Tinnitus - the sensation of ringing or noise, the source of which is perceived by the patient in the ear. There are physiological and pathological tinnitus. Pathological tinnitus divided into objective and subjective. In order to deliver to the patient the correct diagnosis, it is necessary to conduct a survey.
Physiological tinnitus occurs in the absence of diseases in the ear, if the person is in complete silence. Appearing at the same time spontaneous auditory sensations may have the character of sounds of different frequencies and intensities. This phenomenon appears to be associated with the perception of blood vessels and capillaries in the inner ear, and with the biochemical processes that take place at the level of the hair cells of the inner ear or auditory nerve neurons.
The diagnosis of physiological tinnitus is set on the basis of complaints of the patient after his examination and rule out any diseases of the ear.
Pathological objective tinnitus
Objective pathological tinnitus differs from the subjective fact that he hears not only the patient, but the doctor can hear with the help of special methods of investigation, such as listening stethoscope.
Objective pathological tinnitus may depend on the slight twitch muscles lining the tympanic cavity, the muscles of the Eustachian tube (which connects the cavity of the ear with the nasopharynx) and soft palate, changes in blood flow, such as the sudden expansion (aneurysm) or narrowing (stenosis) of the carotid arterial sclerotic changes in the arteries that feed the brain. There may be such a noise and changes in the temporomandibular joint, the change of pressure in the middle ear (eg, in inflammatory processes in the Eustachian tube or with a change in atmospheric pressure). Objective pathological tinnitus is rare and is not accompanied by hearing loss.
Subjective tinnitus pathology
Subjective tinnitus pathology is different from the objective fact that it only hears the patient. Such noise may be due to pathological changes in the middle or inner ear, as well as background toxicity of certain drugs (such as antibiotics
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, Has a toxic effect on the organ of hearing, salicylates, etc.), toxic substances containing arsenic or mercury. Subjective tinnitus can occur during the flu, pneumonia, mumps (mumps) and some other acute and chronic infections.
It explains the appearance of subjective tinnitus in the inner ear that there are physical and chemical changes are accompanied by changes of the pressure and electrolyte imbalance (the ratio of salt). Such changes may occur in the nervous tissue of the acoustic analyzer, leading to the development of edema in it
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, Hemorrhage and destruction of cells.
Other reasons for the emergence of subjective tinnitus (noise reflex) is the presence of a foreign body in the ear canal, pathological changes in the nose, throat and teeth.
Subjective abnormal noise can be permanent or temporary, intense or weak, unilateral or bilateral. According to the characteristics that give it the sick, the noise may resemble the chirping of a grasshopper, babbling brook, the noise of the engine, of the sea and so on.
Pathological diagnosis of objective tinnitus is based on the survey data of the patient and hearing noises on auscultation. The nature of the noise may be different depending on the cause. For example, vascular noises are usually vague, with pathology in the temporomandibular joint is heard the rough noise during movement of the mandible.
In the diagnosis of pathological subjective tinnitus is very important a thorough questioning of the patient about the nature of the noise, his tone, intensity, causes the appearance. The idea of the tone of tinnitus can give a study using a tuning fork or audiometer.
Treatment of pathological tinnitus
Treatment and prognosis of pathological objective tinnitus depends on the nature of the underlying disease that caused the noise.
Treatment of pathological subjective tinnitus reflex character aimed at the elimination of pathological changes in other organs, to restore the nervous system, sleep
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, The removal of metabolic disorders. Of great importance is the correct mode of the day, good nutrition, smoking cessation and alcohol. With the success are different types of acupuncture
Reflexology - a policy of non-drug therapies
(acupuncture, electroacupuncture, and so on).
Local treatment is aimed at elimination of existing pathological changes in the outer and middle ear to restore sound conduction mechanism. With a pronounced subjective tinnitus is sometimes carried out the operation, the nature of which depends on the causes of noise. In some cases, eliminate the noise can not be subjective.