Hearts in the ear What does it mean?

The human ear is able to perceive sounds as long as there is a sound source that produces them. When a person, regardless of the cause, perceives a sound like a whistle, a breath, a buzz, a whisper or other unique noise without a sound source that produces it, it is said that the person suffers from tinnitus or tinnitus.

Tinnitus tinnitus are a noise perception in the ears or head without an exterior sound source And it can be perceived as a buzz, whistle, beep or any other sound.
Tinnitus is a symptom (not a disease) produced by a dysfunction in auditory processing in the brain. In most cases, Tinnitus It is associated with hearing loss and is more frequent from the age of 60.
Topphen is more appreciable in a silent environment, so It affects above all at the time of reconciling sleep. For some patients it can become very annoying and to affect their quality of life.

How are they classified?

• Primary (without known cause) or secondary (with an organic cause).
• Uni or bilateral: If one or both ears affect.
• Subjective or objective: Subjective tinnitus is only perceived by the patient, while if the sound can also be perceived by others it is called tinnitus target. The target tinnitus is relatively rare; The sound originates in some part of the body, usually in the ear, the head or neck, and has a muscular or vascular etiology (vascular anomalies can produce a turbulent flow that can be auscultated with each heartbeat).
• Pulsatile (synchronous or not with heartbeat) or non -pulsatile: pulsatile tinnis is a noise perceived to pulses or regular intervals like a beat.

Causes

Pulsatile aquephen

• Aneurysm (dilation) or narrowing (stenosis) in an artery such as carotid artery, arteriovenous malformation or arteriovenous dural fistula (problems in the connection between arteries and veins).
• High cardiac expenditure states: anemia, hyperthyroidism, febrile syndrome, pregnancy.
• Prominent jugular vein bulb.
• Typanic glomus or paragangliomas: They can affect blood flow in areas near the ear. These tumors, although they are generally benign, can cause other symptoms such as hearing loss, pressure sensation in the ear or even vertigo, depending on their size and location.

Non -pulsatile tinn

Otological factors

• Acoustic trauma due to exposure to strong or prolonged noises (concerts, heavy machinery, high volume headphones …) or barotrauma associated with pressure changes.
• Auditory loss related to age (presbyopia), sudden deafness or sudden hearing loss, autoterosis.
• Obstructions in the auditory duct due to wax accumulation or foreign bodies.
• Typanic ear or perforation infections.
• Ménière’s disease that affects balance and hearing.

Vascular factors

• Arterial hypertension.
• Vasculitis
• Atherosclerosis.

Hematological factors

Drugs

• Antibiotics: aminoglycosides …
• Diuretics
• Anti -inflammatories (mainly acetylsalicylic acid, ibuprofen and naproxen).
• Chemotherapy: Cisplatino …
• Antidepressants and anxiolytics.

Neurological diseases

• Multiple sclerosis.
• Migraine with auditory aura.
• Meningitis.
• Common crisis of the temporal lobe.
• Craneoecephalic trauma.
• Skull base tumors such as acoustic neurinoma.

Metabolic factors

• Hyper or hypothyroidism.
• Vitamin A deficits, B12, Zinc, Magnesium.
• Hyperlipemia.
• Diabetes.

Psychological factors

• Anxious depressive pathology: stress, lack of sleep and mood greatly influence the appearance or worsening of tinnitus.

Others

• Temporomandibular joint dysfunction.
• Tension in cervical muscles.
• Exposure to heavy metals: mercury, lead.

What to do before a Tinnitus?

Go to the specialist that will initially rule out treatable causes of tinnitus such as the presence of Cements in the auditory duct, the dysfunction of the temporomandibular articulation … performing an otoscopy to visualize the external auditory duct and the tympanic membrane and a general exploration. In Mapfre’s health insurance you have a great medical picture of grant specialists who will help you in this and many other ailments.

Calculate your price

• Tonal Audiometry Liminar: Value the minimum auditory threshold that a person needs to listen to different frequencies.
• Other tests to assess hearing: acoustic and potential autumns evoked from the brain trunk.

Depending on the characteristics of the tinnitus and the findings in otoscopy, it may be necessary to perform:

• Analytical with hemogram, thyroid hormones, blood glucose, cholesterol, triglycerides, syphilis serology, autoimmune disease panel …
• Eco-Doppler, RM (magnetic resonance), CT (computerized tomography), angiorm, angiotc or cerebral cervical arteriography. Especially important if the tinn is pulsatile or if the tinn is unilateral and associates a unilateral hypacusia with normal otoscopy.
• To assess the impact of tinnitus on the quality of life, a questionnaire is used, which is the “tinnitus handicap inventory (THI)”.

Treatment

In the secondary tango, the treatment will be that of the cause that is causing it.
As generation measures:

• Avoid excitants such as chocolate, alcohol, coffee, teatail and energy drinks, tobacco or the use of autotoxic drugs.
• Noise protection.
• Control of risk factors such as cholesterol or arterial hypertension.
• It is not available No specifically approved drug. The efficacy of Ginkgo Biloba, Niacin or combinations of vitamins and minerals is not demonstrated. Its use without medical supervision is not recommended.
• If tinnitus is associated with hearing loss, the Use of headphones It can significantly improve symptoms.
• The main and most effective treatment for this pathology is focused on divert attention from this ‘noise’: Sound can be used as therapy due to its ‘masking’ effect on low intensities and at certain frequencies.
• Bimodal stimulation: combines two types of stimuli – ultimately auditory and somatosensory – to try to “retrace” the neuronal pathways that are believed to be involved in the generation of tinnitus.
• Cognitive behavioral therapy: Psychological approach to change the way the person perceives tinnitus helping to reduce their impact on the quality of life.
• Tinnitus Readiestation Treatment: Combine elements of sound therapy and psychological orientation.

What you should know …

• Go to the specialist that will initially rule out treatable causes of tinnitus such as the presence of Cements in the auditory duct, the dysfunction of the temporomandibular articulation … performing an otoscopy to visualize the external auditory duct and the tympanic membrane and a general exploration.
• When the pulsatile tango is a noise perceived to pulses or regular intervals like a beat.
• The main and most effective treatment for this pathology is focused on diverting attention from this ‘noise’: sound can be used as therapy for its ‘masking’ effect to low intensities and at certain frequencies.

Literature

• Juan Carlos Amor: Fisterra guide or love JC. Tinnitus. Review January 29, 2024.
• Benson Ag et al .tinnitus. Medscape. UPDATED: Mar 18, 2024.

Posted by Dr. Roser Mateu