Nervous tinnitus

Introduction Neurological tinnitus is mainly caused by damage to the ear nerves and ear nerves (ear veins). Neurological tinnitus refers to the abnormal sound sensation that people produce without any external stimuli. For the diagnosis of neurological tinnitus, it is necessary to exclude other causes including tinnitus caused by external ear, middle ear disease, etc., and hearing detection has hearing impairment. Generally, for the treatment of neurological deafness, clinically, vasodilator drugs are often used to increase the blood flow of ischemic tissue, reduce endometrial edema and improve endolymphatic circulation to maintain the normal function of tissue cells.

Cause

At present, neurological tinnitus is still unclear, mainly caused by a certain factor causing dysfunction of the auditory nerve endings. Neurological tinnitus is characterized by large or small tinnitus sounds, usually continuous long sounds, such as humming or the sound of telephones, as well as sounds such as running water, wind, and machine sound. The routine examination of the ear, audiological examination, tinnitus test, etc. are required for the diagnosis.

Because the cause of this disease is more complicated, such as cold, mood, fatigue or noise, it should be actively treated early, otherwise it may cause hearing loss and even cause deafness.

an examination

Related inspection

Otolaryngology CT examination of cerebrospinal fluid sodium

It is generally not difficult to diagnose neurological tinnitus based on medical history or symptoms, but in order to confirm the diagnosis, the following tests are still needed:

1. Regular examination of the ear.

2. Electrical audiometry: The functional status of the auditory system can be objectively evaluated. When people have hearing impairment, the initial assessment of hearing impairment is based on electrical audiometry.

3. Acoustic admittance: the reciprocal of the acoustic impedance. The examination included: tympanic sound admittance test, tympanic muscle reflex, eustachian tube function test.

4. Auditory brainstem evoked potential.

5. Otoacoustic emission: such as an "acoustic probe", provides a window for clinical understanding of the mechanical activity of the cochlea, especially the outer hair cells. It is of great significance for guiding clinical treatment and prevention.

6. Masking test.

7, lidocaine test.

8, imaging examination: feasible CT and MRI examination.

Differential diagnosis

Differential diagnosis of neurological tinnitus :

First, subjective tinnitus

(1), external auditory canal disease

Mainly sputum embolism, external ear canal embolism, external auditory canal cholesteatoma, when taking a bath, when the shampoo is wetted by water, it suddenly causes low-key tinnitus and hearing loss.

(B), middle ear disease

Catal otitis media

There are often low-pitched, irregular tinnitus, and the tinnitus can disappear after the eustachian tube is blown, but it is easy to relapse.

2. Acute and chronic suppurative otitis media and its sequelae

The low-pitched tinnitus is stubborn and difficult to treat.

3. Otosclerosis

The low-pitched tinnitus is often aggravated by inappropriate blow-up treatment, menstruation, and fatigue.

(3) Inner ear disease and auditory nerve injury

Lost blood circulation disorder

This is the most serious cause of subjective tinnitus. The tinnitus is high pitch or whistle, humming. Sudden onset, may be due to abnormal reactions, endocrine, anemia, etc. caused by anemia or congestion. The intensity changes greatly, when the time is strong and weak, sometimes there is no, and there is persistence.

2. Ototoxic drug poisoning

All ototoxic drugs can cause tinnitus. Tinnitus often appears before deafness. It can be first developed in one ear and gradually developed into both ears. Tinnitus is a high-pitched tone, and about half of the patients have a head. Tinnitus symptoms can be alleviated or disappeared after acute poisoning. Chronic poisoning patients do not disappear after stopping the drug.

3. Meniere's disease

It often causes low-pitched hair-like tinnitus, which often occurs before the onset of vertigo, or at the same time as deafness and dizziness. Tinnitus can disappear or be alleviated during the remission period of the disease.

Repeated episodes can be converted to persistent high-pitched tinnitus.

4. Senile

Common in people over the age of 60, mostly bilateral, high-pitched tinnitus. Tinnitus is often a precursor to deafness.

5. Acoustic neuroma

Tinnitus is characterized by unilaterality, high pitch such as humming or whistling. Initially it was intermittent and gradually changed to continuous. Often accompanied by other cranial nerve symptoms, such as headache, facial numbness and so on. X-ray filming of the internal auditory canal, CT internal auditory canal scan, and brain electrical response audiometry can confirm the diagnosis.

(four) systemic diseases

1. Hypertensive tinnitus is mostly bilateral, often consistent with the rhythm of the pulse. In addition to tinnitus, you can also have high blood pressure symptoms such as headache and dizziness. The hearing test is normal. Tinnitus can be alleviated or disappeared after taking blood pressure lowering drugs.

2. Autonomic dysfunction is common in women during puberty or menopause. Tinnitus is variable, sometimes high-pitched, sometimes low-pitched, with single ears with alternating ears, sometimes persistent and time-separated. There are also systemic symptoms such as dizziness, insomnia and more dreams.

Second, objective tinnitus

(a) vascular tinnitus

Common in jugular bulbar tumor, carotid aneurysm, intracranial aneurysm, intracranial arteriovenous fistula and so on. This kind of tinnitus is characterized by frequent frequency synchronization with the heartbeat or pulse. You can hear the sound with a stethoscope, and the tinnitus can be alleviated or disappeared when the corresponding blood vessel is pressed hard.

(B) muscle contraction tinnitus

The "Kata" sound caused by the clonic contraction of the sacral muscles, the levator muscles, the tympanic muscles, and the sacral muscles. The ear of such a sound examiner can be heard close to the ear of the patient.

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