A persistent ringing in the ear and no train arriving: it’s thetinnitusor tinnitus. This is a condition that affects a large portion of the population, but despite being so common, its origin is not knownalthough the most recent theories propose that it arises from interference in the nervous pathways and the transmission of sounds between the ear and the brain. It can be continuous or intermittent and among the main causes that could cause it are theaginghead and neck trauma or ear infections. Stress and anxiety also play a crucial role in this condition, sometimes making the unpleasant sensation worse, potentially leading to states of depression. To date there is no shared therapy or therapeutic guidelines, in fact the focus is on annoyance management through psychotherapy and experimental techniques with biofeedback.
What is tinnitus and what causes it?
THE’tinnitus is often described as a buzzing or hissing in the ears, generally perceived with a very high frequency, which can affect only one or both ears and be permanent or intermittent. It is estimated to almost hit one in 5 people globally and is therefore a common condition, although not always chronic or deserving of medical attention. There are two types, that subjectiveperceived only by the patient, and that objectivewhich can also be detected by a doctor, although the first type is far more common.
What are the possible causes of tinnitus
The most accredited theory at the moment explains tinnitus as the product of a compensatory activity of the cerebral cortex, towards a damage to auditory structures more external. By orienting ourselves among the structures of the ear, we will understand better. Its appearance is linked to a series of risk factors, includingexposure to intense noise for prolonged periods, ear infections and trauma head and neck.
In addition to auriclewhich is the part of the ear visible from the outside and to which we are accustomed, we have a auditory canal external, inside which the sound travels until it reaches a membrane, the eardrumwhich through small ossicles transmits vibrations to a rather complex organ called cochlea. This snail shell-shaped structure transforms the mechanical stimuli of sounds (vibrations) into electrical stimulithanks to specifications nerve cells called “ciliated”. These cells then transmit the electrical signal to the neurons of the cochlear nerve which will carry the information to the auditory cerebral cortex for processing.
When the hair cells of the cochlea suffer damage, for example due to exposure to loud noises, aging or infectionsthe flow of information to the brain is reduced or altered. In response to this, the brain tries to compensate for this deficiency generating signals to fill the “empty spaces”, which results in the annoying sensation of a buzzing sound even in absence of external stimuli.
If we want to make an analogy, what happens is similar to what happens with the phantom limb syndrome in amputee patients, in which the nervous system “invents” sensations to compensate for the lack of sensory input.
Effects and possible treatments
Tinnitus is one insidious condition since, although it is a sound of modest volume that usually persists in the background of what we hear, it can significantly affect the quality of a person’s life. Tinnitus can in fact cause difficulty concentrating, insomnia and even states of anxiety or depression in the most serious cases. In turn, pre-existing stress and anxiety are factors that can aggravate tinnitus, creating a vicious circle. Sometimes tinnitus is symptom of some conditionssuch as auditory trauma or certain types of migraines, however when it is associated with pain, it is considered a pathology in its own right.
For tinnitus there are no definitive cures and in most studies conducted on various therapies, patient response is very heterogeneous, with patients responding very well and others with little or no improvement. However, there are a multitude of different therapeutic approaches to this condition, also given the multiplicity of possible causes. Today, with the right support and the right strategies, many people succeed live together with this phenomenon, finding a good balance in their daily life.
The sound therapiesfor example, use relaxing or drowning sounds to reduce the perception of tinnitus. Relaxation techniques e cognitive-behavioral psychotherapy have been found to be helpful in relieving associated stress. Furthermore, innovative approaches are being explored recently, such as non-invasive brain stimulationto modulate the abnormal neuronal activity responsible for tinnitus. Some are also being tested drugswhich would have the aim of interacting with specific nerve cell receptors to act at the level of the auditory cortex. Given the prevalence of tinnitus, these drugs would have a truly remarkable market value, since would find application on a large segment of people who are affected by this condition today.
