Buzzing in the ears or tinnitus is a troublesome symptom and has varying response from the sufferer ranging from simple ignorance of the symptom to psychological problems leading to anxiety and depression.
The causes for this symptom also varies from being a benign condition like age related hearing loss requiring no treatment to the presence of tumour in the brain or an anomaly in the neck blood vessels requiring operative treatment.
Broadly, Tinnitus can be divided into:
- Objective tinnitus – the sound that can be heard by examiner on auscultation.
Objective tinnitus is most often due to causes of anomalous blood vessels leading to turbulent blood flow and is pulsatile in nature.
- Subjective tinnitus – the sound that can be heard only by the patient but not by the examiner.
Subjective tinnitus has got various causes which could be localised from the external canal to the middle ear to the inner ear to the hearing pathway all the way to the brain.
Tinnitus can be either the only symptom or can be associated with reduced hearing and /or Giddiness (Vertigo).
The common causes of Tinnitus are:
- External ear causes:
- Wax in the ear canal
- Fungal infection of the external ear canal
- Middle ear causes: These conditions are associated with hearing loss which is commonly conductive in nature.
- Acute otitis media – infection of the middle ear cleft with or without effusion.
- Secretory otitis media – glue ear. There is collection of sterile fluid in the middle due to chronic negative pressure in the middle ear.
- Otospongiosis – a disease leading to new bone formation around the middle ear ossicles (most commonly stapes).
- High jugular bulb with dehiscence of the floor of the middle ear cavity.
Stapedius muscle myoclonus.
Inner ear causes: These conditions could be associated with hearing loss which is sensorineural, vertigo which is rotational in nature and nausea and /or vomiting.
- Noise induced hearing loss – due to sudden exposure to loud noise or due to continuous exposure to loud noises as a result of professional noise exposure.
Age related hearing loss (Presbycusis)
- Inner ear infection: Labyrinthitis – mostly viral but can be bacterial as well especially if there is associated middle ear infection (suppurative otitis media).
- Sudden hearing loss – unilateral or bilateral is often associated with Tinnitus.
- Menier’s disease – characterized by recurrent episodic triad of Tinnitus, vertigo and hearing loss due to increase in the inner ear fluids –also known as Endolymphatic Hydrops. As the disease advances, these episodes occur more frequently and the hearing loss which used to come back to normal earlier may get permanently reduced.
- Iatrogenic causes of Tinnitus – post surgery for middle ear diseases or after stapes surgery.
- Head injury
- Drug induced – ototoxic drugs like aminoglycosides, Aspirin, NSAIDs etc, which are toxic to the inner ear can give rise to Tinnitus along with hearing loss and vertigo.
- Tumors of the auditory vestibular nerve (Acoustic neuroma). Especially suspected in young adults with associated symptoms of asymmetric hearing loss and at times vertigo and gait disturbance as well.
- Other Cerebello Pontine angle region tumors.
Non otologic causes:
Thus it goes without saying that tinnitus as a symptom should not be taken lightly and only after a proper clinical evaluation, can the underlying pathology can be diagnosed and managed.
Buzzing in the Ear Could be Horrifying!!! Come to us Get Examined… Click Here