Questions concerning the causes and pathogenesis of ear noise have been of interest to specialists in the field of otolaryngology for many decades. Patients at the appointment during the collection of anamnesis and complaints name various characteristics of the noise. Subjective, inaudible to people around them, sounds in the ears can be noted constantly, to which the patient must draw the attention of the attending physician. Sometimes the noise becomes objective - in this case, it is not only the patient who notices it. Doctors of various profiles have to think about how to correctly interpret the phenomenon of ear noise, since explaining the causes of its occurrence is an important step towards determining treatment tactics.
Provoking factors
What is tinnitus? It is an intrusive, unpleasant and annoying sound to the patient and is not generated by any source in the environment. It can manifest itself in different ways - for example, low-frequency tinnitus in silence in elderly people becomes less noticeable against the background of music, conversation. Tinnitus in a child in some cases indicates the presence of inflammatory diseases of the external and middle part of the organ of hearing, has a transient nature, is eliminated by treating the underlying pathology.
If tinnitus occurs, what does it mean? The patient notices an extraneous sound that is not associated with an external sound source in various cases. When something seems to be making a noise in your ear, you need to figure out how to classify the noise. There are two main types of "noise background" - subjective and objective. The subjective sound can only be characterized by the patient himself - no one else can hear it, including the doctor with the help of a phonendoscope (which distinguishes it from the objective version). To understand what tinnitus means, you need to take into account the presence of probable provocateurs:
- Occupational hazards.
- Intoxication, infection, injury.
- Pathology of the cardiovascular system.
- Pathology of the musculoskeletal system.
- High levels of ambient noise.
If a child has a ringing in his ears, this may be due to an infectious disease.
"Sound background" in the ears is a warning sign that sometimes occurs after severe infections (for example, influenza). In the ear, phonitis also occurs with otitis media (usually in the case of an average form), various types of rhinitis.
All of these factors do not cause noise in the ear, but diseases that lead to their appearance. For a high-quality diagnosis, one should take into account the nuances of the patient's professional activity and area of residence, the presence of burdened heredity. The hereditary factor plays an important role in the development
hearing impairment - in particular, in the case of presbycusis, or senile hearing loss. Therefore, before talking about the main reasons provoking tinnitus, it should be emphasized: the occurrence of complaints of an unpleasant sound is characteristic of many pathologies. Noise and ringing in the ears are just symptoms. The type of "sound background" can only presumably be associated with the type of disease. Moreover, in different patients with the same disease, the characteristics of the subjective sound can be strikingly different. The risk of the symptom is considered to be higher in the elderly, as well as in patients with chronic hearing problems.
Noise options
Tinnitus - what could it be? It is necessary to think about what the unpleasant sound is associated with. Some pathologies manifested by the named symptom may be accompanied by irreversible changes and should be identified as soon as possible from the moment the complaints appear. It is useful for every person to know what kind of tinnitus can be. At the same time, we must not forget that only a doctor can establish an accurate diagnosis.
Although it is impossible to describe all the variants of noise, without exception, depending on the cause of the appearance, it is worth mentioning the most common pathologies for which this symptom is characteristic. If we consider the symptoms, tinnitus in classic forms of diseases manifests itself in a different tonality of sounds:
| Pathology type | Sound background type | |||
| Ringing | Hum | Crackle | Ripple | |
| Otosclerosis | More often noise appears in one ear, although a bilateral process is possible. The sound is especially intense in silence and can persist permanently. | Not typical. | Not typical. | |
| Meniere's disease | The noise in the ear arises paroxysmal, at first one-sided, then bilateral. It can be permanent, intensified during attacks. | Not typical. | Not typical. | |
| Occupational hearing loss | The ears are buzzing constantly or intermittently, patients may notice the "sound background" as the primary manifestation of the disease. | Not typical. | Not typical. | |
| Presbycusis | Tinnitus in the elderly is often associated with an increase in blood pressure and disappears when the indicators return to normal. | May occur in rest, quiet environment, is described by patients as less intrusive when turning on music, radio, during a conversation. | Not typical. | It is not typical for exclusively presbycusis. It occurs with various forms of pathology of the circulatory system - including in the presence of an arterial aneurysm of the cerebral vessels, hypertension. |
| Estachitis, tubootitis | Not typical. | Not typical. | If there is a noise in one ear and the sound is comparable to a crackling or clear crackling sound, it should be assumed that the auditory tube is dysfunctional. The process can be two-way. | Not typical. |
Tinnitus in old age can be associated with both manifestations of senile hearing loss and inflammatory diseases - otitis media.
Differential diagnosis between inflammation and age-related changes is necessary because of the likelihood of detecting an atypical picture of otitis media in elderly patients. Attention should be paid to the time of appearance, the nature and frequency of the "noise background", as well as the presence of other pathological signs.
If a child or adult has tinnitus, which doctor should I see? The diagnosis and treatment of diseases, among the manifestations of which can be called "sound background", are dealt with by different specialists - an otolaryngologist (ENT doctor), a neuropathologist, a vascular surgeon. The initial consultation is usually carried out by a pediatrician, therapist or general practitioner, who determines which of the narrow-profile doctors to refer the patient to, whether hospitalization is needed. Much depends on the condition of the patient. If suddenly there is a strong tinnitus, this may be a symptom of sudden sensorineural hearing loss, the treatment of which should be started as soon as possible in an ENT department.
Inflammation
Noise in the right ear or on the left side is one of the likely symptoms of otitis media. Since otitis media are different (according to the localization of pathological changes, the type of inflammatory process, etc.), one cannot speak of a single version of the subjective sound. However, complaints about the noise in the ear are most often presented by patients with acute purulent otitis media.
Noise and whistling in the ears appear with various forms of chronic inflammatory lesions of the structures of the organ of hearing. If the patient suffers from a chronic form of catarrhal or exudative otitis media, there is a high risk of developing adhesive otitis media, which is characterized by the appearance of cicatricial fibrous tissue in the tympanic cavity.The formation of adhesions between the ossicles and deformation of the tympanic membrane cause pathological changes in the sound-conducting system and the appearance of complaints of noise in the left ear or on both sides.
In inflammatory diseases, autophony is often noted.
A patient with autophony hears words and sounds that he pronounces aloud. This phenomenon is usually associated with a feeling of ear congestion. Autophony cannot be classified as a kind of "background noise", since it is not a subjective sound and always has a clearly identifiable source - the patient's own voice.
Noise in the left ear - what is it? The probable cause may be mastoiditis, characterized by the presence of a purulent inflammatory process in the mucous membrane and bone tissue of the mastoid process of the temporal bone. It is rarely isolated and is usually seen as a complication of purulent otitis media.
Severe noise in the ear with lumbago is characteristic of tympanic nerve ganglionitis. This disease can develop in patients with a protracted course of exudative otitis media.
Sulfur plug
The congestion is due to a variety of reasons. The key role, as a rule, is played by an increase in the secretory activity of the glands localized in the external auditory canal. The consistency of the sulfur produced and the presence of skin lesions are also important. The intensity of secretion release depends on many factors - including taking medications, wearing a hearing aid, frequent use of headphones (especially "vacuum" and "earbuds"). The risk of congestion is higher for people employed in the mining industry and other areas associated with exposure to polluted air. Congestion is much more common in older people than in other patients.
The presence of sulfur plug is not a life-threatening condition. In general, many patients may not notice it until water gets into the ear. This is because:
- the plug does not always completely block the ear canal;
- water, when it enters the ear, closes the remaining free lumen of the ear canal;
- the plug swells on contact with water, clogs the ear canal.
Traffic jams on both sides are rare, so if you suddenly make a noise in your ears, you should think about not only this reason for the "sound background". However, when the noise is one-sided - for example, buzzing in the right ear, and just before the onset of the symptom fluid has entered the ear canal - there is a high probability of detecting earwax accumulation.
In the presence of a traffic jam, not only a subjective sound occurs, but also an autophony.
