Treatment and effect of tinnitus

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Definition of tinnitus:

Tinnitus means that when our ears are not stimulated by foreign sounds, they can feel the jingle or rumble (most of them are the noise that bothers people), which may be heard from the ears or the head, called tinnitus. According to the statistical report, tinnitus patients account for about one tenth of the patients in the outpatient department of otology. Only next to the patients with hearing impairment, about 5% of these patients complain about the serious tinnitus, which affects their daily life and causes their physical and mental fatigue, which shows the severity of the tinnitus impact.

Classification of tinnitus:

Tinnitus is classified according to the time of occurrence. It can be divided into two types: transient (acute) tinnitus and chronic tinnitus. Transient tinnitus refers to the tinnitus that has been produced recently but not before, which is less than that within three months. Chronic tinnitus means that the tinnitus has been troubled for more than three months. It is easier to find the possible pathogenic factors of transient tinnitus, and to improve and cure it. Chronic tinnitus is more likely to be related to many pathogenic factors because of its long occurrence time, and patients are often exhausted physically and mentally, and lack of confidence and patience to doctors, so it is not easy to treat, often can only be controlled or improved, it is more difficult to cure.

Types of tinnitus:

At present, the classification accepted by the public is: his conscious tinnitus and conscious tinnitus. He felt tinnitus, that is, other people (doctors) can also use instruments or ears to hear the tinnitus complained by patients (a small part); while conscious tinnitus can only be heard by patients themselves, but others (doctors) can’t hear it (a large part of tinnitus patients).

Causes of tinnitus:

The real cause of tinnitus is not clear; according to the tradition and more popular, the possible causes are as follows; he felt tinnitus: the most common causes are pulsating tinnitus and spasmodic tinnitus caused by vascular diseases (such as problems of vein, artery and arteriovenous catheter) and muscular diseases (such as problems of middle ear muscle, Eustachian tube muscle and throat muscle). Conscious tinnitus: most of the patients are deeply troubled by it, which may be caused by a variety of reasons, from the diseases of the outer ear (earwax blockage, otitis externa), the diseases of the middle ear (tympanic membrane perforation, serous otitis media, otosclerosis), the diseases of the inner ear (Meniere’s disease, ototoxic drugs, noise damage, senile hearing impairment), the diseases of auditory nerve and nerve conduction path（ Acoustic neuroma, brainstem angiosclerosis and diseases of cerebral cortex (stroke, degenerative disease, amnesia), as long as there is a problem in any part of the auditory pathway, it may produce abnormal sound.

Symptoms of tinnitus:

The clinical manifestations of tinnitus are very diverse, which can be unilateral or bilateral, or continuous or intermittent, high-frequency or low-frequency, or other different timbres, such as cicadas, buzzing, ticking, rumbling, insects, jingle, etc., which reflect the complexity of its etiology and test the ability of doctors to diagnose.

Degree of tinnitus disturbance:

There are many kinds of tinnitus troubles in clinical classification, but it is usually a convenient classification in clinical use, which can be generally divided into four levels: Level I is that tinnitus can be heard only when it is very quiet, and level II is that tinnitus can be heard when it is slightly quiet, such as sleeping, and level III is that tinnitus can be barely heard in noisy environment To degree IV, even in noisy environments, the tinnitus is still very loud.

Relationship between tinnitus and hearing:

What is the relationship between tinnitus and hearing loss? We found that patients with tinnitus often have hearing loss, accounting for about 90%; but will people with hearing loss have tinnitus? The answer is not necessarily. Similarly, there are still many people with normal hearing, who will suffer from tinnitus. But is the patient’s hearing loss caused by tinnitus? The answer is no, in fact, it is the cause of the patient’s hearing loss, such as noise exposure, sudden deafness, ototoxic drugs, ear infection, etc., and also accompanied by tinnitus. As for whether tinnitus will cause further hearing loss of patients? Theoretically, it will not. Tinnitus will affect the concentration or attention of patients, but will not cause further hearing loss of patients.

Important concepts of tinnitus treatment:

For the treatment of tinnitus, we should treat tinnitus as a symptom, aiming at improving its symptoms, not treat tinnitus as a disease, and try to cure it completely; therefore, we should adopt combined therapy to improve its improvement rate, not cure rate, so doctors should always remind themselves whether tinnitus may be a serious disease Warning signs of disease?

Therapeutic effect of tinnitus:

The cause of tinnitus is very complex, so the therapeutic effect is not very satisfactory. Therefore, it is suggested to adopt the combined therapy, which includes the treatment of general medicine, tinnitus obscurer and hearing aid, biofeedback training, psychotherapy and otology operation. In the treatment of tinnitus, we must remember that “tinnitus” is only a symptom. We must find out the cause of tinnitus, and aim at the cause of tinnitus, then we can treat it thoroughly. Therefore, it is the most effective method to find out the possible cause of the disease and to give the most appropriate treatment by asking the medical history, otoscopy, a series of instrument examination items, careful diagnosis of doctors and patient’s patience.

Treatment of tinnitus:

1. Strengthen psychological construction and counseling:

A. tell tinnitus that it will not cause further hearing loss or total deafness. Don’t be afraid of tinnitus. Try to enjoy tinnitus and “coexist peacefully” with tinnitus.

B. eliminate unnecessary anxiety and avoid stress.

2. Try to avoid the following:

A. avoid some more irritant food, such as coffee, tea, pepper, etc.

B. avoid long-term exposure to excessive noise and noise.

C. avoid excessive fatigue and staying up late, and fully sleep and rest.

D. avoid using earphone or earplug of Walkman, listening to music and CD.

3. Treatment of general medicine:

It is mainly composed of mild tranquilizers (mental tranquilizers), which can improve the anxiety and insomnia caused by tinnitus; in addition, it can promote the circulation function of inner ear, auditory nerve and brain; in addition, some doctors can add some vitamins that can promote the function of the mind and channel.

4. Biofeedback training:

It is a kind of skill training to relax the body, including moderate exercise and massage. It mainly uses techniques such as relaxing the nervous tension of the whole body, improving the circulation of the head, moderate deep breathing and relaxing the muscles of the whole body. The real purpose of the biofeedback training is to guide the tinnitus patients to learn how to relieve the stress and tension of the general daily life. For serious ears The effect of Ming on patients’ daily life is good.

5. Tinnitus retraining method:

Tinnitus retraining therapy is the latest popular tinnitus therapy. It combines low volume and continuous background sound, and uses one-to-one direct psychological consultation and guidance of doctors and patients. The patient uses an ear type sound generator’s hearing aid to continuously maintain the background sound around him for at least 8 hours a day. In this way, combined with the consultation and guidance methods, the purpose is to help the tinnitus patient to adapt and get used to his tinnitus sound. After 12-24 months, the general tinnitus retraining practice method, after 12-24 months, it is unnecessary to use the ear type sound generator’s hearing aid. Its effect Yes, but it takes time (doctors and patients).

6. Use a tinnitus mask:

Using the principle of “auditory inhibition”, first match the tinnitus frequency of the patient, whether it is low, medium or high frequency? Select a tinnitus hearing aid with similar frequency, use a volume slightly larger than the tinnitus (it can cover the tinnitus), and wear it for about one to two hours every day. This kind of tinnitus masking device is different from the inner ear sound generator hearing aid in tinnitus retraining method. Another method, its principle