"To achieve success in treatment, a multidisciplinary team made up of ear specialists, nurses, audiologists and specialists in psychosomatic medicine is essential".
DR. Mª TERESA HEITZMANN HERNÁNDEZ
SPECIALIST. OTORHINOLARYNGOLOGY DEPARTMENT
What are tinnitus?
Tinnitus or ringing in the ears is a frequent symptom in the population, it occurs between 10-17%, but in most cases, it is not disturbing (because there is no alteration in its central processing) and no specific treatment is necessary.
It is usually a sound such as a beeping, buzzing, noise from the electricity grid, etc. The most frequent are those of high pitch. In the cases in which they bother, they can alter the dream and get to interfere with the concentration and accomplishment of daily activities.
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What are the symptoms of tinnitus?
Tinnitus is not usually a symptom of a serious disease but it is recommended to see a specialist to rule out a hearing problem in the first place.
The diseases in which they can appear are:
- Hearing loss (deafness or hearing loss)
- Wax caps
- Tumors of the auditory system
Do you have any of these symptoms?
You may have tinnitus
What are the causes of ringing in the ears?
At present it is unknown but it is known that the cause of the discomfort is a dysfunction of the auditory pathway that is reversible and can be treated with retraining or habituation therapy (TRT).
The factors that can facilitate its appearance are:
- Hearing loss.
- Ear infections.
- Exposure to loud noise.
- Ototoxic drugs: acetylsalicylic acid, quinine, some antibiotics, etc.
- Cerumen plugs.
- Tumors of the acoustic nerve.
- Other causes such as spinal problems, temporomandibular dysfunction, high blood pressure, etc.
Some circumstances can make notice an increase of the tinnitus in the ear as they are the strong noises and situations of stress.
How are tinnitus diagnosed?
Tinnitus is a perception of noise in the ears or in the head without an external source of sound and without cochlear vibratory activity, a phenomenon that occurs in the presence of an external noise.
Often patients with tinnitus refer to hyperacusis, an increase in sensitivity to external noise that makes it worse tolerated.
In the presence of this symptom, it is necessary to explore the ear and the auditory pathway to rule out a problem at the central level.
If there is no justifiable cause and the patient is very upset, different treatments can be carried out to improve these noises.
How is ringing in the ears treated?
In 95% of the patients, who follow the indications, the discomfort of the tinnitus is removed.
At present there is no effective drug treatment so a retraining or habituation therapy (TRT) is performed
It is known that the cause of a tinnitus is the alteration of its processing at a central level in the auditory pathway. Thanks to the existence of neural plasticity, we can reverse this alteration, returning the auditory pathway to normal, leaving the tinnitus at a subcortical (subconscious) level and removing the discomfort.
The tinnitus thus becomes an irrelevant stimulus (similar to glasses, watch ...), which the brain does not detect and if at some point it detects it, it will not bother you.
This treatment requires two steps:
- Therapeutic advice: a fundamental part of the treatment whose objective is to eliminate the negative significance that the tinnitus has for the patient, achieving that it becomes a neutral signal for the brain.
- Sound therapy: Its objective is to make the tinnitus remain at a subcortical level in the auditory pathway, so that it is not perceived and stops bothering.
Sound therapy can be applied in various ways.
In all cases it is recommended to avoid silence by enriching the environment with music, radio, television in the background, etc.
In addition to this indication, if there is no hearing loss, sound generators should be used. They are small electronic devices that are put in both ears and that emit a white noise. It should be used between 6-8 hours a day, always without masking the tinnitus and at a comfortable level for the patient. They are also used when there is hyperacusis or decreased tolerance to outside sounds.
When there is a loss of hearing or hypoacusis, hearing aids will be indicated that by improving the hearing allow the alteration of the tinnitus processing to be corrected and to be noticed less at cortical level.
In 95% of the patients, who follow the indications, the discomfort of the tinnitus is removed and the patient's quality of life is restored.
In those patients in which there is a significant affectation of the mood, the psychological and/or psychopharmacological treatment to reduce anxiety, improve depression, etc. is fundamental to reverse the tinnitus processing alteration and to achieve the treatment objective.
Where do we treat it?
IN NAVARRE AND MADRID
The Department of Otolaryngology
of the Clínica Universidad de Navarra
The Department of Otorhinolaryngology of the University of Navarra Clinic is a national and world reference in numerous highly specialized surgical procedures.
We have the latest technology and we perform all diagnostic tests in less than 48 hours in order to offer our patients the best solution in the shortest time possible.
We were one of the first centers in Spain to use robotic surgery in the surgical treatment with the Da Vinci® System.
Organized in specialized units:
- Otology - Hearing.
- Rhinology - Nose.
- Pharyngology - Throat.
- Laryngology - Voice.
- Balance disorders.
- Head and neck problems.
Why at the Clinica?
- Experts in the treatment of hearing problems.
- Pioneers in axillary surgery to avoid scarring.
- National reference center in tissue sealing for tonsil removal.