The ringing in the ears is a buzzing sensation that we can feel even in the absence of noise.
There is a specific type of tinnitus characterized by an intermittent sound, like a rumbling noise in the ears.
Often this sound is rhythmic and can be heard continuously or at regular intervals.
It is usually the sound of blood flow that is amplified for some reasons.
The ears become very sensitive and can feel the blood flowing.
In other words, they feel the pulsations.
Hence the name of ” pulsatile ” tinnitus .
Tinnitus affects mainly adults and the elderly, it is very rare in children.
The specialist doctor who cares for tinnitus is the otorhinolaryngologist.
You may feel the hum in one or both ears.
Tinnitus can be:
In case of objective tinnitus , the patient clearly feels the buzzing.
People who are close to an affected person can hear the sound coming from their ears.
The objective tinnitus can have an origin:
- Vascular (at the level of the blood vessels),
- Mechanics (musculoskeletal problem).
The objective tinnitus of vascular origin can be caused by a stenosis (narrowing) of the arteries:
- Carotid ,
Objective tinnitus of mechanical origin is caused by an abnormal muscle contraction of the nasopharynx or middle ear, as in the case of palatal myoclonus , ie a rhythmic contraction of at least one side of the soft palate (veil or muscle palate).
If tinnitus is subjective , only the affected person can hear these sounds.
In this case, it is connected to the movements of the cochlea walls and of the liquids within this structure.
The pulsatile tinnitus can manifest as an increased awareness of blood flow in the ear.
In fact, the cause of pulsatile tinnitus syndrome may be:
- The activation of somatosensory auditory pathways synchronized with the heart at the brain level ,
- The inability of the central nervous system-somatosensory-auditory to interact to bypass the cardiac sounds.
The pulsatile buzzing superimposed on the acute tinnitus may be caused by the pulsation of the capillary flow in the spiral channel of the basilar membrane.
Common Causes of Tinnitus
High blood pressure
The blood pressure or high blood pressure is a common cause of pulsatile tinnitus.
When a person has high blood pressure, the force with which blood flows through the blood vessels is high.
So the sound that the blood makes as it flows through the body (combined with other motives) can cause tinnitus in a person’s ear.
Because of increased blood flow, pregnant women are predisposed to ringing in the ear.
Compression of the arteries
Sometimes the arteries inside the body may be crushed.
If this occurs in the arteries that are located in the area near the ears, neck and head, the blood flowing through these arteries begins to flow forming vortices.
This problem causes intermittent (buoyant) or continuous noise in the ear.
The cervical osteoarthritis can cause the formation of osteophytes (bone spurs) that can compress the vertebral arteries, reducing the flow of blood that reaches the brain.
Among the consequences are:
Middle ear inflammation
In the ear, the central part should remain full of air.
If for some reason (such as inflammation , infection, or dysfunction of the Eustachian tube) fluid accumulates inside the middle ear (dropsy), this may cause a ringing.
Along with the rhythmic sound, one can also suffer from:
- Pain ,
- Hearing impairment.
Muscle Spasms Muscle
spasms inside the ear can also cause a regular ticking in the ear.
There are very small muscles in the ear that can cause this noise.
If there is a spasm in these muscles, the tinnitus is intermittent and is not accompanied by a hearing loss.
The jugular vein is the largest vein in the neck.
This vein passes to the side of the middle ear.
In people suffering from thyroid problems, anemia or even in some pregnant women, can increase blood flow through the jugular vein.
When there is a strong flow of blood through the jugular vein, this could cause a pulsatile tinnitus.
Among the consequences is the blockage (obstruction) of the Eustachian tube that connects the pharynx to the middle ear .
This channel serves to maintain the air pressure in the middle ear equal to the external environment.
In the case of obstruction of the tube, the pressure in the middle ear is smaller and the eardrum is pushed to the internal
. Tinnitus may be the consequence.
If the wax is not removed properly, it can reduce the sound vibrations that hit the acoustic nerve.
The nerves that receive the auditory stimuli become easily excitable to compensate for hearing loss. The consequence is a continuous buzz.
Tinnitus can also be an unwanted effect of the treatment to remove the wax cap .
When removing the cap, the buzzing can be the consequence of the increase of the sonorous vibrations that arrive at the eardrum.
In this case, it is a temporary symptom.
Exposure to noise and loud music can increase the risk of tinnitus.
People who are exposed to very loud sounds or noises may experience tinnitus, even if the exposure is brief, for example:
- In the nightclub,
- In a concert.
This is due to the damage that occurs :
- In the middle ear, tympanic membrane laceration ;
- In the inner ear, damage to the hair cells that transmit the sound inside the cochlea, especially at the level of cellular mitochondria.
- According to a scientific study by Charles Liberman and Sharon G. Kujawa, nerve endings of acoustic fibers can be harmed forever after a brief exposure to loud noise.
The use of certain antibiotics , diuretics, antidepressants and antitumor medications could be a risk factor for whistling in the ears.
Head / Neck Injury Head or neck
trauma could influence the part of the brain or nerves associated with the ear, leaving the person predisposed to ear problems.
Diseases that can cause tinnitus:
- Menière Syndrome
- Otosclerosis (in most cases) is a disorder caused by the growth of bone tissue at the level of the oval window (between the middle ear and the inner ear). This excess tissue blocks the stirrup, reduces the transmission of sound, and may cause a buzzing sound.
- Disorders of the temporomandibular joint
- Acoustic neurinoma
- Abnormal Blood Pressure
- Heart or blood vessel disease
- Thyroid problems
- Abnormal interactions between neural networks, etc.
- Tinnitus in the ear may also be due to ear infections where the cochlea of the ear may be impaired.
- Tinnitus can be caused by a head injury, neurological diseases, multiple sclerosis and any lesion or infection of the sinuses.
- In the case of labyrinthitis , attacks of sudden dizziness and tinnitus occur .
- Some studies have shown that metabolic disorders such as thyroid problems or vitamin B12 deficiency can cause tinnitus.
- Tinnitus can be due to psychological problems like depression , anxiety and stress .
- It can also be a consequence of aging. Hearing capacity is impaired because of natural aging.
You often feel a sense of vertigo along with the buzzing in your ear.
Problems in the functioning of the vestibular labyrinth (an organ of the inner ear) are among those responsible for dizziness.
The vestibular labyrinth consists of small channels that contain sensors and fluids.
With these sensors it is possible to monitor the rotation of the head.
The utricle and the saccule are organs of the inner ear that contain the otoliths, that is, “pebbles” made of calcium carbonate.
These are attached to the sensors that help monitor the movement of the head.
A disease of these organs causes dizziness and in some cases the whistle in the ears .
Among the causes are:
‘s syndrome Menière ‘s syndrome is a disease that affects the inner ear and can cause changes in the internal fluid pressure of the ear.
A labyrinthitis is an inflammation in the inner ear at the level of the semicircular canals of the labyrinth. These are the balance structures, so that labyrinthitis can cause dizziness and serious balancing difficulties.
- Multiple sclerosis ,
- Tumor cerebral.
Diagnosis of ringing in the ear
According to the guidelines of: Interdisciplinary Tinnitus Center, University of Regensburg, Regensburg, Germany , the physician evaluates the patient according to:
- Clinical history,
- Assessment of tinnitus severity,
- Identification of risk factors,
- Associated symptoms (eg, dizziness),
- Other diseases.
Among the tests and exams that the otorhinolaryngologist does are:
- Audiometric test,
- Vascular examination for a blow to the neck: the doctor compresses the jugular or carotid artery to evaluate if this maneuver accentuates the tinnitus,
- Control of the nasopharynx (upper pharynx, behind the mouth) to look for masses that may cause dysfunction of the Eustachian tube and therefore tinnitus,
- For anemia and thyroid diseases, the doctor recommends blood tests ,
- If the doctor suspects a cancer, he or she may prescribe an MRI .