Updated on 14/06/2022
Decreased hearing and ringing in the ears, in other words tinnitus, are very common symptoms. Hearing loss to the extent that affects communication in daily life is seen in 50% of people after the age of 60-70, and in 80% of people over the age of 85. Clinically significant chronic tinnitus is seen at a rate of 10-15% and its incidence increases with age, just like hearing impairment. Tinnitus is often accompanied by decreased hearing. Hyperacusis, which can be defined as intolerance to normal sounds, is rarer, but it may also be associated with ringing in the ears.
Tinnitus is a perception of sound manifesting in the form of ringing, cricket sound, humming or rustling. It is a finding, not a disease, and in most cases the underlying cause cannot be found. Most people (12-30% of the population) experience ringing in the ears, but only 0.5-3% find it disturbing. Its incidence increases with age. Most tinnitus is subjective, meaning that no one but the patient can hear it. Objective tinnitus, which is less common, usually occurs due to vascular or mechanical reasons near the ear and can be heard also by the examiner with appropriate methods.
Tinnitus usually occurs due to damage to the hearing cells in the inner ear. When cells are damaged, the signals they send to the brain change. Damage to these cells is sometimes temporary, but tinnitus can be permanent. Sometimes the cause of tinnitus may not be related to the ear. Temporomandibular joint (jaw joint) diseases, serious anxiety and neck injuries can also cause ringing in the ears.
Risk factors are observed to be decreased hearing, advancing age, male gender, exposure to noise, family history, jaw joint syndrome, occipital tube dysfunction, accumulation of dirt in the external auditory canal, hypertension, diabetes and the use of some ototoxic drugs.
Pulsatile tinnitus is tinnitus concurrent with the heartbeat. Both arterial and venous anomalies can cause pulsatile tinnitus. Pulsatile tinnitus may occur due to reasons that increase heart rate such as thyrotoxicosis, anaemia and pregnancy, and disappear when the underlying cause is rectified.
Tinnitus is usually not curable. However, your doctor may suggest medications and techniques to help you live with your tinnitus more easily.
Dinces E.A Tinnitus Up to Date Oct 2021
Torres J, Cucchiara B.L. Pulsatil Tinnitus Decision-Making in Adult Neurology 2021