What causes ringing in the ears. Why is my ears ringing, what should I do?

Ringing in the ears is an unpleasant phenomenon. When it occurs temporarily and does not affect the usual rhythm of a person’s life, then there is no reason to worry. The cause of intermittent ringing may be overwork, stress, lack of sleep, physical activity, overexertion, or attending concerts with loud music. But what to do when there is constant ringing, when extraneous sounds in your head prevent you from falling asleep or concentrating on your usual activities or work?

In medicine, a similar condition when there is a ringing in the ear is called tinnitus.

Patients note that not only ringing, but buzzing, whistling, gurgling, and clicking can be heard in the ear. These sounds can occur in one ear or in both ears at once, and can be of different volumes or tones.

Is it worth tolerating this condition, and when should you see a doctor? Symptoms, causes and treatment of ringing in the ear - the topic of our new article.

How does ringing in the ear occur?

Ringing in the ear does not occur on its own. This is just a symptom that accompanies the underlying disease. Moreover, there are many more reasons that cause this symptom than might seem at first glance. And the real reason is not always related to ear disease.

Let's figure out how our ear functions. The sound wave captured by the auricle is transmitted to the middle part of the ear, where it causes vibrations eardrum. These vibrations are transmitted through the auditory ossicles to the internal part of the hearing organ - the cochlea. The snail is filled with fluid. There are also special hair cells in the inner ear. Fluctuations in the fluid set these same cells in motion. And already at the last stage, hair cells convert sound vibrations into nerve impulses, which go directly to the brain. This is what the algorithm for sound perception looks like in a healthy person. A malfunction of the hearing organ can occur at every stage of sound transmission, which will lead to hearing impairment and the sensation of ringing.

Types and degrees of ringing

There are several classifications of tinnitus. According to one of them, it is divided into objective and subjective. Objective - these are sounds that really exist, and they are also heard by the ENT doctor when examining a person. This type of ringing is rare. Subjective ringing is perceived only by the patient.

Noise can be vibrational, which is created by elements of the organ of hearing, and non-vibrational, caused by irritation of nerve endings.

According to the nature of the ringing, the sound can be monotonous (whistle, buzz) or complex (music, ringing bell, etc.).

There are four degrees of tinnitus based on intensity. In the first degree of tinnitus, the sounds are unobtrusive and do not affect a person’s usual lifestyle. In the second degree, sounds are characterized by sufficient constancy and intensify at night. The third degree greatly reduces the quality of life: noises are heard constantly, the patient becomes irritable, and performance decreases. The fourth degree is the most dangerous. A person completely loses his ability to work due to an obsessive symptom.

During a consultation with an otorhinolaryngologist, it is necessary to describe the nature of the ringing in the ear as accurately as possible in order to establish the cause of the disease as accurately as possible and prescribe the correct treatment regimen.

Causes of tinnitus

The causes of ringing in the ear need to be given special attention, because the reasons that cause this unpleasant symptom quite a lot, and they are not always associated with ear diseases.

The reasons that lead to tinnitus may be the following:

• otitis - an inflammatory process in the ear (its outer, middle and inner parts can be affected by inflammation);
• wax plugs formed in the ear canal (plugs can form due to copious discharge sulfur, structural features of the ear canal, improper ear hygiene);
• a foreign object in the ear canal (this could be insects, water, small parts of toys, beads, etc. Most often, for this reason, parents with small children who stick small objects into the ear while playing or out of curiosity turn to an ENT doctor .);
• otomycosis - fungal infection in the outer part of the ear;
• mastoiditis - inflammation of the area temporal bone;
• eustachitis - inflammation auditory tube connecting the organ of hearing with the nasopharynx;
• inflammation and perforation of the eardrum;
• otosclerosis - the cause of hearing loss and the appearance of ringing in the ear in this disease are neoplasms in the labyrinth that put pressure on the cochlea and auditory ossicles;
• Meniere's disease - the cause of attacks of dizziness, ringing in the ears and loss of coordination in the case of Meniere's disease is an excess of endolymphatic fluid in the internal part of the hearing organ;
• sensorineural hearing loss - the cause of noise in this case is damage to the hair cells that convert sound vibrations into nerve impulses;
• neuroma - tumor of the auditory nerve;
• problems with cerebral blood supply;
• osteochondrosis - with this disease, in addition to tinnitus, the patient complains of pain in the cervical spine;
• oncological diseases;
• atherosclerosis;
• diabetes;
• hypertension;
• taking medications that have an ototoxic effect - if taking medications provokes such a symptom, you must inform your doctor about this so that he can adjust the treatment regimen.

As we can see, the list of possible reasons is quite impressive and serious. All listed diseases must be treated! And here we do not mean home treatment with folk remedies, but full-fledged treatment from a doctor, and sometimes from several specialists at once.

Friends! Timely and correct treatment will ensure your speedy recovery!

How is ringing in the ear diagnosed?

To choose the right and effective treatment, it is necessary to determine the cause of tinnitus. Diseases that lead to this symptom belong to different areas of medicine. But the solution to the problem must begin with a visit to an otolaryngologist.

The ENT doctor will definitely begin the appointment by collecting the patient’s medical history and discussing his complaints. The doctor will clarify when the first symptoms appeared, at what time of day the ear noise appears, how often it bothers you and how long such an attack lasts. Here the patient needs to answer the ENT doctor’s questions as accurately as possible and describe the nature of the sounds that arise - this is necessary for correct diagnosis followed by prescribing the correct treatment.

The next stage is a direct examination of the hearing organ to assess the condition of the external auditory canal. This examination is called otoscopy. By using endoscopic examination The ENT doctor examines the middle part of the hearing organ and all its remote areas that are not visible during a classic examination.

To measure hearing acuity, an ENT doctor performs an audiometric examination. To study the functions of the middle part of the hearing organ (mobility of the eardrum, work auditory ossicles) a tympanometric study is performed.

By using x-ray examination head and neck, it is possible to detect the presence of neoplasms. If necessary, carried out CT scan and magnetic resonance imaging.

Vestibular function hearing aid examined using special tests.

During the diagnostic measures Other specialists may also be involved.

If the diagnosis does not reveal any abnormalities in the functioning of human organs and systems, the patient is referred for consultation and treatment to a psychotherapist, since in such a situation there is a high probability of influence mental factor.

Treatment for tinnitus

Treatment is prescribed only after a diagnosis has been established. If the problem lies solely in diseases of the hearing organ, an otolaryngologist treats the patient. Therapy for infectious diseases includes taking medications, physiotherapeutic procedures and performing the necessary manipulations in the clinic. Efficient removal cerumen plug or foreign body is also carried out under the supervision of an ENT doctor. Treatment of sensorineural hearing loss is carried out using microcurrent electrical stimulation of hair cells using special ENT equipment: Transair 07 and Audioton devices. Some pathologies, such as tumors, require surgical treatment.

If necessary, doctors of other specializations join in treating the patient.

Constant ringing in the ears cannot be tolerated. This condition can very quickly provoke severe stress and psychological disorders. Not to mention the development of the underlying disease.

The appearance of annoying constant noise in the ears cannot be ignored. This condition may be a symptom of serious illnesses that require immediate treatment. Why do my ears constantly ring?

Otolaryngologists call this phenomenon tinnitus and classify it by sound strength and tonality. The identification of the causes of tinnitus directly depends on these characteristics, as well as on the accompanying symptoms.

Causes constant ringing in the ears can be quite roughly divided into two large local groups: diseases of the organ of hearing and systemic pathologies.

If the first is treated by an otolaryngologist, then for optimal treatment of the second you will need to visit specialists. Another group of causes of tinnitus, which experts identify, relates to the temporary or permanent ototoxic effect of certain substances.

Ear diseases as a cause of tinnitus

Most often, constant ringing is caused by pathological conditions of the hearing organs.

1. Cochlear neuritis. When the auditory nerve is damaged, in addition to subjective ringing in the ears, there is a noticeable progressive deterioration in the functionality of the ear. The disease itself can be triggered by infection, injury, toxins and age-related changes in the internal part of the hearing organ. Cochlear neuritis is characterized by irreversible disturbances in sound perception; if qualified therapy is not started in time, the disease can develop into hearing loss.
2. Otosclerosis. With this disease, spongy bone tissue begins to grow uncontrollably inside the ear. It gradually fills the entire space of the cavities of the hearing organ and interferes with normal sound conduction. The lack of vibrational information from the outside is replaced by the appearance of constant ringing in the ears, which increases in proportion to the degree of hearing loss.
3. Swelling. This condition of the auditory tube can occur against the background of acute respiratory viral infection, which is accompanied by rhinitis. Swelling leads to the disruption of natural ventilation processes in the ENT system, and stagnation causes congestion in the hearing organ, a temporary decrease in its functionality and ringing in the ears.
4. Head injury, in which hemorrhage occurred in the cavity inner ear, leads to dysfunction of sound receptors. Against this background, ringing in the ear appears as a temporary compensation due to hearing impairment.
5. Exudative otitis media characterized by the accumulation of fluid in the tympanic cavity. Its pressure on the walls of the middle section leads to severe shooting pains, hearing impairment and the appearance of subjective noise. Patients complain that they have a ringing in their left ear or only in their right ear.
6. Blockage of the ear canal with wax plug, foreign body or furunculosis causes deterioration in the functionality of the hearing organ and the appearance of ringing in the ears.
7. For Meniere's disease A large volume of fluid begins to accumulate in the cavity of the inner ear, which prevents the receptors in the cochlea from correctly capturing sound vibrations coming from the outside. In addition to significant hearing impairment, patients with this syndrome also note the appearance of an annoying constant ringing in the ear.

Systemic diseases

Persistent or episodic tinnitus can be caused by various systemic diseases and pathologies. Such conditions will be treated by those specialized specialists who are in charge of the root cause of the annoying noise.

1. Periodically occurring ringing in the ears may well be associated with high blood pressure in the patient. When the vessels do not have time to adapt to changed conditions, turbulence occurs in the blood flow at the periphery. The noise of this turbulence in areas close to the hearing organs is perceived as a pulsating ringing in both ears.
2. Atherosclerosis of blood vessels can also cause constant ringing in the ears. Cholesterol plaques, stuck to the walls circulatory system, interfere with the free passage of blood flow. In areas affected by atherosclerosis, zones of turbulence appear, the noise of which is perceived by the ear as a constant ringing and rustling.
3. Tinnitus almost always accompanies diabetes. Due to disruption of the nutrition of ear tissues and internal receptors, sound-receiving cells begin to lose their functionality. Against the background of hearing impairment, a characteristic high-pitched noise occurs in both ears.
4. Constant ringing in the ears is sometimes the very first symptom that patients notice when tumors develop in the head and neck. An actively growing tumor compresses the blood vessels, which causes a deficiency in the nutrition of the hearing organs.
5. Osteochondrosis cervical spine is also accompanied by the appearance high noise in the ears.
6. A number of pathologies, united by the common name “vegetative-vascular dystonia,” are accompanied by severe headaches, paroxysmal migraines and maddening ringing in the ears.

The influence of different substances

Some substances can cause ringing in the ears:

• caffeine, nicotine and quinine, which is part of energy drinks, have a stimulating effect on the nervous system;
• taking gentamicin during antibacterial therapy can be detrimental to auditory receptors, which will cause background ringing in the ears;
• A large amount of aspirin taken by the patient may cause temporary ringing.

The effects of these substances are different. Thus, after taking aspirin or consuming excessive amounts of stimulants, the ringing in the ears will gradually go away as they are eliminated from the blood. But with noise caused by ototoxic antibiotics, the damage to the receptors is irreversible.

Symptoms that often accompany ringing

To make the correct diagnosis, specialists question in detail patients who complain of ringing in the ear. They will be interested not only in the nature of the noise and the circumstances under which it manifests itself most clearly - the accompanying symptoms are no less important for determining the root cause of the disease. So, in addition to constant ringing, some diseases are accompanied by:

• increased blood pressure;
• pain inside and behind the ear;
• nausea and dizziness;
• pounding in the temples;
• headaches;
• sensation of pulsation;
• sensation of fluid transfusion;
• feeling of stuffiness;
• hearing impairment;
• sleep disturbance and memory impairment.

So what symptoms can give a specialist a more or less clear picture of the disease?

Dizziness and ringing

The combination of these symptoms may indicate pathological processes occurring in the inner ear, where the vestibular apparatus. Dizziness and ringing in the ears can occur after an injury, against the background of inflammatory processes in the cavity of the organ of hearing, as well as in cases of impaired cell nutrition or intoxication.

Thus, the following set of symptoms will indicate osteochondrosis:

• tinnitus;
• irritability;
• increased dizziness when moving;
• pain in the neck, temples and back of the head;
• stars in the eyes;
• Deterioration of vision in low light and at dusk.

Vegetative-vascular dystonia will manifest itself with the following symptoms:

• Constant or occasional dizziness;
• blood pressure surges;
• tinnitus;
• tachycardia with increased dizziness;
• frequent episodes of lightheadedness;
• weather sensitivity;
• cold sweat during attacks.

Ringing and pressure

This combination of symptoms will indicate hypertension. This pathology occurs due to the inability of blood vessels to respond to changes in blood pressure. As a result, small capillaries begin to suffer and brain nutrition deteriorates. Hypoxia of its tissues leads to the following symptoms:

• Pulsating ringing in the ears;
• vomiting;
• the appearance of flies or veils before the eyes;
• dizziness;
• lethargy;
• cold sweat.

Diagnosis of the underlying disease

First of all, if you experience persistent ringing in your ears, you should contact an otolaryngologist. During the examination and diagnostic measures, the specialist will look for the causes of annoying noise in “their area.” If during the examination the true disease is not identified, the ENT specialist will redirect you to certain specialized specialists, based on the accompanying symptoms.

Treatment

The treatment program will be based entirely on the underlying disease. Once the disease is defeated or stopped, the obsessive ringing in the ears will go away on its own.

1. To treat otitis, the otolaryngologist will prescribe you to take antibacterial drugs designed to stop the development of pathogenic microflora.
2. For swelling eustachian tube they will help you because of ARVI vasoconstrictor drops into the nose.
3. If an ENT specialist discovers a wax plug or foreign body in your ear, he will perform a rinse, which will restore the patency of the ear canal and eliminate subjective noise.
4. If the audiogram indicates the progression of sensorineural hearing loss, the ENT specialist will prescribe medications that can stop the development of the pathology and preserve your hearing.

Subject specialists, having diagnosed the problem, will prescribe the patient a course of medications and procedures to help cure the underlying disease. So, an endocrinologist for diabetes mellitus recommends that you stick to a diet and, if necessary, prescribe medications that level out metabolic processes. Diagnosed osteochondrosis requires therapeutic massage, physiotherapy and a course of drugs that improve cell nutrition. The cardiologist, having found out that the cause of tinnitus is hypertension or atherosclerosis, will draw up a program for lifelong treatment of the disease.

Methods to help temporarily “kill” ringing in the ears

If the ringing in the ears has become completely unbearable, and the prescribed therapy has not yet brought positive result, what to do? The following methods will help you drown out the noise:

• Listen to music quietly on headphones;
• stop eating salt;
• do exercises to improve blood circulation in tissues;
• rest more often;
• If your ear is ringing, limit your intake of caffeine, nicotine and quinine.

Preventing tinnitus

It is better to prevent any problem than to deal with it later. What are the preventive measures against ringing in the ears?

1. Avoid noisy places, and when working in production, use protective headphones or earplugs.
2. Don't turn on the TV too loudly, and also turn down the volume when listening to music with headphones.
3. Carefully read the instructions for the prescribed medications: if they have an ototoxic effect, it is better to ask the doctor to replace them with others that are not harmful to hearing.
4. If you suffer from hypertension, take the medications prescribed by your cardiologist regularly, and not just during attacks.
5. Go through medical examinations and medical commissions - this way you can identify dangerous diseases and conditions in a timely manner.

Tinnitus is known in medical circles as tinnitus. Sounds can be of different tones, loud and quiet. Some people hear a buzzing sound, others hear a ringing sound, and others hear a beeping sound. When you turn your head, they may intensify or disappear. High-frequency sounds bring particular discomfort to a person at night, when external noise is reduced.

The nature of noise

The nature of the appearance of noise may be due to such factors.

1. External . Disturbances and malfunctions occur in the functioning of some organs. As a result, sound vibrations appear, which are picked up by the receptors of the hearing aid through the tissues. This noise is heard by both the sick person and the doctor using a stethoscope. It depends on muscle contractions, blood flow, and changes in pressure of the eardrum.
2. Interior . In this case, only the sick person hears extraneous sounds, although they actually do not exist. They are caused by a malfunction of receptors that transform mechanical vibrations into nerve impulses. This is the most common form of tinnitus. It has both a psychogenic nature and occurs when there is a change in the permeability of sound. Pathological ringing is varied. It can be long-term, short-term, simple or complex, and occur in one or two hearing organs.

The main causes of tinnitus

Tinnitus doesn't just happen. Tinnitus occurs for the following reasons:

Internal diseases

• Hypertension . If the noise begins to haunt and irritate you, be sure to measure your blood pressure. At constant high blood pressure contact a specialist who will prescribe a course of treatment. Hypertensive patients should listen carefully to their body: the occurrence of tinnitus in combination with a headache, discomfort in the heart, or the appearance of “spots” before the eyes may be a harbinger hypertensive crisis. Call a doctor or " ambulance».
• Atherosclerosis . Cholesterol plaques clog blood vessels, including those in the brain and inner ear. As a result, the arteries begin to discord with the rhythm of the blood flow and extraneous noise appears.

ARVI, influenza, acute respiratory infections

These diseases can cause swelling of the ear, which leads to extraneous sounds.

Inflammatory processes in the ear. Otitis

It is characterized by swelling, redness, the appearance of fluid in the inner ear, discharge of pus and an annoying ringing in the head.

Severe headaches - migraine

Usually they persecute the weak half of humanity. The pain spreads to one part of the head, throbs and is accompanied by noise.

Otosclerosis

A disease that leads to complete loss of hearing. For reasons that are still unclear, bone tissue begins to grow between the middle and inner ear.

Acoustic neuroma

The neoplasm grows from nerve tissue cells. At the very beginning, the disease is asymptomatic. Then there is ringing, dizziness, tingling of the face

Other reasons

The appearance of noise is also associated with such phenomena as:

• Stressful or restless state.
• Vegetative-vascular dystonia.
• A whole complex of disturbances in the interaction of the nervous system.
• Head injuries, which are also accompanied by nausea and vomiting.
• Diseases caused by metabolic disorders - diabetes, thyroid disease, obesity.
• Poisoning.
• Concussion caused by explosion, stunning.
• Water, insect, or foreign body entering the ear.
• Formation of sulfur plug.
• Taking medications and narcotic drugs that cause this side effect. For example, streptomycin, caffeine, quinine, aspirin, cocaine.
• Lack of vitamins in the body - group B and K, minerals - potassium, iodine, manganese.
• Age indicator. In older people, age-related changes in the hearing organs occur and, as a result, noise appears.
• Weather. Weather-dependent people may experience discomfort when there is a sudden change in atmospheric pressure.

Ringing in the ears and head - why?

Based on the type of noise, we can assume that it is caused by:

• Pulsating sounds are usually associated with diseases of the cardiovascular system.
• Shooting occur against the background of inflammation inside the ear or nasopharynx.
• Metal Ringing is often heard with osteochondrosis.
• Whistling and squeaking - for traumatic brain injuries.
• Lingering amplifying sounds characteristic of neuroma.

Sounds that do not have an objective nature of occurrence are associated with pathology of the nervous system.

Ringing in the right or left ear

The insidious Meniere's disease, in which blood flow in small vessels is disrupted, causes ringing in one ear - the right or left.

With progressive dynamics, there is a lack of coordination, constant nausea. In the advanced form of the disease, complete loss of hearing occurs. Also, noise in one ear may indicate the occurrence of a tumor; with the further course of the disease, dizziness and hearing loss are observed.

When and which doctor should I contact?

If you are only concerned about tinnitus, you should initially contact otolaryngologist (ENT) . He checks hearing acuity and makes diagnostics important indicators affecting the functioning of the hearing organ. They also check for the presence of sulfur plugs, otitis media and patency of external canals.

If everything is in order from the otolaryngological side, computed tomography and magnetic resonance imaging are performed. This study shows the full picture of the condition blood vessels, the presence of neoplasms.

Sometimes you may need to consult a neurologist if you suspect multiple sclerosis or brain tumor.

If your head rings for a long time in one or both ears at once, you notice a decrease in hearing or partial (complete) loss of it, and you also experience: vomiting, nausea, loss of coordination of movements, pain in the head and heart area, immediately call a specialist at home.

Treatment for ringing in the ears

When the root cause of the ringing is identified, treatment of the underlying disease begins, since noise in the head is only a symptom. For example:

• For vegetative-vascular dystonia, general strengthening and immunostimulating drugs are prescribed.
• For atherosclerosis and other diseases associated with problems of blood vessels, medications are prescribed to improve cerebral circulation.
• For hypertension, patients are treated with drugs that block the effects of adrenaline.
• At inflammatory processes in the ears, limit the consumption of table salt to reduce swelling.
• For otosclerosis, replacement surgery is performed auditory bone or using a hearing aid.
• For osteochondrosis it is prescribed complex treatment. The doctor prescribes tranquilizers, sleeping pills, antidepressants. During the course, avoid drinks containing caffeine and do not take aspirin.

Prevention of tinnitus not related to internal diseases

There are a number of actions that can help prevent noise that is not associated with the presence of diseases:

• In noisy places or workplaces, use headphones or earplugs. If possible, avoid places with excessive noise.
• Reduce the dose of medications if side effects occur, if possible, ask a specialist to replace them with others.
• Clean your ears regularly and promptly contact an ENT doctor to remove wax plugs.
• In stressful situations, after consultation with a specialist, take sedatives as necessary.
• If you suffer from phantom sounds in your head, pouring water will help drown them out.

Video: There is a ringing in the ear - what is it?

Elena Malysheva and her colleagues will help you figure out what ringing in the ears signals.

There are many ailments, one of the symptoms of which is ringing in the organ of hearing - in one or both. This signal cannot be ignored. The sooner the cause of the ringing is found, the sooner you will begin treatment for the underlying disease. Tinnitus cannot be cured without addressing the root cause.

Update: December 2018

Tinnitus or the sensation of any sounds in the ears and head without external auditory stimuli is a very difficult diagnostic task for a doctor. Since this is not a diagnosis, but a symptom, in order to find out the reasons for its occurrence and pathophysiological mechanisms, a lot of effort should be made, a series of examinations should be carried out, and a careful collection of the patient's medical history is necessary.

Is noise in the ears and head a pathology or a normal variant?

The noise can be either bilateral or unilateral if it occurs in conditions of complete silence - this is a physiological noise that can be caused by the perception of the movement of blood in the inner ear in small vessels.

For various diseases, such as diseases of the auditory nerve, inner or middle ear, poisoning, taking certain medications is already pathological causes. By nature, it can resemble ringing in the ears, whistling, hissing, be weak or, on the contrary, intense, all this has implications for establishing a diagnosis and prescribing treatment for the detected pathology.

In many cases, such a symptom indicates diseases of the hearing organs, but in 10-16% of cases, the causes of noise in the ears and head are cerebral circulation disorders that occur with age-related changes, in young people from nervous overload, after injuries or with increased arterial or intracranial pressure. A common cause is vertebral artery syndrome, which develops with osteochondrosis of the cervical spine.

Almost 90% of adults experience various kinds tinnitus, which is considered normal and is caused by the perception of the functioning of the auditory organs, therefore it is quite difficult to determine the intensity and frequency of tinnitus in a patient based on the described sensations and complaints.

Many studies claim that 30% of the population periodically experience ringing and sounds in the ears, 20% of which consider such noise to be quite pronounced and intense. Moreover, half of all patients complain only of noise in the left or right ear, the other half of bilateral noise.

Constant noise in the head is one of the main symptoms in 80% of patients with hearing loss. The frequency of manifestation of this syndrome is very high in middle-aged and elderly people 40-80 years old. However, in men, the likelihood of detecting hearing loss and developing a similar symptom is higher, since they are more susceptible to household and industrial noise.

In addition, such an unpleasant sensation is usually accompanied by feelings of stress, anxiety, fear, leads to insomnia, increases fatigue and reduces performance, interferes with concentration, and interferes with hearing other sounds. From a long-term anxious state, such patients often suffer from depression, and it has been noted that the presence and intensity of such a symptom in most patients is aggravated by additional mental symptoms.

What could be the tinnitus?

When visiting a doctor, the patient should clearly explain what noise is bothering him:

• monotonous sound - whistling, hissing, wheezing, buzzing, ringing in the ears
• complex sound - the ringing of a bell, voices, music - this can already be attributed to drug intoxication, psychopathology, auditory hallucinations

Moreover, tinnitus should be divided into:

• objective - which is heard by both the patient and the doctor, which rarely happens
• subjective - which only the patient hears

Noise can also be divided into:

• vibrational - mechanical sounds that are produced by the organ of hearing itself and its structure, more precisely neuromuscular and vascular formations, these are the sounds that both the doctor and the patient can hear
• non-vibrational - the sensation of various sounds in the ears, the cause of which is irritation of the nerve endings of the central auditory tract, auditory nerve, inner ear, in this case the noise is heard only by the patient himself.

Most often in clinical practice various noises in the ear or ears are non-vibratory, subjective in nature and are the result of pathological irritation or excitation of the central or peripheral auditory pathways. Therefore very important task diagnosis is to exclude or confirm serious diseases of the auditory tract.

Causes of tinnitus

The ear, as an organ, consists of three main parts (external, internal and middle), innervated by certain nerves and partially supplied with blood from the system of cerebral arteries. Any of these structures can become damaged and lead to tinnitus.

Blockage of the ear canal

The most common cause of noise is a partial closure of the ear canal. Most often, only one ear suffers. The patient is bothered by a constant intrusive noise, which is accompanied by a feeling of “stuffiness”, pain and hearing loss.

The ear canal can get:

• Water;
• Dust;
• Small insects;
• Children can independently push objects into the ear (small toys, paper, etc.).

How possible reason blockage should be noted the formation of cerumen plug. It can occur due to several factors: a large amount of sulfur released, narrow sizes ear canal, lack of regular ear hygiene and a number of others.

Even if an external examination fails to detect the cause of the blockage, this does not mean that it is not in the ear canal. A foreign body or plug may be located near the eardrum. In this case, only a doctor can see it using an otoscope - a device for examining the entire ear canal.

Diseases of the external ear

This department consists only of auricle and ear canal. Main function outer ear - to catch and conduct sound. The noise may occur if there is an obstruction in one of these structures. The reasons associated with blockage of the ear canal were discussed above. Other diseases of the external ear include:

External ear disease	Description
Otitis externa	This is an inflammation of the skin in the area of ​​the passage, which can develop due to infection of the ear by various microbes (Staphylococcus aureus, Pseudomonas, Streptococci). Tinnitus is often accompanied by severe pain, discharge of pus from the external auditory opening, redness of the skin. As the disease progresses, it may spread to the middle ear through the eardrum. Therefore, at the first signs of it, you should consult a doctor as soon as possible.
Mycosis of the outer ear	This disease occurs most often in people with reduced immunity (HIV-infected, taking steroid hormones and cytostatics, living in constant stress, etc.). A fungal infection, usually candidiasis, occurs in the area of ​​the external auditory canal. In addition to tinnitus and pain, patients may complain of frequent milky-white ear discharge and a feeling of “fullness.”
Furuncle	If a boil forms in the outer ear, this is a reason to urgently seek the help of a doctor. Doctors call it “malignant” because this small purulent lesion can quickly lead to a general infection with high fever and severe symptoms of intoxication (weakness, loss of appetite, dehydration)
Exostosis	This is enough rare disease, at which growth occurs bone tissue in the initial part of the auditory canal. Because of this, there is an obstacle to passing sound wave, which leads to noise. As a rule, pain and other symptoms of ear damage do not bother patients.

Middle ear injury

The middle ear is vulnerable to infections - among all lesions of the hearing system, they occupy first place. The poor statistics are due to the structure of this department. The middle ear is separated from the outer part by a thin eardrum, which can become inflamed as otitis externa progresses. There is another important feature - the department communicates with the oral cavity through the Eustachian tube, through which bacteria and viruses can spread to the organ of hearing.

The following inflammatory diseases of the middle ear can lead to tinnitus:

• Acute otitis media– caused by bacteria and viruses introduced both from oral cavity, and from the outer ear. Often occurs after previous sore throat, laryngitis, nasopharyngitis. Accompanied by shooting pain, hearing loss and general symptoms(increased temperature to 37-38 o C, weakness). Feature tinnitus – it, as a rule, has a pulsating character and does not bother you constantly, but periodically;
• Chronic otitis media – incorrect treatment acute inflammation can lead to this disease. Tinnitus comes first during remission in chronic otitis media. Over time, the patient begins to notice a decrease in hearing and the appearance of a feeling of “stuffiness”. During an exacerbation, all signs are observed acute otitis.

It is very difficult to treat this disease, since patients, as a rule, have already taken most of the antibiotics to which microbes have developed resistance. It is important to choose the right antibacterial drug and carefully follow the regimen;

• Mastoiditis- located behind the middle ear cavity mastoid(part of the temporal bone), which contains cells with air. It is they that become inflamed during mastoiditis, which is manifested not only by noise, but also by pain behind the ear, high temperature (more than 38 o C) and symptoms of intoxication.
• Eustachite– inflammation of the Eustachian tube, which connects the middle ear to the oral cavity. Characteristic symptoms and has no particularities in treatment. Manifests itself in the form of acute otitis media;
• Myringitis- This is an infection of the eardrum. As a rule, it is combined with one of the forms of otitis. Additional signs, which allow you to detect myringitis - increased pain when sounds of normal volume appear and discharge of pus from the ear.

Besides infectious causes, pathologies of the middle ear include tympanosclerosis and damage to the eardrum (ruptures, injuries). With the first disease, gradual scarring of the membrane occurs, which is manifested by tinnitus and severe hearing loss. As a rule, there is no pain or fever.

Eardrum injury can occur during strong pressure changes (during takeoff or rapid immersion under water), or when it is directly damaged (with an ear stick or other object that is immersed in the ear canal). The main symptoms are acute unbearable pain and absence/severe hearing loss on the affected side. Tinnitus with damage to the membrane comes into the background.

Inner ear diseases

Damage to this part of the hearing organ is the most dangerous, since it is extremely difficult to cure. There are two important devices located here - vestibular, which is responsible for balance, and auditory, which directly converts sound waves into nerve impulses.

As a rule, hearing loss and periodic tinnitus accompany the patient throughout his life after the disease. The most common diseases of the inner ear include:

Inner ear disease	Description
Otosclerosis	The peculiarity of this disease is that it almost always affects two ears. With otosclerosis, uncontrolled growth of areas of the bone labyrinths occurs. These growths can put pressure on the cochlea and stapes (the small bone on the inside of the eardrum). Tinnitus will be accompanied by progressive hearing loss. Otosclerosis is hereditary, so there is a high probability that the patient’s relatives will have the disease. This has great diagnostic value.
Labyrinthitis	An infectious process affecting the inner ear. Often occurs after acute otitis media. In addition to hearing impairment, patients are concerned about: dizziness, lack of coordination of movements, and constant nausea. Temperature and signs of intoxication may appear.
Labyrinth contusion	Lightning-fast pressure changes between external environment and the cavity of the inner ear leads to damage to the cochlear apparatus. In this case, the middle ear is damaged less frequently, since the presence of the Eustachian tube somewhat protects it from barotrauma. With contusion of the ear labyrinth, not only noise, but also a sharp decline hearing loss (often temporary), dizziness, nausea and pain in the ear area.
Meniere's disease	This disease leads to swelling of almost all structures of the inner ear, due to the increased content of endolymphatic fluid. Most often, the following symptoms occur with Meniere's disease: Noise in ears; Balance imbalance; Hearing loss; Dizziness.

Pathologies of the auditory nerve

Currently, there are following reasons lesions of the auditory nerve: sensorineural hearing loss (synonym – acoustic neuritis), tumor and neurosyphilis. The first disease can occur either acutely or gradually. It mainly affects receptors - special nerve cells, which convert sound wave vibrations into impulse. The types of sensorineural hearing loss are:

• Occupational hearing loss is a disease acquired as a result of working in hazardous work;
• Senile hearing loss is the gradual destruction of receptors due to a slowdown in metabolic processes in the body.

Treating the disease is quite difficult, since damage to the receptors is often irreversible.

Neurosyphilis almost always occurs acutely and affects not only the auditory nerve, but also meninges, spinal nerve roots. In this case, a large number of neurological disorders arise (skin dystrophy on the back, paresis, decreased sensitivity mainly on the torso, etc.), one of which is constant tinnitus.

A tumor of the auditory nerve is one of the most common oncological processes in nervous tissue. The first symptoms of a neuroma (this is the name of this tumor) are:

• Constant ringing in the ears;
• Perverted perception of sounds (louder/quieter than objective sound; perception of sounds that do not exist).

You should be wary of cancer and if you suspect a neuroma, undergo the necessary examination by a doctor.

Chronic disorders of cerebral blood flow (CBC)

Acute disturbances in the blood supply to the brain are called “vascular catastrophes” and they manifest themselves with pronounced symptoms - paralysis, loss of sensitivity, impaired consciousness, etc. With a chronic lack of blood flow, the brain receives enough nutrients and oxygen to continue to function fully. However, patients may be concerned about:

• Noise in ears;
• Periodic dizziness and weakness;
• Distraction of attention.

Deficiency of blood flow most often occurs due to the growth of plaque in the lumen of a large artery (atherosclerosis) or arterial hypertension. When these diseases are detected, it is important to treat them promptly and prevent complications such as stroke or ischemic attack.

Tinnitus with osteochondrosis

Lack of blood supply can occur not only due to damage to the cerebral arteries, but also to the cervical vessels. In this case, the doctor diagnoses not CNM, but vertebrobasilar insufficiency (VBI). Despite the fact that the symptoms for these pathologies are almost the same, the approaches to treatment have certain differences.

Tinnitus with osteochondrosis occurs due to compression of the vertebral artery and the development of VBI. A distinctive feature of osteochondrosis, which allows us to distinguish it from other diseases, is periodic neck pain and constant tension in the neck muscles.

One of the reasons is taking medications

In addition to taking various medications, provoking factors that increase this unpleasant symptom can be smoking, coffee abuse, head injuries, overwork, stressful situations, prolonged strong external noise, and old age.

List of drugs that have ototoxic effects of varying severity:

• Substances and drugs that have a negative effect on the central nervous system- antidepressants, haloperidol, aminophylline, tobacco, marijuana, caffeine, lithium, Levodopa
• Anti-inflammatory drugs— Mefevamic acid, Quinine, Prednisolone, Tolmetin, Indomethacin, Salicylates, Naproxen, Zamepirac
• Diuretics - Furosemide, Ethacrynic acid
• Cardiovascular drugs— Digitalis, B-blockers
• Antibiotics - Vibramycin, Metronidazole, Dapsone, Clindamycin, Aminoglycosides, Tetracyclines, Sulfonamides
• Organic solvents — methyl alcohol, benzene.

Major diseases manifested by noise, ringing in the ears

• Metabolic diseases- thyroid diseases
• Inflammatory diseases- acute, purulent, chronic otitis of the middle and external ear, exudative otitis media, cochlear neuritis, hepatitis, labyrinthitis,
• Vascular pathologies— , aneurysms carotid artery, high cardiac output, insufficiency aortic valve, venous noise, fever, anemia, arteriovenous malformations.
• Tumor diseases- meningioma, temporal lobe or brainstem tumor, cerebellopontine angle tumor, epidermoid tumor, tympanic membrane tumors
• Degenerative pathologies— , hearing loss due to poisoning with industrial poisons, arterial hypertension, spine
• Traumatic causes- ear or head injuries, perilymph fistula, acoustic trauma
• Mechanical reasons- foreign body, stenosis of the external auditory canal, osteomas and exostoses, blockage of the auditory tube.

Diagnostics

To find the cause of the noise it is necessary comprehensive examination, which should start with a visit to an otolaryngologist. This doctor will analyze your complaints and medical history, examine the outer ear and eardrum, perform audiometry and make a conclusion about the condition of the hearing organ.

Otoscopy

This is an important examination that helps identify:

• blockage of the ear canal (wax or foreign body);
• presence of external/otitis media;
• boil in the ear canal cavity;
• myringitis;
• exostosis.

Using a special device (otoscope), the doctor can examine all the structures of the hearing system, right down to the eardrum. If the cause of tinnitus is associated with pathology of this part of the ear, then diagnosis, as a rule, does not cause difficulties.

Pure-tone threshold audiometry

This research is based on the brain's ability to selectively perceive the loudest sounds. The amplitude of the noise heard by the patient is measured by playing different noises in frequency and volume and asking the patient to indicate what they hear. By compiling an audiogram in this way, you can determine the patient’s hearing threshold:

Auscultation of the temporal region

To diagnose the presence of noise, it is necessary to auscultate the skull with a phonendoscope:

• If the noise appears as a pulsation- then this is a vascular noise, as a consequence of a possible arterial aneurysm, tumor, arteriovenous malformation, and other diseases requiring surgical intervention.
• If by clicking- then this is muscle noise created by contractions of the soft palate and middle ear. For such convulsive contractions, treatment with anticonvulsants is indicated.

Additional diagnostic methods

If, using the above methods, the doctor was unable to detect the cause of tinnitus, other diagnostic methods should be used. The presence of vertebrobasilar insufficiency, CNMK and mastoiditis.

How is it carried out?	What can you find?
X-ray of the temporal areas Performed X-ray in two projections - front and side.	Mastoiditis– in this case, focal darkening will be noted on the image.
X-ray/MRI of the cervical spine X-rays are performed in a sitting position, with the head straightened, in two projections. MRI is a more accurate and expensive examination. It is performed in a lying position, without any preliminary preparation.	Osteochondrosis– the presence of deformation of the intervertebral discs or displacement of the cervical vertebrae indicates possible availability VBN.
Examination of the patency of the auditory tube The auditory tube (which opens in the mouth) forces air into the middle ear. The presence of protrusion of the eardrum when examined with an otoscope is considered normal.	Eustachite– due to swelling of the auditory tube, air will not be able to pass into the middle ear cavity and displace the eardrum.
Angiography of cerebral arteries and vertebrobasilar region A special instrument (catheter) is inserted through the subclavian artery and advanced to the mouth of the vertebral artery under X-ray control. A contrast agent is injected through the catheter, and the arteries of the vertebrobasilar and medullary areas are visualized.	KhNMK and VBN– Angiography shows narrowing of certain areas of the arteries.
Vestibular function study Using simple tests, the patient's coordination functions are assessed: Finger test - a person with his eyes closed must reach with his second finger with his left and right hand to the tip of the nose; Romberg pose - the patient puts his feet together, closes his eyes and tries to maintain balance; Complicated Romberg pose - the patient crosses his feet, closes his eyes and tries to stand in place.	Damage to the inner ear or auditory nerve– in this part of the ear the vestibular and auditory parts work together. Violation vestibular functions together with tinnitus suggests pathology of the inner ear/nerve.

Treatment

Only after a thorough diagnosis, when the causes of noise (ringing) in the ears have been established, treatment is prescribed by a qualified ENT doctor. Drug treatment consists of courses of metabolic, vascular, psychotropic, antihistamine and other drugs:

• Nootropic and psychostimulant drugs— Phezam, Omaron, Cortexin
• Psychotropic drugs are prescribed in extreme cases after consultation with a neuropsychiatrist - of course, they improve noise tolerance, but have a number of side effects, such as drowsiness, constipation), difficulty urinating, tachycardia, addiction, etc. You can use softer ones.
• Anticonvulsants- prescribed only for tinnitus caused by clonic contractions of the muscles of the soft palate or middle ear - carbamazepine (Tegretol, Finlepsin), phenytoin (Difenin), valproates (Depakine, Encorat, Convulex),
• Slow calcium channel blockers— Cinnarizin, Stugeron
• Antihypoxic agents — active substance Trimetazidine (Preductal, Trimectal, Angiosil, Deprenorm, Rimekor)
• Antihistamines- are prescribed when allergic reactions when there is stagnation of fluid in the ear, this is hydroxyzine (Atarax), promethazine (Pipolfen, Diprazine)
• Drugs that improve cerebral circulation— Betahistine, Betaserc , Vinpocetine, Cavinton, Telektol.

Except drug treatment the doctor may suggest physiotherapeutic treatment - endaural electrophonophoresis. At inflammatory diseases, otitis media, pneumomassage of the eardrum is indicated.

At severe violation Today there are modern models of hearing aids with digital programming; they can be behind-the-ear or miniature in-ear.

It is also possible to carry out psychocorrection using hypnotherapy, autogenic training, meditation, Yoga, pronouncing positive attitudes, affirmations that encourage a positive attitude and the desire for recovery through self-hypnosis. Can be used various options anti-stress therapy - massage, hydrotherapy.

Noise in the right ear is not an independent disease. This is a symptom that accompanies a wide variety of pathological conditions. In medicine, this manifestation is called tinnitus.

It should be noted that it is observed in a large number of people. It can manifest itself in both the right and left ears, or even in two at once, which is much less common.

Should I be concerned about an intrusive, albeit painless manifestation? The answer to this question is contained in this article.

General information

The occurrence of sounds of unknown origin in the ears causes anxiety in patients and is not entirely easy problem for doctors in the process of determining their cause.

Noise or ringing in the ears (both right and left) in most cases occurs due to natural processes. Its appearance is associated with irritation of the hairs localized in the inner ear. IN calm state they do not remind of themselves in any way, but when irritated, the movement of the hairs becomes chaotic, resulting in noise manifestations.

Noise that occurs in complete silence is usually called physiological. It is mainly caught due to the movement of blood through the small vessels of the inner ear. It is not possible to determine the nature of such noises solely from the patient’s description of symptoms.

The manifestation of physiological noise is more often observed in people over 40 years of age.

Pathological noises in the ear are associated not only with the condition of the hearing aid, but also with the presence of various diseases. This:

• acute otitis;
• instability of blood pressure;
• vegetative-vascular dystonia;
• osteochondrosis of the cervical spine;
• vascular atherosclerosis;
• hearing loss;
• Meniere's disease;
• consequences of traumatic brain injury;
• intoxication;
• oncology.

Diseases of the hearing aid in rare cases (no more than 15% of the total) cause noise or ringing in the ear.

Why is there a ringing in my right ear?

Among the factors that provoke noise and ringing in the right ear are diseases such as:

1. Right-sided otitis media. The accumulation of liquid secretions in the middle ear creates pressure on the delicate septum (tympanum). It manifests itself as noise.
2. Acute tubo-otitis. Characteristic manifestations of this pathology include not only inflammation of the eardrum, but also inflammation of the mucous membrane of the Eustachian tube. In addition to noise effects, the patient experiences intense pain, accompanied by a feeling of congestion in the auditory organ.
3. Meniere's disease. The accumulation of fluid in the inner ear causes compression of the arteries and poor circulation. The condition is accompanied by dizziness, and there is a high probability of hearing loss.
4. Intoxication caused by uncontrolled use of antibiotics provokes noise in the right ear without pain.
5. Tachycardia and others cardiovascular diseases contribute to the appearance of discomfort in the ear, manifested in the form of constant noise.
6. Formations of benign or malignant etiology are also accompanied by the appearance of sound effects.
7. Pathological deviations in the activity of the nervous system cause discomfort in the form of noises of various types - from ringing to musical melodies.

In addition to pathological factors, noise in the right ear can be the result of the banal formation of a wax plug in the ear canal, the entry of a foreign object into it, or a head injury.

Fatigue and nervous shock, alcohol abuse, strong tea and coffee also become prerequisites for the appearance of a sound spectrum in the ear.

Types of noise

When visiting a doctor, patients describe quite a variety of sound manifestations. This:

• constant pulsation;
• clicking;
• hiss;
• whistling;
• high-pitched squeak;
• buzzing insects;
• the fluttering of a butterfly's wings;
• dull hum.

Such noises are classified as simple. A more serious type of noise is the appearance of voices and musical sounds. These are complex manifestations indicating mental disorders and conditions requiring treatment under the supervision of a neurologist or psychiatrist.

A wide range of sounds found an explanation in folk superstitions. For example, ringing in the right ear means a wish will come true, and ringing on the left side means a change in the weather.

Doctors strongly recommend not to treat negative manifestations to the category simply discomfort, and immediately investigate the cause of their occurrence, since such symptoms may be a signal for the development of serious pathological processes in organism.

Associated symptoms

In addition to tinnitus, patients usually experience a state of fear and anxiety in front of an incomprehensible symptom. This causes:

• sleep disorders;
• fatigue;
• decreased performance;
• impaired attention and inability to concentrate;
• depression, complicated by the manifestation of symptoms characteristic of diseases associated with mental disorders.

Ringing and tinnitus in most cases are replaced by congestion, which significantly reduces the perception of external sounds.

For diseases

The appearance of noise against the background of various pathological conditions causes the following negative manifestations:

• headache;
• dizziness;
• pain inside the ear apparatus;
• hyperemia of the auditory organ;
• discharge from the ear;
• chills;
• general weakness.

Failure to promptly eliminate the root cause of noise effects leads to hearing loss.

Diagnostics

It is possible to get rid of an irritating symptom only if the causes and factors that provoke its occurrence are clarified.

Among the most effective diagnostic measures are:

1. Otoscopy.
2. Audiometry.
3. Vestibulometry.
4. Valsava's test.
5. Angiography.
6. Dopplerography.
7. Ultrasound of cerebral vessels.
8. X-ray of the cervical spine.
9. CT and MRI.

A mandatory procedure is a laboratory blood test to detect inflammation or infection, and a sensitivity test to antibacterial drugs is also performed.

A comprehensive examination involves consultation with an otolaryngologist, therapist, ophthalmologist, cardiologist, neurologist, neurosurgeon.

Treatment

The fundamental principle of eliminating a negative symptom is the obvious interdependence of treatment and causes. Without detecting diseases or various conditions, which have become provocateurs of noise in the ear, it is impossible to cure such irritating manifestations.

An integrated approach to eliminating them involves the use medications, which help relieve anxiety, normalize the condition of organs and systems, and relieve the inflammatory process.

Medicines are prescribed taking into account the underlying disease:

1. Antibiotics. Their use is due to the presence of inflammation or infection localized in the ear. At the same time apply antihistamines to relieve swelling and reduce exudative discharge from the auricle. Among the most effective are Fenkarol, Hydroxyzine and Promethazine.
2. Cerebral circulation stimulants. Their purpose is justified by the need to normalize blood flow. These are Betahistine, Cinnarizine, Cavinton.
3. Nootropic drugs. Their use makes it possible to achieve positive dynamics in the fight against manifestations of noise in the ear. The most effective are Mexidol, Cortexin, Phezam.
4. Vitamin complexes. Helps strengthen vascular walls and restoration of nerve endings.

Other therapeutic methods

In addition to using medications, to eliminate annoying noise, it is recommended to undergo a course of physiotherapeutic procedures. This:

• pneumomassage sessions to improve the condition of the eardrum;
• electrophoresis;
• laser therapy;
• acupressure;
• acupuncture.

There is no specific treatment aimed solely at eliminating ear noise. Only comprehensive treatment that takes into account all aspects of the patient’s condition and accompanying symptoms gives positive results. The disease that became the root cause is eliminated severe symptom, the symptom itself disappears.

Traditional medicine recipes

The use of folk recipes is allowed as an adjuvant to the main therapeutic treatment.

Here are some tried and tested recipes that are easy to make at home:

1. Peppermint infusion. 1 tbsp. l. dried leaves pour 200 ml of boiling water. Leave for 5 minutes, strain. It is recommended to drink this portion in two doses - morning and evening.
2. A medicinal collection of cornflower, lilac and thyme flowers. All components (1 tablespoon of each raw material) are poured boiled water(300 ml). Then simmer over low heat for 3 minutes. Cool. Strain. Take 20 ml three times a day.
3. Tincture of red clover flowers. 2 tbsp. l. pour 50 ml of vodka over the raw material and keep in a dark place for 5 days. Drink 1 tsp. before eating.

It should be remembered that it is not possible to cure tinnitus only with the help of folk remedies; they are not an alternative to the main treatment. Their use must be agreed with your doctor.

Elimination of noise in the right ear can be treated if you consult a doctor in a timely manner.

Positive dynamics are observed in a short time if the patient strictly follows the instructions of the attending physician.

Self-medication leads to a protracted course of the symptom and is accompanied by the likelihood of developing serious complications, including complete deafness.