The causes and mechanisms by which buzzing arises & Co. are still largely unknown. In most cases the annoying and insistent sound originates in peripheral structures.
Tinnitus are auditory perceptions of various kinds (whistling, buzzing, rustling, crackling, pulsation, ticking) that do not correspond to any real sound stimulation, neither external nor internal to the body.
The mechanisms by which they arise are complex and have not yet been fully understood.
Auditory perceptions are, in general, the result of the brain’s processing of bioelectrical signals into which acoustic receptors located in the inner ear transform sounds.
Tinnitus derive from similar bioelectric signals, which however are generated autonomously (in the absence of sound stimuli) along the path of the auditory pathways.
They can originate anywhere in the auditory system:
- receptors of the inner ear (so-called hair cells cochleagers)
- auditory nerve (which carries bioelectric signals to the brain)
- central auditory structures (brainstem nuclei) and auditory area of the cerebral cortex.
In most cases, tinnitus arises on the periphery of the auditory system, that is, from the acoustic structures of the ear, due to a pathological process that alters the functioning of cochlear hair cells.
What seems to happen if this peripheral alteration persists is that the cerebral nerve centers, “alerted” by the anomaly of the situation, begin to selectively process ghost sounds, helping to amplify their perception.
The causes of tinnitus
Among the possible causes of tinnitus of peripheral origin are:
- Bacterial otitis
- Otitis viral
- otosclerosis
- congenital deafness
- sensorineural hearing loss (with gradual or sudden loss hearing)
- traumatic injuries
- Ménière’s disease
- local vascular changes (due to malformations, atherosclerosis, hypertension)
- systemic inflammatory or endocrine diseases
- some food intolerances
- continuous or frequent exposure to loud noise
- the abuse of alcohol, toxic substances and numerous drugs.
Given the great heterogeneity of possible causes, the therapeutic approach to tinnitus is also very varied.
Tinnitus therapies
In addition to the therapies indicated to treat individual diseases of origin and some symptomatic pharmacological treatments, in truth not very specific, there are also targeted rehabilitation techniques that aim to reduce the discomfort created by the perception of ghost sounds when it is not possible to completely eliminate the cause.
Among the rehabilitation therapies, the most consolidated is Tinnitus Retraining Therapy, better known by its acronym TRT.
It consists in inducing the subject to gradually become accustomed to tinnitus so as to reduce its conscious perception.
This result is achieved by “convincing” its nerve centers to reprogram the filtering activity of the sound signals they normally perform, learning to no longer pay attention to ghost sounds.
The technique commonly used for this purpose is the so-called “sound enrichment”, to which the subject must be subjected for a period of at least 12-18 months and as continuously as possible.
This is done through small wearable hearing aids, but made in such a way as not to obstruct the ear canal, which constantly generate sound stimulation with particular physical characteristics (called white noise), which serves to “mask” tinnitus thus making it more difficult for the brain to identify them.
Diagnosis
The diagnosis of tinnitus involves several tests, in addition to the ENT visit. Let’s see them in detail:
| Tonal and vocal audiometry | Assess hearing ability |
| Impedancemetry | Assess the functionality of ear structures medium |
| Acuphenometria | Measures intensity and frequency of perceived sounds |
| Test with auditory evoked potentials | Check the functionality of the auditory nerve structures |
| Electrocochleography | Check the functionality of auditory receptors |
| TAC | Visualize middle and inner ear morphology |
| Magnetic resonance imaging | Highlights any lesions of the structures Nerve |
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
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