காதில் இரைச்சல், What is tinnitus?

கேட்பது இசையா, இரைச்சலா என நாம் உணர்ந்து கொள்வதற்காகப் படைக்கப்பட்ட காதுக்குள்ளேயே இரைச்சல் ஏற்படுவது பலருக்கும் பெருந்தொல்லையாக இருக்கும்.

இந்தியாவில் பத்தில் ஒருவருக்கு இந்தப் பிரச்சினை உள்ளது. உலக அளவில் முதியோருக்கு ஏற்படும் முக்கிய உடல்நலப் பிரச்சினைகளில் இதுவும் ஒன்று.

What Exactly is Hyperacusis?

Hyperacusis is a little known condition that seems to arise from a problem in the way the brain perceives noise. The underlying cause of the condition is elusive, however its impact on people who suffer with it is well documented. The condition of hyperacusis often leads to pain and discomfort when sufferers are exposed to louder sounds. While we say louder, we don’t mean very loud, in fact most people would consider the level of the sound as normal.

People suffering with the condition find some sounds intolerable, for instance, vehicle noise, the sound of a fan, the shuffling of papers. While all sound can be perceived as too loud, high frequency sounds in particular cause real issue for someone with Hyperacusis. This can have a dramatic effect on the lives of people who suffer with the condition, sometimes it can be difficult if not impossible to function during a normal day. We have seen the condition contribute to social isolation, phonophobia (fear of normal sounds), and depression.

What is tinnitus?

Tinnitus happens when we consciously hear a sound that does not come from any source outside the body. It is not a disease, but a symptom of an underlying problem.

The noise is usually subjective, meaning that only the person who has tinnitus can hear it.

The most common form is a steady, high-pitched ringing. This can be annoying, but it does not usually indicate a serious condition.

In fewer than 1 percent of cases, it may be objective. This means that other people can hear the noise. This type of noise may be caused by cardiovascular or musculoskeletal movements in the person’s body. This can be a sign of a medical emergency.

Symptoms

Tinnitus involves the sensation of hearing sound when no external sound is present. Tinnitus symptoms may include these types of phantom noises in your ears:

• Ringing
• Buzzing
• Roaring
• Clicking
• Hissing
• Humming

The phantom noise may vary in pitch from a low roar to a high squeal, and you may hear it in one or both ears. In some cases, the sound can be so loud it can interfere with your ability to concentrate or hear external sound. Tinnitus may be present all the time, or it may come and go.

There are two kinds of tinnitus.

• Subjective tinnitus is tinnitus only you can hear. This is the most common type of tinnitus. It can be caused by ear problems in your outer, middle or inner ear. It can also be caused by problems with the hearing (auditory) nerves or the part of your brain that interprets nerve signals as sound (auditory pathways).
• Objective tinnitus is tinnitus your doctor can hear when he or she does an examination. This rare type of tinnitus may be caused by a blood vessel problem, a middle ear bone condition or muscle contractions.

காது இரைச்சல் (Tinnitus) என்பது ஒரு தனிப்பட்ட நோயல்ல; உடலில் இருக்கும் ஒரு நோயின் வெளிப்பாடு; அறிகுறி. காது இரைச்சலுக்கான காரணம் காதிலும் இருக்கலாம்; உடலின் வேறு பகுதியிலும் இருக்கலாம்.

சில மனநோயாளிகள்கூடக் காதில் இரைச்சலும் குரலும் கேட்பதாகக் கூறுவார்கள். காது, காதிலுள்ள எலும்புகள், காதிலிருந்து மூளைக்குச் செல்லும் காது நரம்பு, மூளை ஆகியவற்றில் எது பாதிக்கப்பட்டாலும் காதில் இரைச்சல் ஏற்படும்.

காதுக்குள் வண்டு ரீங்காரம் செய்வது போன்றோ, `இஸ்ஸ்ஸ்…’ என்ற இரைச்சலோ, குக்கர் விசில் அடிப்பது போன்றோ, புயல் மாதிரிப் பேரிரைச்சலோ கேட்பதாக இருந்தால் அந்த நபருக்கு ‘காது இரைச்சல்’ இருப்பதாக அர்த்தம். இந்த இரைச்சலின் தன்மை ஆளுக்கு ஆள் வேறுபடும். ஒருவருக்கு இரைச்சல் தொடர்ச்சியாகக் கேட்கும்; இன்னொருவருக்கு விட்டு விட்டுக் கேட்கும். ஒரு சிலருக்கு இரைச்சல் தாங்கமுடியாத அளவுக்குக் கடுமையாக இருக்கும்.

பாதிப்புகள் என்ன?

சுற்றுப்புறம் அமைதியாக இருந்தால், காதுக்குள் இரைச்சல் அதிகமாகக் கேட்கும். குறிப்பாக, இரவில் இது அதிகம் தொல்லை தரும். உறக்கம் வராது. மனக் குழப்பத்துக்கு அடிபோடும். நினைவாற்றல் குறையும். மன அழுத்தம் அதிகரிக்கும். பகல் நேரப் பணியில் கவனம் செலுத்துவது சிரமம் தரும். உடல் சோர்வாக இருக்கும்.

காரணம் என்ன?

காது இரைச்சலுக்குப் பல காரணங்கள் உண்டு. அவற்றைத் தற்காலிகக் காரணங்கள், நிரந்த காரணங்கள் என்று பிரித்து வைத்துள்ளது மருத்துவம். காதுமடலைச் சேர்த்துச் சிறு துவாரமாகக் காதுக்குள் செல்கிற வெளிக்காதுக்குழலில், இயற்கையாகச் சுரக்கிற மெழுகு உருண்டு திரண்டு கட்டியாகிக் காதை அடைத்துக்கொண்டால், அயல் பொருட்கள் ஏதாவது அடைத்துக்கொண்டால், காளான் தொற்று ஏற்பட்டால் காதுக்குள் இரைச்சல் கேட்கும். இவையெல்லாமே தற்காலிகமாகக் காது இரைச்சலை உண்டாக்குபவை.

காதில் உள்ள அழுக்கை / அயல் பொருளை அகற்றிவிட்டால் அல்லது காளான் தொற்றுக்குச் சிகிச்சை பெற்றுவிட்டால் காது இரைச்சலில் இருந்து விடைபெறலாம். ஜலதோஷம் பிடிப்பதால்கூடச் சில நேரங்களில் தற்காலிகமாகக் காது இரைச்சல் உண்டாகும்.

அதேநேரத்தில் சில காரணங்களால் காது இரைச்சல் நிரந்தரமாகிவிடும். முதுமை இதற்கு முக்கியக் காரணம். வயதாக வயதாக நடுக்காது எலும்புகள், காக்ளியா எனும் நத்தை எலும்பு மற்றும் காது நரம்பிழைகள் சிதைவடைவதால் காதுக்குள் இரைச்சல் தொடங்குவது வழக்கம். காதுக்குப் போகும் ரத்தம் முதுமையில் குறைவதாலும் காதில் இரைச்சல் ஏற்படுவதுண்டு.

வெளிக்காதையும் நடுக்காதையும் பிரிக்கிற செவிப்பறையில் துளை விழுந்துவிட்டால், காது இரைச்சல் ஏற்பட அதிக வாய்ப்பு உள்ளது. இதுபோன்று நடுக்காதுக்குள் நீர் கோத்துக்கொண்டால், சீழ் பிடித்துவிட்டால் காது இரைச்சல் ஏற்படும். நடுக்காதில்தான் நம் உடலிலேயே மிகச் சிறிய எலும்புகளான சுத்தி, பட்டடை, அங்கவடி எலும்புகள் உள்ளன.

இவற்றில் ‘எலும்பு முடக்கம்’ (Otosclerosis) எனும் நோய் தாக்கும்போது, எலும்புகள் இறுகி, ஒலி அதிர்வுகள் காது நரம்புக்குச் செல்வது தடைபடும். அப்போது காது மந்தமாவதோடு, இரைச்சலும் கேட்கும். அடுத்து, தொண்டையையும் காதையும் இணைக்கிற ‘காது – மூக்கு -தொண்டைக்குழாய்’ (Eustachian tube) அழற்சி அடைந்து, வீங்கிக் கொண்டாலும் காது இரைச்சலுக்கு வழி அமைக்கும். காதில் அடிபட்டாலும் இந்தப் பிரச்சினை ஏற்படலாம்.

What causes tinnitus?

Tinnitus (pronounced tin-NY-tus or TIN-u-tus) is not a disease. It is a symptom that something is wrong in the auditory system, which includes the ear, the auditory nerve that connects the inner ear to the brain, and the parts of the brain that process sound. Something as simple as a piece of earwax blocking the ear canal can cause tinnitus. But it can also be the result of a number of health conditions, such as:

• Noise-induced hearing loss
• Ear and sinus infections
• Diseases of the heart or blood vessels
• Ménière’s disease
• Brain tumors
• Hormonal changes in women
• Thyroid abnormalities

Tinnitus is sometimes the first sign of hearing loss in older people. It also can be a side effect of medications. More than 200 drugs are known to cause tinnitus when you start or stop taking them.

People who work in noisy environments—such as factory or construction workers, road crews, or even musicians—can develop tinnitus over time when ongoing exposure to noise damages tiny sensory hair cells in the inner ear that help transmit sound to the brain. This is called noise-induced hearing loss.

Service members exposed to bomb blasts can develop tinnitus if the shock wave of the explosion squeezes the skull and damages brain tissue in areas that help process sound. In fact, tinnitus is one of the most common service-related disabilities among veterans returning from Iraq and Afghanistan.

Pulsatile tinnitus is a rare type of tinnitus that sounds like a rhythmic pulsing in the ear, usually in time with your heartbeat. A doctor may be able to hear it by pressing a stethoscope against your neck or by placing a tiny microphone inside the ear canal. This kind of tinnitus is most often caused by problems with blood flow in the head or neck. Pulsatile tinnitus also may be caused by brain tumors or abnormalities in brain structure.

Even with all of these associated conditions and causes, some people develop tinnitus for no obvious reason. Most of the time, tinnitus isn’t a sign of a serious health problem, although if it’s loud or doesn’t go away, it can cause fatigue, depression, anxiety, and problems with memory and concentration. For some, tinnitus can be a source of real mental and emotional anguish.

Why do I have this noise in my ears?

Although we hear tinnitus in our ears, its source is really in the networks of brain cells (what scientists call neural circuits) that make sense of the sounds our ears hear. A way to think about tinnitus is that it often begins in the ear, but it continues in the brain.

Scientists still haven’t agreed upon what happens in the brain to create the illusion of sound when there is none. Some think that tinnitus is similar to chronic pain syndrome, in which the pain persists even after a wound or broken bone has healed.

Tinnitus could be the result of the brain’s neural circuits trying to adapt to the loss of sensory hair cells by turning up the sensitivity to sound. This would explain why some people with tinnitus are oversensitive to loud noise.

Tinnitus also could be the result of neural circuits thrown out of balance when damage in the inner ear changes signaling activity in the auditory cortex, the part of the brain that processes sound. Or it could be the result of abnormal interactions between neural circuits. The neural circuits involved in hearing aren’t solely dedicated to processing sound. They also communicate with other parts of the brain, such as the limbic region, which regulates mood and emotion.

What should I do if I have tinnitus?

The first thing is to see your primary care doctor, who will check if anything, such as ear wax, is blocking the ear canal. Your doctor will ask you about your current health, medical conditions, and medications to find out if an underlying condition is causing your tinnitus.

If your doctor cannot find any medical condition responsible for your tinnitus, you may be referred to an otolaryngologist (commonly called an ear, nose, and throat doctor, or an ENT). The ENT will physically examine your head, neck, and ears and test your hearing to determine whether you have any hearing loss along with the tinnitus. You might also be referred to an audiologist who can also measure your hearing and evaluate your tinnitus.

What if the sounds in my ear do not go away?

Some people find their tinnitus doesn’t go away or it gets worse. In some cases it may become so severe that you find it difficult to hear, concentrate, or even sleep. Your doctor will work with you to help find ways to reduce the severity of the noise and its impact on your life.

Are there treatments that can help me?

Tinnitus does not have a cure yet, but treatments that help many people cope better with the condition are available. Most doctors will offer a combination of the treatments below, depending on the severity of your tinnitus and the areas of your life it affects the most.

• Hearing aids often are helpful for people who have hearing loss along with tinnitus. Using a hearing aid adjusted to carefully control outside sound levels may make it easier for you to hear. The better you hear, the less you may notice your tinnitus. Read the NIDCD fact sheet Hearing Aids for more information.
• Counseling helps you learn how to live with your tinnitus. Most counseling programs have an educational component to help you understand what goes on in the brain to cause tinnitus. Some counseling programs also will help you change the way you think about and react to your tinnitus. You might learn some things to do on your own to make the noise less noticeable, to help you relax during the day, or to fall asleep at night.
• Wearable sound generators are small electronic devices that fit in the ear and use a soft, pleasant sound to help mask the tinnitus. Some people want the masking sound to totally cover up their tinnitus, but most prefer a masking level that is just a bit louder than their tinnitus. The masking sound can be a soft “shhhhhhhhhhh,” random tones, or music.
• Tabletop sound generators are used as an aid for relaxation or sleep. Placed near your bed, you can program a generator to play pleasant sounds such as waves, waterfalls, rain, or the sounds of a summer night. If your tinnitus is mild, this might be all you need to help you fall asleep.
• Acoustic neural stimulation is a relatively new technique for people whose tinnitus is very loud or won’t go away. It uses a palm-sized device and headphones to deliver a broadband acoustic signal embedded in music. The treatment helps stimulate change in the neural circuits in the brain, which eventually desensitizes you to the tinnitus. The device has been shown to be effective in reducing or eliminating tinnitus in a significant number of study volunteers.
• Cochlear implants are sometimes used in people who have tinnitus along with severe hearing loss. A cochlear implant bypasses the damaged portion of the inner ear and sends electrical signals that directly stimulate the auditory nerve. The device brings in outside sounds that help mask tinnitus and stimulate change in the neural circuits. Read the NIDCD fact sheet Cochlear Implants for more information.
• Antidepressants and antianxiety drugs might be prescribed by your doctor to improve your mood and help you sleep.
• Other medications may be available at drugstores and on the Internet as an alternative remedy for tinnitus, but none of these preparations has been proved effective in clinical trials.

Can I do anything to prevent tinnitus or keep it from getting worse?

Noise-induced hearing loss, the result of damage to the sensory hair cells of the inner ear, is one of the most common causes of tinnitus. Anything you can do to limit your exposure to loud noise—by moving away from the sound, turning down the volume, or wearing earplugs or earmuffs—will help prevent tinnitus or keep it from getting worse.

What are researchers doing to better understand tinnitus?

Along the path a hearing signal travels to get from the inner ear to the brain, there are many places where things can go wrong to cause tinnitus. If scientists can understand what goes on in the brain to start tinnitus and cause it to persist, they can look for those places in the system where a therapeutic intervention could stop tinnitus in its tracks.

In 2009, the National Institute on Deafness and Other Communication Disorders (NIDCD) sponsored a workshop that brought together tinnitus researchers to talk about the condition and develop fresh ideas for potential cures. During the course of the workshop, participants discussed a number of promising research directions, including:

• Electrical or magnetic stimulation of brain areas involved in hearing. Implantable devices already exist to reduce the trembling of Parkinson’s disease and the anxieties of obsessive-compulsive disorder. Similar devices could be developed to normalize the neural circuits involved in tinnitus.
• Repetitive transcranial magnetic stimulation (rTMS). This technique, which uses a small device placed on the scalp to generate short magnetic pulses, is already being used to normalize electrical activity in the brains of people with epilepsy. Preliminary trials of rTMS in humans, funded by the NIDCD, are helping researchers pinpoint the best places in the brain to stimulate in order to suppress tinnitus. Researchers are also looking for ways to identify which people are most likely to respond well to stimulation devices.
• Hyperactivity and deep brain stimulation. Researchers have observed hyperactivity in neural networks after exposing the ear to intense noise. Understanding specifically where in the brain this hyperactivity begins and how it spreads to other areas could lead to treatments that use deep brain stimulation to calm the neural networks and reduce tinnitus.
• Resetting the tonotopic map. Researchers are exploring how to take advantage of the tonotopic map, which organizes neurons in the auditory cortex according to the frequency of the sound to which they respond. Previous research has shown a change in the organization of the tonotopic map after exposing the ear to intense noise. By understanding how these changes happen, researchers could develop techniques to bring the map back to normal and relieve tinnitus.

Thanks

https://invizear.com/hyperacusis/

https://www.hindutamil.in

https://www.medicalnewstoday.com

https://www.nidcd.nih.gov

https://www.mayoclinic.org/diseases-conditions/tinnitus