Tinnitus

Tinnitus (buzzing) is the symptom of an underlying condition whereby sound is heard in one or both ears, without there being external sound stimuli.

     Tinnitus (ringing in the ears) is the subjective perception of sounds in the ears in the absence of an external sound stimulus.
Patients describe tinnitus as ringing, whistling or rustling sounds in their ears. Just as fever or headache can accompany many different illnesses, tinnitus is also a common symptom of various conditions, whether physical or psychological.

     The causes of tinnitus may be environmental, dietary or related to medication misuse. Tinnitus may also be caused by ear disorders or be associated with anemia or hypertension.
An ENT evaluation is essential to rule out or treat underlying ear conditions that may be causing tinnitus.

The examinations required for patients with tinnitus include:
1. Complete ENT clinical examination: This includes otoscopy, anterior rhinoscopy, examination of the pharynx and larynx, and palpation of the neck to investigate possible causes of tinnitus.
2. Audiometry (hearing test): This test assesses hearing and helps determine the intensity and frequency characteristics of tinnitus. It is essential when sound masking is used as a treatment, as it helps determine the level of sound required to mask the tinnitus.
3. Tympanometry and acoustic reflex testing: These tests assess the condition of the middle ear (the part of the ear located behind the eardrum and before the cochlea). If an abnormality is identified, appropriate treatment can be provided.
4. Otoacoustic emissions (OAE): This test evaluates the function of the outer hair cells in the cochlea of the inner ear.
5. Auditory brainstem response (ABR): By presenting specific sounds and recording the resulting electrical auditory responses, this test provides information about the auditory and vestibular nerves, as well as the brainstem.
6. Laboratory tests: Complete blood count, urinalysis, urea (URE), glucose (GLU), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), SGOT (AST), SGPT (ALT) and cholesterol.
7. Computed tomography (CT) of the brain and inner ear: According to the original text, this examination is performed only if tinnitus persists for more than one month.
8. Carotid artery Doppler ultrasound (duplex scan).
9. Digital cerebral angiography: Performed only in rare, specific cases.
10. Complete thyroid function assessment: Measurement of thyroid hormones (T3 and T4) in the blood and thyroid ultrasound.

     Tinnitus, either alone or accompanied by hearing loss, may become a permanent condition. One important cause is repeated exposure to loud sounds. Noise levels above 80–90 dB for at least six hours per day are considered harmful to hearing and may cause tinnitus and hearing loss.
Therefore, the use of earplugs and specialized hearing protection earmuffs is recommended for workers in high-noise environments. Ototoxicity is another possible cause of tinnitus. Medications that carry this risk should be avoided when possible. When their use is necessary, the patient should be closely monitored.

     If earwax or a foreign body is causing tinnitus, it should be removed. Stress, alcohol, caffeine and other factors may aggravate tinnitus. In every case, investigating the exact underlying causes is essential for selecting the appropriate treatment.

     Recent clinical studies have highlighted the effectiveness of preparations such as Memovigor, which contain substances intended to support vascular function, vitamin B complexes, Ginkgo biloba and various trace elements, such as magnesium and zinc.
By acting on the microvascular system of the inner ear and vestibular labyrinth, these preparations are intended to help improve tinnitus and vertigo, particularly when these symptoms are associated with vascular or microvascular causes.