Tinnitus Causes and Treatment

Pseudotumor cerebri

It is a benign disease in which intracranial pressure increases. The cause is generally unknown. It is generally seen in young, overweight women. Intracranial pressure increases without hydrocephalus and IV, V, VII. It is a condition that does not cause neurological symptoms other than findings related to the cranial nerves. In addition to ringing in the ears with a rapid pulse, headache, visual disturbances and dizziness may occur. Tinnitus with pulsation; It is thought that this disease is due to pulsation of the cerebrospinal fluid. It is typically a benign and self-limiting disease. However, it may be chronic in 25% of patients.

vascular origin. tumors

Glomus tumors are vascular tumors originating from the head and neck region. They may originate from the neck area or middle ear. Tinnitus is observed in 80% of these patients. Those originating from the middle ear can be seen during otoscopic examination (ear examination) as red, pulsating masses. Less commonly, middle ear and facial nerve hemangiomas are also the cause of tinnitus.

Vascular anomalies

Tinnitus along with pulsation, some abnormal connections or anomalies between arteries and veins. may occur as a result. Some of these are congenital anomalies, and some are acquired. Abnormal connection between artery and vein (arteriovenous fistula); It may occur after infection, trauma, tumors or surgery. Meningeal arteriovenous fistulas (dural arteriovenous fistulas) may cause intracranial bleeding.

Ringing due to arteriosclerosis (atherosclerotic disease)

Tinnitus accompanied by pulsation is a headache. -It may be due to stenosis or blockage in various veins in the neck area. Stenosis of the main jugular vein (carotid artery) is one of the common conditions that can cause this condition. This situation should be taken into consideration in patients who are at risk of atherosclerosis or have other diseases related to atherosclerosis.

Tinnitus due to other arterial anomalies

A wide variety of Arterial developmental anomaly may cause tinnitus accompanied by pulsation. Normally, if the artery of the stapes bone (stapedial artery) does not stop regressing before birth, the development of another artery (middle meningeal artery) and the hole through which it passes is prevented. This condition can often be seen as a red, pulsating mass behind the eardrum during otoscopic (ear examination) examination.

Various developmental anomalies of the branch of the common carotid artery leading into the head may cause a mass and tinnitus in the middle ear (aberrant, dehiscent, herniated carotid artery). Again, this condition can be seen as a red, pulsating mass behind the eardrum during otoscopic (ear examination) examination.

Spontaneous Rupture of the intracranial branch of the main carotid artery due to trauma is another cause of ringing (pulsatile tinnitus). In this case, it is usually accompanied by findings related to lack of oxygen in the brain, but it may also be accompanied by tinnitus alone.

Balloons in the part of the main carotid artery close to the ear may cause ringing heard along with the pulse. The cause of tinnitus is the pressure on the auditory nerve by the vessels passing nearby in the inner ear canal (this is called the vascular loop).

Vein anomalies:

Anomalies in a part of the venous system of the head and neck region may be the cause of tinnitus (jugular bulb extending to the middle ear, high jugular bulb, jugular diverticulum, etc.). Tinnitus may occur due to blood flow turbulence in this area and the sigmoid sinus area. This is called venous hum. It has been determined that patients with venous hum are generally women between the ages of 30-50. Tinnitus is unilateral and is usually on the right side.

In tinnitus caused by anomalies of the venous system of the head and neck region, the intensity of the tinnitus decreases or disappears by turning the head to the opposite side. Anomalies of this system can be detected by tomography.

Systemic diseases that cause tinnitus

Anemia, pregnancy, and excessive secretion of thyroid hormone may cause tinnitus heard along with the pulse. When Paget's disease affects the bone in the ear, ringing (pulsatile tinnitus) accompanied by a pulse may be seen in otosclerosis, a disease of the inner ear.

Causes other than vascular origin

Involuntary contractions of the soft palate, stapes (stirrup bone) muscle and tensor tympani muscles in the middle ear can cause tinnitus heard along with the pulse. However, this ringing is not simultaneous with the patient's pulse and may occur at a frequency of 10-240 minutes. Involuntary contractions of these muscles may occur in multiple sclerosis and some neurological diseases in which the blood supply to the brainstem region is reduced and may cause tinnitus.

Ringing is also seen in diseases related to the jaw joint.

Nonpulsatile tinnitus (from pulsation). What are the causes of independent tinnitus? rdir?

Nonpulsatile tinnitus is subjective in type and is the most common form of tinnitus. In most cases, there is also hearing loss. However, tinnitus can occur without hearing loss. Sometimes an underlying acoustic neuroma (a tumor of the auditory nerve) or Meniere's disease (an inner ear disease accompanied by dizziness, ringing and hearing loss) may be the cause of tinnitus. Tinnitus and hearing loss often occur together and there is no underlying structural disorder. Noise exposure and some medications can cause tinnitus. However, the pathophysiology of tinnitus is not clearly known.

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