Tinnitus Symptoms, Causes, and Treatment
Table of Contents
Hello. This is Miol Korean Medicine Clinic Incheon Songdo Branch. Today, we will summarize information regarding tinnitus. Tinnitus is also referred to as ringing in the ears. It refers to cases where various sounds, such as a beeping noise, occur in the ears, causing interference with daily life. Generally, since tinnitus is a symptom rather than a disease, it can occur due to various causes and is a symptom occasionally experienced even by healthy people. On the other hand, if the symptoms are so severe that they cause interference with daily life, appropriate treatment should be received.
Classification of tinnitus according to cause
McCombe, A., Baguley, D., Coles, R., McKenna, L., McKinney, C., & Windle-Taylor, P. (2001). Guidelines for the grading of tinnitus severity: the results of a working group commissioned by the British Association of Otolaryngologists, Head and Neck Surgeons, 1999. Clinical Otolaryngology and Allied Sciences, 26(5), 388–393. doi:10.1046/j.1365-2273.2001.00490.x
Tinnitus is divided into various forms depending on the cause.
Medication history also needs to be checked
Tinnitus can appear as a side effect of more than 130 different medications; therefore, if tinnitus occurred relatively recently and there is a history of medication use, it is necessary to check whether medications were taken. The table above presents medications that can cause tinnitus, including analgesics, anti-inflammatory drugs, and antibiotics.
Various tinnitus sounds
The sounds that can appear during tinnitus are very diverse. They can manifest as various sounds such as a beeping sound, a sharp beeping sound, the sound of water boiling in a kettle, the sound of cicadas crying, the sound of TV static, mechanical sounds, vacuum cleaner sounds, wave sounds, and more.Sounds of TinnitusIf you go to, you can listen to examples of sounds that may appear during tinnitus.
Tinnitus evaluation and questionnaire tools
Objective tinnitus is tinnitus that a doctor can objectively verify and is very rare (within 5%). Because most tinnitus symptoms are subjective, evaluation is also quite difficult. It is a challenging task to actually verify the sound perceived by the patient.
One of the representative tinnitus evaluation questionnaire tools is the THI Tinnitus Handicap Inventory. It consists of 25 questions, and simplified versions are also frequently used. A study on the reliability and validity of the Korean translated version of the Tinnitus Handicap Inventory
Scores are summed for each item as No (0 points), Sometimes (2 points), and Yes (4 points) to be categorized into grade 1,2,3,4,5. Depending on the score, the severity of tinnitus is evaluated as follows.
- 0-16: slight
- 18-36: mild
- 38-56: moderate
- 58-76: severe
- 78-100: catastrophic
In the simplified version of the THI, only questions 1,8,10,12,18,20,21,22,23 are sometimes used. Reference material: Development of the Korean Simplified Tinnitus Questionnaire
Points to consider in tinnitus patients
When taking the medical history of a patient with tinnitus, the following elements should be examined together: duration of tinnitus, sound, number, specific patterns, subjective loudness, time when tinnitus is felt, and the degree of distress caused by tinnitus (VAS).
As it is often accompanied by depression or anxiety, these are also evaluated together. There is a considerably high correlation between depression, anxiety, and tinnitus. Patterns of anxiety and depression can make the nerves sensitive, causing tinnitus to be felt more severely; conversely, as tinnitus worsens, anxiety and depression may become chronic, meaning there are many aspects where they influence each other.
In the treatment of tinnitus, considering neuropsychiatric symptoms such as anxiety and depression and combining appropriate treatments helps in leading the treatment prognosis in a positive direction.
Tinnitus treatment
There are various treatments for tinnitus, such as sound therapy, drug therapy, and relaxation meditation therapy, but there are not a few cases where treatment is not successful. In particular, in cases where tinnitus has persisted for a long time or where tinnitus symptoms are very severe, we frequently see cases where the treatment response is very low.
In Korean medicine treatment, the causes of tinnitus are categorized into deficiency and excess for treatment, and it is recognized that correcting the balance of body and mind is also important. Accordingly, to help facilitate circulation in the craniofacial region and normalize the function of the auditory organs, treatment is carried out with the goal of symptom relief by integrating various treatments such as acupuncture, pharmacopuncture, and manual therapy in the craniofacial region.
In tinnitus caused by structural abnormalities of the craniofacial and cervical regions, such as cervicogenic tinnitus or temporomandibular joint disorders, physical therapy and self-exercise can help alleviate symptoms. Reference material: Physiotherapy assessment and treatment of chronic subjective tinnitus using mechanical diagnosis and therapy: a case report
