Definition of Tinnitus
Tinnitus is a hearing loss in the form of complaints feelings while listening to the sound without any sound or noise stimuli from the outside. As far as the complaints of the ringing, hissing, roaring, or a variety of other sounds.
There are 2 kinds of tinnitus, which is divided into objective tinnitus and subjective tinnitus. Objective tinnitus occurs when sound can also be heard by the examiner or by auscultation may also around the ear. Vibritorik nature is derived from vibration or vibration muscular system (muscles) or cardiovascular around the ear. Whereas subjective tinnitus occurs when sound is only heard by the patient himself, and the type of tinnitus is most often the case. The nature of subjective tinnitus is irritating nonvibratorik due process or degenerative changes in the auditory tract that starts from cells of the cochlea hair shakes up the nerve center of the listener.
Pathophysiology of tinnitus
The mechanism of tinnitus due to electrical activity in the auditory that cause feelings about the sound, but the impulse that occurs not from external or external sound is transformed, as it were, from the sources of abnormal impulses in the body of the patient himself.
Abnormal impulses that can be caused by a variety of ear disorders. Tinnitus can occur in a variety of intensities. Tinnitus in a low voice, as rumbling or high-pitched, like a buzzing. Tinnitus can be constant or intermittent sound.
Tinnitus is usually associated with sensor neural deafness and can also occur due to conduction disturbances. Tinnitus is caused by conduction disturbances, usually in the form of sound in a low tone. If accompanied by inflammation, the hum was throbbing (pulsation tinnitus).
In a low tone tinnitus and there are conduction disturbances, usually occurs in the ear canal due to wax blockage or tumor, tuba Katar, otitis media, otosclerosis, and others.
Objective tinnitus is often caused by vascular disorders. It reads in tune with the pulse, such as aneurysms and atherosclerosis. Mechanical disturbances can also cause tinnitus objective, such as Eustachian tube is open, so that when the tympanic membrane to move and breathe happened tinnitus.
Klonus muscular spasms tensor tympani and stapedius muscular, and soft palate muscles can cause objective tinnitus.
If there is a vascular disorder of the middle ear, such as tumor carotid (carotid-body tumors), then the sound of blood flow will cause tinnitus as well. At sensor neural deafness, subjective tinnitus usually occurs high notes (around 4000Hz). On drug intoxication such as salicylates, quinine, streptomysin, dehidro-streptomysin, garamysin, digitalis, kanamysin, high-pitched tinnitus can occur, continuous or intermittent.
At endolymphatic hypertension, such as Meniere's disease can occur tinnitus at low and high tones, so it sounds rumbling or buzzing. This disorder is accompanied by sensor neural deafness and vertigo. Terminals cochlear vascular disorders that occur in patients with stress-induced endocrine balance disorders, such as premenstrual, hypo metabolism or during pregnancy can also arise tinnitus or the disorder will go away when the situation is back to normal.
Tinnitus diagnosis
Tinnitus is a symptom of ear disease clinic, so the diagnosis for treatment need to find a cause that is usually difficult to know. Anamnesis is a priority and is essential in the diagnosis tinnitus. need to be asked Quality and quantity tinnitus, the other accompanying symptoms, such as the presence or vertigo and hearing loss and other neurologic symptoms, a history of the occurrence of unilateral or bilateral tinnitus, whether to interfere with daily activities. ENT physical examination and Otoskopi should be routinely performed, inspection tuner, speech audiometry, BERA examination if necessary and or ENG and laboratory examinations.
Some things to note in anamnesis are: long attack tinnitus, when it takes place in a time of 1 minute it goes away on its own; it is not a pathological condition. When it takes place within 5 minutes is a pathological condition. Subjective tinnituses with unilateral hearing loss have suspected the possibility of an acoustic neuroma tumor or head trauma. When the possibility of bilateral tinnitus occurs in drug intoxication, presbiakusis, noise trauma, and other systemic diseases. If the patient is difficult to identify the right or the left likely in the central nervous system. Quality tinnitus, when a high-pitched tinnitus disorder usually at basal cochlear regions, peripheral and central auditory nerves. Such low-pitched roaring tinnitus waves as typical for cochlear hydrops endolimfa abnormalities.
Tinnitus treatment
Tinnitus treatment is a complex issue and is purely psychoacoustic phenomena, so that cannot be measured.
Needs to know the causes of tinnitus that can be treated according to the cause. Sometimes it is difficult to know the cause.
In general, the treatment of the symptoms of tinnitus can be divided in 4 ways:
- Electrophysiologic is to create an electro acoustic stimulus intensity louder than tinnitus, hearing aid or tinnitus mask.
- Psychological, to provide psychological consultation to reassure patients that the disease is not harmful, and by teaching relaxation every day.
- Medikamentosa therapy treatment, until now there is no clear agreement among others to increase cochlear blood flow, tranquilizers, antidepressants, sedatives, neurotonik, vitamins, and minerals.
- Surgery performed on tinnitus that has been proven to be caused by acoustic neuroma.Pasien suffering from this disorder should be given a good explanation, so fear not aggravate the complaint.
Sedatives or sleeping pills may be given at bedtime in patients whose sleep is very disturbed by the tinnitus. The patient should be explained that the disorder is difficult to treat and are encouraged to adapt to the disorder.
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