Tinnitus in the ear: causes and types

Tinnitus in the ear is a buzz that is heard even in the absence of sounds.

There is a certain type of tinnitus characterized by a jerky sound, like a bang that echoes in the ear.

Often this sound is rhythmic and can be heard continuously or at regular intervals.
Usually it is the sound of blood flow that is amplified for some reason.

The ears become very sensitive and can hear the blood flowing. In other words, you can hear the pulse.
Hence the term ‘pulsating‘ tinnitus.
Tinnitus mainly affects adults and the elderly, but is very rare in children. The specialist you turn to is the ear doctor.


Types of tinnitus

You can hear a buzzing in one or both ears.
The tinnitus can be:

  • Subjective
  • Objective.

With objective tinnitus, the patient hears a clear buzz.
People who are near an affected person may hear the sound from their ears.
The objective tinnitus can be caused:

  • vascular (through blood vessels),
  • Mechanical (skeletal muscle problem).

The objective tinnitus of vascular cause can be caused by stenosis (narrowing) of the arteries:

  • Carotid
  • Vertebralis.

Objective tinnitus of mechanical cause is caused by abnormal muscle contractions in the throat or middle ear, such as soft palate myoclonus (a rhythmic contraction of at least one side of the soft palate).

If the tinnitus is subjective, only the affected person can hear these sounds.
In this case, it is bound to the movements of the walls of the screw and the liquid inside this structure.

The pulsating tinnitus can manifest as a stronger awareness of blood flow in the ear.
In fact, the cause of pulsating tinnitus can be:

  • activation of the somatosensitive auditory pathways, which are synchronized with the heart at the level of the brain,
  • Inability to interact with the somatosensitive-auditory pathways of the central nervous system to ignore heart sounds.

The pulsating tinnitus superimposed on acute tinnitus may be caused by capillary flow in the spiral canal of the basilar membrane.

Most common causes of tinnitus

High blood pressure Hypertension or high blood pressure
is a common cause of pulsating tinnitus.
If a person has elevated blood pressure, the blood flows with more force through the blood vessels.
The sound that the blood produces as it flows through the body (in combination with other situations) can cause a buzz in a person’s ears.
Due to increasing blood flow, women are more prone to tinnitus in the ears during pregnancy.

Compressed arteries
Sometimes arteries inside the body can be compressed.
If this happens to arteries that are located near the ears, neck and head, the blood begins to flow swirled in these arteries.
This situation causes an intermittent (fluctuating) or continuous noise in the ear.

Osteoarthritis of the cervical joints can lead to bony changes (bone cones) that narrow the vertebral arteries leading to the brain.
Consequences of this include:

Otitis media
The central part of the ear should be filled with air.
If for any reason (such as inflammationinfection of the Eustachian tube) fluid accumulates in the middle ear (hydrops), this can cause tinnitus.
With its rhythm you can also suffer from:

  • Ache
  • Decreased hearing.

Muscle spasms
Muscle spasms in the inner ear can also cause regular ticking in the ear.
There are many small muscles in the ear that can cause this noise.
When these muscles cramp, tinnitus is intermittent and is not accompanied by hearing loss.

Venous noise
The jugular vein is the largest vein of the neck.
This vein runs along the middle ear.
In people who have thyroid problems or anaemia or in some pregnant women, blood flow in the jugular vein may increase.
If there is a strong blood flow in the jugular vein, this can lead to pulsating tinnitus.

Sinusitis and inflammation of the nasal cavities
Diseases of the nasal cavities and sinuses are another cause of pulsating tinnitus.
Sinusitis is an inflammation of the paranasal sinuses.
The consequences are blockages (occlusions) of the Eustachian tube, which connects the pharynx with the middle ear.
This channel is used to balance the air pressure between the middle ear and the external environment.
With a tube occlusion, the pressure in the middle ear is lower and the eardrum is pushed inwards.
The result can be tinnitus.

Earwax accumulation
If the earwax is not drained in a normal way, it can dampen the vibrations reaching the auditory nerve.
The nerves receiving the auditory signals become more easily excitable to compensate for the hearing loss.
The result is persistent tinnitus.
Tinnitus can also be an unwanted effect when removing an earwax plug.
If a plug is removed, the hum can be a result of the increase in sound vibrations reaching the eardrum.
In this case, this is a temporary phenomenon.

Noise pollution
If you are exposed to very loud music or noises, the risk of tinnitus increases.

Loud noises
People who are exposed to loud sounds or very strong noises may suffer from tinnitus, even if the exposure was short-term, for example:

  • In a discotheque,
  • At a concert.

This is due to occurring damage:

  • In the middle ear, rupture of the tympanic membrane membrane;
  • In the inner ear, damage to the hair cells that transmit sound inside the snail, especially in the area of mitochondrial cells.
  • According to a scientific study by Charles Liberman and Sharon G. Kujawa, the ends of the acoustic nerve fibers can be permanently damaged even after short-term exposure to very loud noises.

The use of some antibiotics, diuretics, antidepressants and anti-tumor drugs can be a risk factor for whistling.

Trauma to the head or neck can affect parts of the brain or nerves connected to hearing, making a person prone to ear problems.
Diseases that can cause tinnitus:

  • Meniere’s disease
  • Otosclerosis (in most cases) – this is a disease caused by an increase in bone tissue in the oval window (between the middle ear and inner ear). In extreme cases, this fabric blocks the stirrup, reduces sound transmission and can cause humming.
  • Temporomandibular joint diseases
  • Acoustic neuroma
  • Abnormal high blood pressure
  • Fibromyalgia
  • Cardiovascular diseases
  • Thyroid disorders
  • Abnormal interactions in the neural network, etc.

Other causes

  • Buzzing in the ear can also be caused by an infection in the ear, which can damage the cochlea.
  • Tinnitus can result from head trauma, nerve disorders, multiple sclerosis, and any kind of injury or infection of the nasal cavities.
  • With labyrinthitisdizziness and tinnitus occur unexpectedly.
  • Some studies have shown that metabolic disorders such as thyroid problems or a lack of vitamin B12 can cause tinnitus.
  • Tinnitus can result from psychological problems such as depression, anxiety and stress.
  • It can also be a consequence of aging. Hearing is naturally reduced due to the aging process.

Tinnitus and dizziness

Very often one suffers dizziness together with a hum in the ear.
Functional problems of the vestibular labyrinth (an organ of the inner ear) are responsible for dizziness.
The vestibular labyrinth consists of small tubules containing sensory cells and fluid.
These sensors monitor head rotation.
Utriculus and sacculus are organs of the inner ear that contain otoliths, which are “pebbles” of calcium carbonate.
These are connected to the sensory cells, which serve to monitor the movement of the head.
A disease of this organ causes dizziness, and in some cases, whistling in the ears.
Reasons for this can be:

  • Meniere’s syndrome – Meniere’s syndrome is a disease that affects the inner ear and can lead to changes in the pressure of fluid in the inner ear.
  • Labyrinthitis– Labyrinthitis is an inflammation of the inner ear in the area of the semicircular ducts of the labyrinth. These form the organ of balance, which is why labyrinthitis can cause dizziness and significant balance disorders.
  • anemia,
  • Multiple sclerosis
  • Brain tumor.

Diagnosis of ear whistling

According to the guidelines of the Interdisciplinary Tinnitus Center, University of Regensburg, Regensburg, Germany, the doctor assesses the patient’s condition by:

  • Medical history
  • assessment of the severity of tinnitus,
  • identification of risk factors,
  • associated symptoms (for example, dizziness),
  • Other diseases.

Other tests and examinations that the ear specialist performs include:

  • Heard
  • Vascular examination for sounds on the neck: The doctor compresses the jugular artery or carotid artery to determine whether this increases the tinnitus.
  • Control of the nasopharyngeal ring (upper pharyngeal area at the back of the mouth) to find tissue parts that can lead to a malfunction of the Eustachian tube and thus to tinnitus.
  • In case of anemia and diseases of the thyroid gland, the doctor advises a blood test,
  • If the doctor suspects a tumor, he may order a magnetic resonance imaging.

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