When many patients seek medical attention, they often complain of tinnitus. The majority of patients believe that tinnitus is a problem with the ears. However, in reality, there are over a hundred different causes of tinnitus, far exceeding the causes of hearing loss. Tinnitus is a warning signal. In a sense, many cases of tinnitus are like well-intentioned alarm systems within the body, often reminding patients to follow the rules, pay attention to a regular lifestyle, and get proper rest.
1. Migraine
Migraine is considered a primary brain dysfunction disorder. Certain visual, motor, and sensory symptoms are classified as migraine auras.
Research on cochlear symptoms in migraine patients has found that the proportion of individuals experiencing tinnitus is much higher than that with hearing loss. Among migraine patients with accompanying dizziness symptoms, the prevalence of tinnitus is particularly high. Tinnitus studies have shown that 27% of tinnitus patients complain of headache symptoms, and there is a clear correlation between the side of the headache and the side of the tinnitus. Headache occurs before tinnitus in 54.9% of cases, tinnitus occurs before headache in 34.7% of cases, and both occur simultaneously in 10.4% of cases. Epidemiological data shows that migraine is a high-risk factor for tinnitus. A large-scale study in Taiwan showed that the incidence of tinnitus in migraine patients was 3.3 times higher than that of the control group.
During a migraine attack, the auditory system may be damaged, triggering acute tinnitus. In the compensatory process of a sensitized migraine center, excessively distorted tinnitus signals are more likely to be perceived. Acute tinnitus associated with migraines may account for a significant proportion of cases of acute tinnitus. Migraines repeatedly affect the function of the inner ear and central nervous system, generating a process of repeated acute tinnitus, which is one of the important factors leading to the chronicization of tinnitus.
2. Gastroesophageal Reflux
Gastroesophageal reflux is commonly understood as the reflux of acidic fluids from the stomach into the esophagus and throat. However, in clinical practice, it is not necessarily limited to acidic liquids. Some acidic gases can travel from the stomach, pass through the throat, rise to the nasopharynx, and stimulate the pharyngeal recess and the orifice of the Eustachian tube. Through the channel connecting the nasopharynx and the middle ear cavity, namely the Eustachian tube, the mucous membrane function of the nasopharynx and middle ear is affected, leading to the occurrence of tinnitus.
3. Vascular Origin Tinnitus
Vascular disorders in the carotid artery or vertebral artery systems, including intracranial and extracranial vascular lesions, can cause tinnitus. Examples include arteriovenous fistulas and aneurysms, which often produce pulsatile tinnitus synchronized with the pulse.
4. Nasal Cavity Disorders
Allergic rhinitis, sinusitis, nasal polyps, benign or malignant tumors in the nasal and nasopharyngeal regions (such as nasopharyngeal angiofibroma, nasopharyngeal carcinoma, lymphoma, etc.). Nasal symptoms mainly manifest as nasal congestion, runny nose, changes in smell, and headaches. Since the nasal cavity and the middle ear are connected by the Eustachian tube, nasal and nasopharyngeal disorders can cause tinnitus.
5. Neurological and Psychiatric Disorders
In the process of auditory compensation, both classical and non-classical pathways are closely related to the amygdala. The connection between the classical pathway and the emotional system forms the high-level pathway. The non-classical system and the emotional system form the low-level pathway. Sound plays an important warning role in survival, and harmless sounds are quickly adapted by the auditory system in normal individuals. The low-level pathway remains inactive in normal individuals. However, in tinnitus patients, the low-level pathway is associated with the emotional system. Once activated, the emotional system triggers excessive reactions. The more severe the tinnitus, the heavier the emotional burden, leading to anxiety, depression, tension, despair, and other psychological conditions. The more anxious and depressed the tinnitus patient becomes, the worse the tinnitus gets, resulting in a vicious cycle.
6. Obstructive Sleep Apnea (OSA)
Patients with OSA exhibit snoring with breathing pauses. In severe cases of OSA, intermittent hypoxia can affect the blood supply to the inner ear, leading to tinnitus, hearing loss, or associated otogenic dizziness in some patients.
7. Temporomandibular Joint Disorder
Temporomandibular joint disorder (TMJD) is a term used to describe a group of related diseases and is one of the most common joint disorders in dentistry. It is characterized by localized joint pain, soreness, clicking or popping sounds in the joint, and difficulty in jaw movements. Sometimes, patients may experience dizziness and tinnitus, which may be due to misalignment of the temporomandibular joint. During movement, different parts of the joint may undergo displacement, resulting in abnormal collisions.
8. Systemic Diseases
(1) Metabolic diseases: Endocrine imbalances involving the thyroid, pancreas, pituitary gland, and other organs can affect the circulation of lymphatic fluid and ion concentrations in the cochlea, leading to tinnitus. Hypothyroidism, for example, can cause hydrops in the membranous labyrinth and result in low-pitched tinnitus. Postmenopausal women may experience tinnitus due to hormonal imbalances.
(2) Vascular diseases: hypertension, hypotension, arteriosclerosis, hyperlipidemia, diabetic microvascular complications, anemia, microthrombi, cervical spondylosis, and other conditions can cause impaired blood supply to the auditory system, leading to tinnitus.
(3) Autoimmune diseases: Autoimmune-mediated inner ear damage may occur, resulting in symptoms such as unilateral or bilateral tinnitus, sensorineural hearing loss, dizziness, and a feeling of fullness in the ear.
Tinnitus is not limited to ear disorders but can also be a “warning bell” for systemic diseases.
It is important to pay attention to this warning sign, make lifestyle adjustments, and seek prompt medical attention from a reputable hospital.
–In pain rehabilitation, using physical therapy tools is frequently prioritized over correcting muscle imbalances and biomechanical problems as long-term pain management strategies.Many physical therapy tools for treating pain only address the body’s surface parts; they do not provide thorough coverage for treating deep-seated joint and muscle discomfort.
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From the Chinese Association of Rehabilitation Medicine
Post time: May-17-2024