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How to cite this article Nicolas-puel C, Faulconbridge RL, Guitton M, Puel J, Mondain M, Uziel A. The aim of this study was to highlight the clinical characteristics of tinnitus and to attempt a quantitative assessment in relation to any underlying etiologies.
Tinnitus constitutes an important public health problem; it is estimated that in France alone, there are 5 million tinnitus sufferers.
One hundred twenty-three patients were treated in a specialist tinnitus clinic at Gui de Chauliac1 Hospital, Montpellier, France, between 1998 and 2000 [1]. The assessment was based on a questionnaire that was used to evaluate the clinical aspects of tinnitus (see the appendix at end of article). When asked, patients usually liken the sound of their tinnitus to environmental noise, such as the sound of the wind or the sound of an insect. To investigate the temporal variation of tinnitus, patients were asked whether the intensity of their tinnitus was stable or whether it fluctuated during the course of the day. The aim of the clinical examination was to determine any underlying etiology that would explain the presence of tinnitus. The great majority of patients (almost 90%) presented with tinnitus associated with deafness of known etiology (Table 1). Hearing losses were divided into four groups: highfrequency (60%), low-frequency (25%), flat losses (11%), and dead ear (2%).
Of the patients from the endocochlear group, 65% had stable tinnitus, and 32% had fluctuating tinnitus. Of patients with Meniere's disease or Meniere's-like syndrome, 84% described fluctuating tinnitus. Of patients with endocochlear deafness, 77% described their tinnitus as a high-pitched whistling, and 21 % described it as a low-pitched buzzing (Fig. In our study, 58 of the 77 patients with a stable high-pitched tinnitus (77%) had a high-tone hearing loss. This study attests to the rare incidence of objective tinnitus: There was no case of objective tinnitus in this series. The study of the etiology of the underlying deafness offers interesting results for understanding tinnitus, especially in patients with high-frequency hearing loss.
We have confirmed in this study that the general frequency of tinnitus pitch perceived by the patient is correlated in broad terms with the frequency of the hearing loss, in agreement with some other studies [7].
This study has raised interesting findings about the fluctuation of tinnitus after periods of sleep, especially in patients with low-frequency tinnitus. We have shown in this study that audiometry can be used as a simple indirect test to evaluate tinnitus, as it correlates well with a visual analog scale of tinnitus intensity in the majority of our patients. We thank Professors Bernard Guerrier and Remy Pujol, who supported and encouraged this work. Tinnitus is usually described as the ringing in the ears; although not always the ringing sound that is heard but often times sufferer hear the hissing, roaring, clicking or buzzing sounds. I have been searching for an effective natural remedy for Tinnitus since last year when I had an ear infection that scared me to death.
I searched and searched online for the natural remedy of my ear infection because I do not have any intention of going to the doctor for hearing aid or something. If the ear does not clear on the first application, repeat the treatment daily until the problem goes away. If this treatment works for you, you may do this application once a month to clean your ears. Statistics show that 1 in 5 Americans suffer from a form of Tinnitus, a condition in which sufferer’s complain of a constant ringing or hissing in the ear, sometimes both. Noise-induced tinnitus is the most common form that a lot of times develop after a rock concert. I found a website that offers natural remedy to get rid of tinnitus or stop the ringing in your ears in 10 days or your money back. If you want to know how to make money by blogging about your passion, I would be happy to show you. Lorem ipsum dolor sit amet, consectetur adipisicing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. 1968: Jimi Hendrix uses feedback to play "The Star Spangled Banner" at Woodstock, taking the electric guitar where it has never gone before. Sound is often measured and described using two distinct reference points: the psychophysical perception of sound in the human ear and brain, and the scientific quantification of sound with acoustic measuring devices. A given note is comprised of a series of "pitches" that vibrate in harmony with its fundamental frequency or pitch. Tinnitus refers to a condition where a person constantly experiences buzzing sound in the ears.
A common myth is that tinnitus leads to loss of hearing, but studies have revealed that people experiencing tinnitus face no problem in hearing. If you don’t like bananas, you can go for other potassium rich fruits that include apple or apricots. One study published in American Journal of Otolaryngology found that ringing in the ears is associated with deficiency of vitamin B12.
Though researchers are not exactly sure, but few studies have shown that a link exists between ringing in the ears and inflammation. We are suggesting such a strategy because pineapple contains bromelain that is capable of reducing inflammation in the body. A condition called tinnitus causes unusual sounds in the ears: high-pitched hisses, lower-pitched buzzing sounds, clicking. Conductive hearing loss makes it easier to hear blood flowing through two large blood vessels that travel through each ear.
Your doctor will likely examine your ears and listen to the blood flow through the arteries in your neck. Harvard Health Publications is the publishing division of Harvard Medical School, providing the general public with authoritative, trustworthy, and accessible health information. To submit your own health question to Doctor K for consideration in a future column, click here.
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If you think you may have a medical emergency, call your healthcare provider or 911 immediately.
The information you share, including that which might otherwise be Protected Health Information, to this site is by design open to the public and is not a private, secure service. Characteristics of Tinnitus and Etiology of Associated Hearing Loss: A Study of 123 Patients. We undertook to study a population of 123 patients attending a tinnitus clinic between 1998 and 2000. Although previous studies have been descriptive, few have attempted a quantitative assessment of tinnitus qualities, such as its intensity, and have correlated it with the etiology of any associated hearing loss. To allow its easy use during normal otological clinic visits, the questionnaire was based on a vertigo and hearing loss questionnaire already in use, and it was limited to certain aspects. The frequency composition of tinnitus is extremely difficult both to describe and to understand, especially for those patients with low-pitched or complex tinnitus, even when using an audiometer or a synthesizer to define tinnitus pitch [2].


If the latter was the case, we asked them to evaluate this fluctuation on a visual analog scale, with the maximum value corresponding to the loudest intensity during the course of the day and the minimum value corresponding to the weakest intensity. All patients underwent a full otological, audiological, and vestibular examination, which included audiometry, evoked otoacoustic emissions (OAEs), evoked auditory brainstem potentials, and videonystagmoscopy (two CCD cameras mounted on lightproof goggles). All but one of the patients with tinnitus seen in this specialist clinic had an associated hearing loss. Evoked OAEs were performed in the first 50 patients only, because the high incidence of hearing thresholds greater than 30 dB in our patients meant that OAE assessment contributed little to the evaluation of the etiology. Patients with active endolymphatic hydrops described fluctuation of their tinnitus during vertiginous attacks but, interestingly, also every day between crises, even when they thought that their hearing was stable. Obviously, our hospital population was selfselected and does not necessarily reflect the true epidemiology of tinnitus. This type of subjective tinnitus reflected a cochlear problem in the majority of cases: More than 80% were associated with an endocochlear hearing loss. A strong correlation was seen between clinical characteristics of tinnitus and the nature of the cochlear pathology.
By simply having three categories of tinnitus pitch in the questionnaire (high pitch, low pitch, or other), we have avoided some of the problems associated with pitch matching using an audiometer. Many studies report tinnitus associated with sleep disturbance, but a literature review does not reveal any other studies reporting such marked increase in tinnitus on waking. We believe that it is important to develop this clinically based approach, and we will continue to investigate further correlations in our clinic. Gui de Chauliac (1300- 1368) was a physician associated with the Montpellier School of Medicine; he wrote what became the standard book on surgery for the next two centuries.
The sounds are variable in volume and pitch from low to high and can be heard on both ears. In July of last year, I suffered from what they called hissing sound in both of my ears that may be due to ear infection. This one was using hydrogen peroxide, a common chemical that is found in our first aid kits and medicine cabinets. This condition can affect the quality of life because they are unable to sleep, concentrate and hearing loss for some. This condition can also be found in factory workers, construction workers or any other individuals who work in a noisy environment.
Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Psychophysical terms such as loudness and pitch describe the human perception of the same acoustical phenomena as amplitude and frequency. Loudness refers to the human perception of sound, while amplitude refers to quantifiable measurements of air pressure variations.
Rapid vibrations of air molecules create a high-pitched sound (treble); a slower rate of vibration creates a low-pitched sound (bass). Other foods that contain high amounts of potassium include yogurt, salmon, white mushrooms and baked potato. So, if you are suffering from tinnitus, include foods that are rich in vitamin B12 can help you to alleviate the symptoms associated with tinnitus. However, make sure that you don’t eat too much of these because high intake of animal protein can cause other problems. In such a case, including pineapple in your diet plan can be an effective way of reducing inflammation. For this reason, it is crucial to include zinc rich foods in your eating plan.  Examples of such foods can include meat and shellfish. However, at the same time, you should avoid certain foods so that the situation is not aggravated. You accept that you are following any advice at your own risk and will properly research or consult healthcare professional. What he was worried about was not that he might have an ear condition which could take away his hearing — he was worried that he might be going crazy! On the other hand, if he heard the voice of Abraham Lincoln whispering in his ear, he might have something to worry about.
This is a remarkably common problem; an estimated 50 million people in the United States have it to some degree.
David Vernick, assistant clinical professor of otology and laryngology at Harvard Medical School.
The accumulation of fatty buildup (plaque) inside the carotid arteries can create turbulent blood flow.
When blood pressure is high, blood flow through the carotid artery is more likely to be turbulent. Tiny little muscles that attach to the bones inside the ear can sometimes go into spasms, and this can cause pulsatile tinnitus. These are the carotid artery and the jugular vein, which circulate blood to and from the brain. He or she will listen for an unusual sound that blood makes when it rushes past an obstruction. Anthony Komaroff is a practicing physician, Professor of Medicine at Harvard Medical School, and Editor in Chief of Harvard Health Publications. The Content is not intended to substitute for professional medical advice, diagnosis, or treatment. Any mention of products or services is not meant as a guarantee, endorsement, or recommendation of the products, services, or companies. Their answers on a questionnaire allowed detailed evaluation of the characteristics of tinnitus, including such variables as the circumstances in which the tinnitus was first noticed and evaluation of its intensity and frequency. If the assessment did not uncover any obvious precipitating events, the tinnitus was considered to have arisen spontaneously. Tinnitus that was present on some days but entirely absent on others was designated as intermittent (Fig.
Three categories of tinnitus emerged from our survey: tinnitus with a stable intensity over time, tinnitus perceived to fluctuate in relation to periods of sleep, and tinnitus perceived as intermittent (present on certain days but not on others).
If it was necessary for diagnosing the hearing loss, we also performed supplementary investigations: videonystagmography when hearing loss was associated with vertigo, magnetic resonance imaging when retrocochlear hearing loss was suspected, or magnetic resonance angiography, Doppler imaging of the local vasculature, and tomodensitometry of the temporal bone to evidence vascular problems. Even though deafness had not been described by any of the patients, audiometry unmasked in each patient a high-frequency loss that was more marked (10 dB) in the ear affected with tinnitus. At age 23, he described his tinnitus as "creaking"; it was precipitated by movement of his head. Because such a significant number of patients with tinnitus had an endocochlear hearing loss (8l.3%), we looked in more detail at this subgroup. Each portion of the chart represents tinnitus associated with endocochlear deafness according to its variability of intensity over time. It is interesting to note that the remaining 16% of patients with Meniere's disease or syndrome had had it for more than 5 years; they had a stable hearing loss and no vertiginous attacks for 2 years, and they described their tinnitus as stable (see Fig. Only 2% of patients were unable to categorize their tinnitus into either of these categories.
Each portion of the chart represents tinnitus associated with endocochlear deafness according to its frequency characteristics.


This correlation was calculated for those patients with stable, high-pitched tinnitus and a high-pitched hearing loss.
Studies that use an audiometer or synthesizer for pitch matching have found the process to be very difficult, both because of the difficulty that patients have in matching complex tinnitus and because of the possible modulation of the tinnitus by the external sound [8]. He recommended fumigation of the ear with ox urine , vinegar, and myrrh for certain cases of tinnitus.
It is a symptom that indicates something is wrong  in the auditory system which includes the ear, auditory nerve connecting the inner ear to the brain that process sound. This happened when for 12 months straight I have been listening to audio books with my headphones every day until one day I noticed hissing sounds in my ears that never seem to stop. I saw many home remedies but, I first tried one and see if it works otherwise, I will be experimenting on other remedies until I find what works. It will produce a fizzing noise, which is oxygen bubbling off the peroxide that leads to the production of water that must be drained from the ears.
DO NOT use this method if you have ear infection, perforated ear drum or any other ear-related problems, you should consult a doctor before using any home remedies. For example, amplitude is the measurement of the range of air pressure quantified in decibels or dB.
Amplitude is the change in air pressure over time and is universally measured in decibels (dB). You can experience this phenomena both aurally and visually by listening to and watching a guitar string being plucked. This book gives one of the best in-depth explanations of the science of sound and human hearing.
Right: Reflections that reach the ear within 40ms are perceived as richness and warmth (reverberation). This is because bananas are rich in potassium, which ensures proper flow of fluids in the body. These include an abnormal connection between an artery and vein, twisted arteries, or a benign blood vessel tumor behind the eardrum. Always seek the advice of your healthcare provider with any questions you may have regarding your medical condition. What you have written may be seen, disclosed to, or collected by third parties and may be used by others in ways we are unable to control or predict, including to contact you or otherwise be used for unauthorized or unlawful purposes. The patients each underwent a full neurootological examination with the aim of diagnosing an etiology. The assessment of patients with tinnitus was similar to that for patients with vertigo and hearing loss, within the setting of a neurootology clinic. In each case, the patients were able to state the exact time and date of onset of their tinnitus.
In none of these four patients did clinical or vascular examination identify an underlying cause.
It is impossible to say whether the deafness was linked to the head trauma (although this is likely) or whether it preceded it. Tinnitus was stable in 65 cases, fluctuant in intensity in 32 cases, and intermittent in 3 cases. Tinnitus was perceived as a high-pitched whistling in 77 cases and as a low-pitched buzzing in 21 cases. The intensity of the tinnitus (x axis) was measured on a visual analog scale graduated from 0 to 100. In cases of active Meniere's disease or Meniere' s-like syndrome with low-frequency hearing loss, the tinnitus was almost always described as a fluctuating low-pitched noise, even between vertiginous crises.
In J-M Aran, R Dauman (eds), Tinnitus 91: Proceedings of the Fourth International Tinnitus Seminar.
Hydrogen Peroxide has antiseptic and solvent properties that enable it to kill pathogens and dilute compounds which make it an ideal ear infection treatment. The string will vibrate at a root, or fundamental, frequency, as well as at higher multiples of this frequency.
However, if you are suffering from tinnitus, including certain foods in the diet plan can help you to reduce the symptoms associated with it. Never disregard professional medical advice or delay in seeking it because of something you have read in a public group(s). As with any public forum on any site, this information may also appear in third-party search engines like Google, MSN, Yahoo, etc. The great majority of tinnitus patients had an endocochlear deafness and, among these patients, acoustic trauma, endolymphatic hydrops, and presbyacusis were the commonest diagnoses (32%,32%, and 23%, respectively). Zero corresponds to an absence of tinnitus; 100 corresponds to the loudest tinnitus you can imagine. One patient attending the tinnitus clinic was given a diagnosis of an acoustic neuroma, two patients of vascular loops in the internal auditory meatus, and two of cholesteatoma. Even though it was thought that his tinnitus had an origin in some head or neck joint and thus was a somatic noise, it was not possible to define it further. All patients who described their tinnitus as fluctuating in intensity described a very clear increase in intensity of their tinnitus after periods of sleep (whether nighttime or siesta).
The highfrequency hearing loss (y axis) was calculated as a mean of the thresholds over three frequencies (4 , 6, and 8 kHz). I remembered the interview with the doctor that I saw on TV 3 years ago where the doctor predicted that this generation will see individuals as early as age 30 who will be experiencing hearing loss caused by extensive use of headphones for 3 hours straight while listening to music. The aim of the clinical examination was to diagnose the etiology of any underlying hearing loss. For example, a cello note playing the pitch of middle C will predominantly resonate at 261 cycles per second, but it will also contain frequencies vibrating at 1,000, 2,000, and 4,000 cycles per second. There are many health concerns for which we successfully provide care, so please feel free to call or email us to find out more.
Those patients with active Meniere's disease or Meniere's-like syndrome described a low-pitched buzzing tinnitus. However, four patients did have a presbyacusis, and one had a mild hearing loss in the higher frequencies. Many audio equipment manuals and professionals use these terms interchangeably, which can create confusion for newcomers.
Analysis of those patients with a stable high-pitched tinnitus associated with a high-frequency hearing loss shows a statistically significant correlation between the elevation of the audiometric thresholds and the loudness of the tinnitus.
The quality of the bestfitting linear regression curve is indicated by r, and the number of patients by n. For a large majority of patients with tinnitus, therefore, audiometry provides an indirect test for evaluating the tinnitus.



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