Tinnitus: Causes, Symptoms, and When to Seek Help - Otolaryngology

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Tinnitus, commonly referred to as "ringing in the ears," is a condition characterized by the perception of sound when no external sound is present. It can manifest as various sounds, including ringing, buzzing, hissing, or even a pulsing sensation. Understanding tinnitus involves recognizing its potential causes, symptoms, and when to seek medical assistance.


Causes of Tinnitus
Tinnitus can arise from a variety of factors, including:
1. Hearing Loss: Age-related hearing loss (presbycusis) is one of the most common causes. Damage to the inner ear can lead to abnormal neural activity, resulting in the perception of sound.

2. Exposure to Loud Noises: Prolonged exposure to loud sounds, such as concerts or machinery, can damage the hair cells in the cochlea, leading to tinnitus.

3. Ear Infections or Blockages: Conditions like earwax buildup, middle ear infections, or Eustachian tube dysfunction can cause pressure changes in the ear, leading to tinnitus.

4. Neurological Disorders: Conditions such as Meniere's disease, vestibular schwannoma (acoustic neuroma), or other neurological disorders can also contribute to tinnitus.

5. Medications: Certain medications, particularly ototoxic drugs (those that can damage hearing), can cause or exacerbate tinnitus.

6. Injury: Trauma to the head or neck can affect the auditory system, leading to tinnitus.

7. Stress and Anxiety: Psychological factors can influence the perception of tinnitus, making it more noticeable during stressful times.


Symptoms of Tinnitus
The primary symptom of tinnitus is the perception of sound in the absence of external stimuli. This sound can vary in pitch and intensity and may be constant or intermittent. In your case, the "殷殷聲" (a sound resembling a low-frequency hum or electrical noise) that you experience, particularly in quiet environments, is a common manifestation of tinnitus. The fact that it diminishes when external sounds are present suggests that it may be more pronounced in silence, which is typical for many individuals with tinnitus.


When to Seek Help
While tinnitus is often benign, there are circumstances where it is advisable to seek medical attention:
1. Sudden Onset: If tinnitus appears suddenly, especially if accompanied by hearing loss or dizziness, it is important to consult a healthcare professional.

2. Persistent Symptoms: If the tinnitus persists for several weeks or worsens over time, it is wise to seek evaluation.

3. Associated Symptoms: If you experience additional symptoms such as pain, significant hearing loss, or neurological symptoms (e.g., balance issues, facial weakness), immediate medical attention is warranted.

4. Impact on Daily Life: If tinnitus significantly affects your quality of life, sleep, or concentration, discussing treatment options with a healthcare provider can be beneficial.


Connection to Recent Events
Regarding your recent injury and the tetanus vaccination, while it is unlikely that the vaccination directly caused your tinnitus, any physical trauma or stress can potentially exacerbate existing conditions or lead to new symptoms. It is essential to monitor your symptoms and discuss any concerns with a healthcare provider, especially if they persist or worsen.


Conclusion
In summary, your experience with tinnitus, characterized by a persistent sound in your right ear, warrants attention. Given that you have normal hearing and the sound is affected by external pressure, it may be related to physiological changes in your auditory system. If the symptoms continue or if you have any concerns about your health, it is advisable to consult an ear, nose, and throat (ENT) specialist or a healthcare provider for a thorough evaluation and appropriate management. They may recommend hearing tests, imaging studies, or other assessments to determine the underlying cause and potential treatment options.