Tinnitus

Tinnitus

Tinnitus is the perception of noises (ringing, hissing) within the ear or head, in the absence of external sound.

Tinnitus can occur as a symptom of almost all diseases of the ear, sound trauma (often associated with dizziness and hearing problems), or ENT (chronic sinusitis, snoring with sleep apnea), neurological diseases, allergies, cardiovascular diseases (hypertension), or even toxic attack (drugs), general metabolic disorders…

Initially, the clinical check-up consists of diagnosing and treating these diseases. Certain types of tinnitus are, however, perceived without any active disease of the ear or neurological symptoms (isolated tinnitus). Their pathological character does not come from the perception of a more or less intense sound but from their permanent character.

Poorly tolerated, tinnitus can cause sleep disorders, disruption of work and social life, “nervous” fatigue… even depression.

IT IS WRONG TO SAY THAT THERE IS NOTHING TO DO ABOUT IT AND YOU NEED TO LIVE WITH!

The patient has two main fears more or less conscious and expressed, first, that the noise increases and then that he/she will lose his/her hearing. i.e. the perception of surroundings and ability to communicate.

A full check-up of sensorineural hearing pathway is required to:

  • Confirm the absence of any pathology and reassure the patient,
  • Confirm the absence of relationship with a progressive hearing loss.

The check-up consist of an audiometric test (measure of the hearing), otoacoustic emissions test (evaluations of the sensory cells) and auditory brainstem evoked potentials test (check the integrity of the auditory nerve). An MRI with contrast injection may be necessary.

Free-field psychoacoustic tests are then performed to determine the association to:

  • hyperacusis (intolerance to noise), matching filters can be then realized,
  • test the sound intelligibility, laterality and speed of analysis as compared to vision. Sensory perception problems are involved in the hyperexcitabilityof the auditory system and the sensorineural pressure increases tinnitus.

Tinnitus often occurs during a period of intense stress and fatigue, during an emotional shock, and the patient memorizes the sound and can no longer get rid of it.

An interview with the Clinique Roosevelt’s specialized psychologist is necessary to explain to the patient:

  • the sensory functioning
  • the different type of memories
  • the stages of perception
  • to understand the pathogenesis of tinnitus and the difficulty of living with it
  • as well as the possible links with anxiety , depression…

Relaxation and behavioral monitoring help address the meaning of tinnitus, which conditions its tolerance. Following the assessment, more than half of patients feel better and no longer suffer from their tinnitus. For the other half the goal is to learn to manage the tinnitus, forget about it, and live without it.