Tinnitus – Phenomenon
Tinnitus can act like a pain. If we consider headache, it may be caused by several causes, migraine, hangover, hitting a head to something etc. Tinnitus also can be triggered by several diseases or accidents. The most common acute tinnitus cases are caused by some explosions or other sudden noises. But also less intense noise, when it is repeated or the patient is too close to the sound, can cause tinnitus. Noisy occupational environments are the most common causes of chronic tinnitus, that starts little by little during the years. Also infections in the ear, like acute otitis media, can heal otherwise, but leave tinnitus in the ear. Less is spoken about muscular tension and tinnitus. Overuse of the masticatory and cervical muscles can cause tinnitus, sometimes even the shoulder area tensions can be connected to the ipsilateral tinnitus. This type of tinnitus, which is caused by muscles is called somatosensory tinnitus. There are many drugs, that can cause tinnitus. Most of them are used in severe diseases (cancer and deep infections) and they might save the patient’ s life but damage the inner ear. The treatment of tinnitus is easier to do if the suspected cause of tinnitus is found.
Tinnitus is not just a problem of the ear, it is recognized by the neurons in the brain. There are several parts of the brain, which are involved in tinnitus appearance. Audrey Maudoux found difference in the brain activity of tinnitus patients compared to the patients without tinnitus. One interesting discovery was that amygdala is one important place to explain the distress caused from the situation. If amygdala an from it the sensory part of the brain is involved, the patients suffer more from their tinnitus even if they seem to have the same amount of tinnitus otherwise. Vagus nerve is used to ease tinnitus, there are different ways to do that and some results have been accomplished. I myself have been working with muscles and their connections to the tinnitus network in the brain. Chinese medicine, trigger point treatment and fascial manipulation, all seem to act through the same neural connections, which could be the autonomic neural network. Autonomic neurons explain many phenomenon, that are connected to tinnitus like aural fullness and pain, sometimes hyperalgesia and hyperacusia.
I have treated tinnitus for more than 20 years. Because I am the only ENT-doctor in my town, all the tinnitus patients come to me. I try to see acute tinnitus patients as soon as possible, but at least within a week. Of course it does not work all the time, but we try. I discovered, that if I start trigger point treatment in the same day, most of the patients got rid of their tinnitus. If I do it within a week, over half of the patients recovered. But if the patients come after some years, only one third responded to the treatment and we had to repeat it several times to keep the results. There have been a lot of discussions about tinnitus going from the ear to the brain. There seems to be a certain time, during which the tinnitus should be treated. If we are quick enough, we are able to stop tinnitus from reaching the tinnitus networks of the brain and no tinnitus is formed. How we manage to do it depends to the cause of tinnitus. If tinnitus is combined to the hearing loss we should maybe give the patient an acute hearing aid fitting. We do not know yet, but I have discussed with several tinnitus professionals in international congresses. A lot of work is to be done to find the best solutions in tinnitus treatment for everybody.