Deafness caused by cochlear injury

The cochlea is a spiral tube containing auditory and sensory cells. The cochlea breaks down sound according to its frequency and is then converted by sensory cells into neural code within the auditory nerve. The common causes of hearing loss and tinnitus caused by cochlear damage are as follows:

Meniere’s disease Meniere’s disease is a progressive disease, which is defined as periodic vertigo attack, fluctuating sensorineural hearing loss, tinnitus and ear fullness.

In the early stage of the disease, hearing loss only affects the low frequency and is almost reversible. But as the disease progresses, residual hearing eventually deteriorates and spreads to a higher frequency. Symptoms start on one side, but in many patients, the contralateral ear is involved 10 or 15 years later, depending on the course of the disease. Tinnitus may persist between acute attacks, but it usually worsens two days before vertigo.

Changes of cochlear blood flow: the cochlea needs appropriate blood supply to maintain its function. The labyrinthine artery is a terminal artery, and there is no collateral blood supply to the inner ear. Even slight changes in blood perfusion can cause cochlear damage. In addition, the cochlea relies on the high energy consumption of blood supply to make it vulnerable, so it needs to maintain an excellent cochlear fluid balance.

Many systemic diseases that cause hearing loss are also accompanied by tinnitus if they are caused by changes in circulation or microcirculation. Many hypotheses are proposed to explain the pathology of sudden hearing loss without any other symptoms. One hypothesis is vascular damage. Although no conclusive evidence has yet been found, it has been suggested that viral infection, which attacks endothelial cells, causes sudden hearing loss. Hearing loss can be very severe at first, and is often accompanied by tinnitus. Hearing can deteriorate in a few hours. Fortunately, tinnitus is almost always limited to one ear and has good spontaneous recovery.

In general, hearing function recovered spontaneously in 1 / 3 of the patients and improved in 1 / 3 of the patients, but there was no change in the remaining patients. In some cases, hearing will improve, while tinnitus will remain unchanged. Use steroids, antiviral drugs or hyperbaric oxygen.

Barotrauma tinnitus may appear after diving or in flight, especially when suffering from cold or allergy symptoms at the same time. In these cases, barotrauma may cause symptoms because sudden changes in barometric pressure affect cochlear fluid. Tinnitus may be temporary or persistent. Tinnitus often occurs if the trauma is severe enough to cause rupture of the tympanic membrane or rupture (leakage) of the round window, resulting in hearing loss and / or vertigo. Appropriate medical or surgical treatment is needed to restore hearing and relieve tinnitus.

Tinnitus and balance symptoms are common in mild and severe head trauma. After head injury, temporal bone fracture may occur, causing cochlear damage accompanied by serious hearing loss, vertigo and tinnitus. Acute vertigo usually lasts for several days and then relieves, but dizziness may last. Hearing loss is often permanent, and tinnitus may be reduced or sustained with hearing loss.

Head trauma without temporal bone fracture may cause cochlear damage, accompanied by such symptoms as dizziness, tinnitus, and sometimes hearing loss. These symptoms can last for months and then gradually disappear, while tinnitus often persists. The mechanism of hearing loss caused by concussion is not fully understood. It has been suggested that higher neural structures are involved.

Head injury can also cause blood to seep into the cavity of tympanum, rupture of tympanic membrane and dislocation of ossicular chain, leading to conductive hearing loss and tinnitus. These injuries often require appropriate surgical treatment.

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