ear pain, tinnitus and hearing loss.

For those who cannot do without a cotton swab: use a tight, lint-free cotton stick. It should be placed at the entrance to the ear canal, without pushing it in, and then remove the earwax with a gentle movement from the inside out.

How do you clean ears without a cotton swab?

ENT doctors recommend simple ear cleaning in the shower.

  • Run a small stream of warm water into the ears (but with little pressure). You can gently and quickly lather the pinna, but this is not necessary;
  • Then gently dab the entrance to the ear canal with a clean towel or cloth to dry and remove the fluid. This prevents the risk of otitis.

Alternatively, use a moistened handkerchief or clean cloth and clean the ear opening and pinna directly.

It is advisable to clean your ears once or twice a week at most.

Only do this if your eardrum does not show any signs of perforation, pain, pus or blood. If this is the case, visit your doctor quickly.

Too much earwax in the ears: use a cleaning spray

In the case of heavy earwax “production”, a classic washing is not enough. It is advisable to spray a spray (A-Cerumen from Gilbert, Docuspray from Quiès…) which sends droplets of surfactants to the bottom of the canal. These break up and solubilise the cerumen clusters, encouraging their physiological elimination. This procedure should be carried out 3 to 4 consecutive evenings.

On the other hand, forget :

  • Ear candles;
  • Water sprays that cause maceration at the bottom of the canal;
  • Oily solutions that stain and give an impression of grease in the ear.

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Ear Disorders

What are the main Hearing diseases and disorders?

The human ear and hearing are fragile and prone to developing various conditions other than hearing loss. Some are incurable, others can be cured or corrected.

Hearing disorders

Many hearing disorders can be frustrating or even painful. These disorders can mask serious diseases that need to be treated quickly. Here is a list of the most common hearing diseases that affect the inner and outer ears, their causes and treatments.

Tinnitus

Tinnitus can be described as ringing, whistling or pulsating sounds that can be heard in either one or both of the ears. A hearing professional can treat these noises.

Permanent tinnitus is a permanent whistling or buzzing noise heard only by the patient. It usually occurs as a result of an acute sound trauma or accompanies presbycusis.

There is no cure for this condition. There are, however, solutions to relieve tinnitus, such as hearing aids and relaxation therapy.

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Presbycusis

Presbycusis refers to the natural wear and tear of the ear, which causes gradual loss in hearing. A hearing aid can improve speech comprehension and slow down the progression of presbycusis.

Meniere’s Disease

Meniere’s Disease is a condition that causes a gradual decline in hearing. A hearing aid can improve speech comprehension and slow down the progression of presbycusis.

Hearing loss or Hyperacusis

Hyperacusis is a disorder of the auditory system that lowers the threshold of tolerance to sound. It is a loss of hearing. Depending on the intensity, this hypersensitivity can be more or less important or even painful. It can occur suddenly following a sound or psychological trauma, but also following other medical events (head trauma, surgery, facial paralysis ….).

To date, there is no treatment for hyperacusis. However, there are some approaches that can help relieve the symptoms or even reduce the intensity of the symptoms. For example: CBT (Cognitive Behavioural Therapy), gradual desensitisation therapy, sophrology or hearing aids.

Otitis

Otitis, which is inflammation of the inner ear, is a condition that affects infants and young children in particular. To avoid complications, this condition needs to be treated quickly and appropriately.

It can affect different levels of the ear:

  • Otitis externa such as swimmer’s ear which results in pain and inflammation of the external ear canal;
  • Otitis media, which can be both transient acute otitis media and persistent otitis media (with serous otitis and fluid discharge);
  • Internal otitis (labyrinthitis) which is a consequence of poorly treated otitis media or trauma.
Otosclerosis

Otosclerosis is a common cause of deafness. It can be congenital or hereditary.

Otosclerosis is a disorder of the middle ear and its ossicular chain. Often inherited, otosclerosis affects more women between the ages of 20 and 40.

This pathology results in a poor quality bone development of the ossicular chain, in particular the stapes.

This metabolic malformation interferes with the transmission of sound to the inner ear. It leads to conductive deafness, or even mixed deafness when it affects the inner ear in the most advanced cases.

Vestibular disorders

Vestibular disorders are conditions that affect the vestibule in the inner ear.

This organ, which is central to the management of balance, can be dysregulated and cause chronic disorders such as meniere’s disease.

This vestibular disorder, the best known, is accompanied by attacks of vertigo, tinnitus and nausea caused, according to researchers, by a large quantity of endolymph (endolymphatic hydrops).

Sound trauma

Noise trauma is a sudden or prolonged exposure of excessive noise that can lead to hearing loss.

THE IMPORTANCE OF MANAGEMENT

Most of ear infections are generally benign and can be treated very well. They should be treated correctly to avoid any after-effects. Some cases of ear infections that are not treated properly, for example, can have a permanent impact on hearing or even lead to tinnitus. In case of pain or doubt, do not hesitate to consult an ENT or general practitioner.

A hearing test and a consultation with a specialist allow a diagnosis to be made of one’s hearing ability and to rule out or confirm the presence of any ear diseases and to find an appropriate treatment.

The treatment of ear infections generally involves antibiotics and painkillers, but it is recommended to try Calminax first, in many cases it would solve your problems without needs of other medicine.

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