Conductive tinnitus
Introduction
Introduction to Conductive Tinnitus The cause of conductive tinnitus is the obstruction of the conductive part of the auditory system, such as swelling of the external auditory canal, occlusion, perforation of the tympanic membrane, invagination, inflammation of the middle ear, adhesion, and hardening. The sound barrier reduces the ability to listen to the outside world, weakens its role in masking the sounds that occur in the body, allowing it to feel and become tinnitus. Moreover, the sound transmitted into the ear through the bone conduction is blocked by the conduction barrier, and the outward escape channel is blocked, thereby improving the feeling of the sound in the ear, becoming a low-frequency, whirling sound like a wind. . We can try it ourselves, use one hand to cover the ear, and feel the sound of the thunder in the ear. This is the typical conductive tinnitus. basic knowledge The proportion of sickness: 0.2% Susceptible people: no special people Mode of infection: non-infectious Complications: insomnia
Cause
Conductive tinnitus
Conductive tinnitus is caused by lesions in the middle ear of the outer ear, which causes obstacles in the sound conduction process and causes tinnitus. Common causes of convulsions are external auditory canal, foreign body, inflammation, congenital ear canal atresia, acute and chronic suppurative otitis media, acute and chronic non-suppurative otitis media, congenital malformation, tumor, bullous tympanitis, early stage of otosclerosis. The summary is summarized as follows:
1 occlusion of the external auditory canal, such as congenital or acquired external ear canal malformation or atresia, external auditory canal embolism, osteophytes, foreign bodies, tumors, inflammation, etc.
2 Middle ear dysplasia, such as tympanic membrane and ossicular chain absent or deformed.
3 inflammatory diseases in the middle ear, such as middle ear purulent or non-suppurative inflammation.
4 ossicular fixation, such as tympanosclerosis or otosclerosis.
5 trauma, such as the middle ear, tympanic membrane trauma, ossicular chain interruption.
Prevention
Conductive tinnitus prevention
One: bathing in the ear, anti-fouling into the ear.
Bath bathing keeps the external auditory canal clean and is an important part of preventing ear disease. If the dirty water is in the ear, it can often cause pain in the ear canal, red and red swelling, and even perforation of the tympanic membrane. Therefore, when bathing, swimming, and shampooing, use clean cotton to block the outer ear canal to prevent water from entering the ear. When swimming in rivers and ponds, if the sewage is in the ear, clean the ear canal with clean cotton immediately.
Second: Pay attention to hygiene and quit ear.
The ear canal hole is deep and the tympanic membrane is very thin. If you use hard objects such as iron, wood, bone, etc. in a crowded environment, it is easy to cause ear injury due to collision, and even tympanic membrane trauma, so that the ear canal Pain, bleeding, swelling, or hearing loss, so you need to get rid of ear habits.
Three: educate children to prevent foreign bodies from falling into the ear.
Educate children not to put toys, beans, food, paper scraps and insects into the ear canal, so as not to cause foreign bodies in the ear canal. If the ear canal is painful, hearing impaired, or even pus in the running water, it must be checked in time to remove the foreign body.
Four: There are festivals and the volume is moderate.
The tympanic membrane is very thin, and if the volume is too large, it is susceptible to damage. Therefore, the volume of the Walkman, MP3, TV, recorder, and audio should be moderate, and the tone should not be too high or too low. If the sound is transmitted into the ear, there is discomfort, even a pain in the ear, or affecting face-to-face conversation and upset, indicating that the volume is too large, should avoid, or reduce the volume. Wear noise-proof earplugs if you are working in a noisy environment for a long time, and check your hearing regularly.
Complication
Conductive tinnitus complications Complications insomnia
Nervous breakdown, insomnia, depression and other diseases.
Symptom
Conductive tinnitus symptoms Common symptoms Tinnitus ear swelling ear vertigo
1. Ambient noise has a slight hearing disturbance to patients with conductive paralysis. This patient's ability to accept language in a noisy environment is often similar to that of a normal person.
2, the hearing loss of conductive sputum generally does not exceed 60 decibels, because more than 60 decibels of sound can be directly transmitted to the inner ear through the skull.
Examine
Conductive tinnitus examination
1. Tuning fork inspection: Linna test air conduction is greater than or equal to bone conduction, Weber test is biased to the affected side ear, and Schwabach test bone extension is extended. See table
2. Electrical audiometry (audiogram): The bone conduction curve is normal or close to normal, and the air conduction curve hearing loss is between 30 and 60 dB. Generally, the low frequency hearing loss is heavier and there is a gas bone conduction distance.
3, acoustic impedance test: through the tympanogram and acoustic reflection to judge.
4. Speech audiometry: Speech audiometry is a method of testing a subject's speech threshold and speech resolution score. Under normal circumstances, the speech discriminant score can reach 90%-100%, and the discriminative threshold of the conductive sputum is not affected. The sensory neuropathic sputum caused by cochlear lesions not only improves the verbal discriminant threshold, but also reduces the speech discriminant score. The decline in speech discrimination scores of auditory neuropathy is more pronounced.
Diagnosis
Conductive tinnitus diagnosis and identification
First, subjective tinnitus
(1) External auditory canal disease
Mainly sputum embolism, external ear canal embolism, external auditory canal cholesteatoma, when taking a bath, when the shampoo is wetted by water, it suddenly causes low-key tinnitus and hearing loss.
(two) middle ear disease
1. The catarrhal otitis media often has low-pitched, irregular tinnitus, and the tinnitus can disappear after the eustachian tube is blown, but it is easy to relapse.
2. Acute and chronic suppurative otitis media and its sequelae. The low-pitched tinnitus is very stubborn and difficult to treat.
3. Otosclerosis low-pitched tinnitus, often aggravated by inappropriate blow treatment, menstruation, fatigue.
(3) Inner ear disease and auditory nerve injury
1. Lost blood circulation disorder This is the most serious cause of subjective tinnitus. The tinnitus is high pitch or whistle sound, humming sound. Sudden onset, may be due to abnormal reactions, endocrine, anemia, etc. caused by anemia or congestion. The intensity changes greatly, when the time is strong and weak, sometimes there is no, and there is persistence.
2. Ototoxic drug poisoning All ototoxic drugs can cause tinnitus. Tinnitus often appears before deafness. It can be first developed in one ear and gradually developed into both ears. Tinnitus is a high-pitched tone, and about half of the patients have a head. Tinnitus symptoms can be alleviated or disappeared after acute poisoning. Chronic poisoning patients do not disappear after stopping the drug.
3. Meniere's disease causes low-pitched hair-like tinnitus, which often occurs before the onset of vertigo, or at the same time as deafness and dizziness. Tinnitus can disappear or be alleviated during the remission period of the disease.
Repeated episodes can be converted to persistent high-pitched tinnitus.
4. Senile sputum is common in the elderly over the age of 60, mostly bilateral, high-pitched tinnitus. Tinnitus is often a precursor to deafness.
5. The characteristics of auditory neuroma and tinnitus are unilateral, high-pitched such as humming or whistling. Initially it was intermittent and gradually changed to continuous. Often accompanied by other cranial nerve symptoms, such as headache, facial numbness and so on. X-ray filming of the internal auditory canal, CT internal auditory canal scan, and brain electrical response audiometry can confirm the diagnosis.
(four) systemic diseases
1. Hypertensive tinnitus is mostly bilateral, often consistent with the rhythm of the pulse. In addition to tinnitus, you can also have high blood pressure symptoms such as headache and dizziness. The hearing test is normal. Tinnitus can be alleviated or disappeared after taking blood pressure lowering drugs.
2. Autonomic dysfunction is common in women during puberty or menopause. Tinnitus is variable, sometimes high-pitched, sometimes low-pitched, with single ears with alternating ears, sometimes persistent and time-separated. There are also systemic symptoms such as dizziness, insomnia and more dreams.
Second, objective tinnitus
(a) vascular tinnitus
Common in jugular bulbar tumor, carotid aneurysm, intracranial aneurysm, intracranial arteriovenous fistula and so on. This kind of tinnitus is characterized by frequent frequency synchronization with the heartbeat or pulse. You can hear the sound with a stethoscope, and the tinnitus can be alleviated or disappeared when the corresponding blood vessel is pressed hard.
(B) muscle contraction tinnitus
The "Kata" sound caused by the clonic contraction of the sacral muscles, the levator muscles, the tympanic muscles, and the sacral muscles. The ear of such a sound examiner can be heard close to the ear of the patient.
