耳鸣

迹象 & 症状

耳鸣是医疗保健专业人员面临的最难以捉摸的情况之一. 它是一种不直接由外部产生的听觉感知.

它通常被描述为嘶嘶声, 咆哮的, 一耳或双耳的嗡嗡声, 叫做耳鸣, 或者在脑子里, 叫做耳鸣.

声音范围从高到低音调，可以是一个单一的音调, multi-tonal, 或声, 没有音质的没有音质的. 耳鸣可能是持续性的、脉动性的或间歇性的. 它可能突然开始，也可能逐渐发展.

耳鸣大致可分为两类:客观耳鸣和主观耳鸣.

客观性耳鸣

This form is audible to an observer either with a stethoscope or simply by listening in close proximity to the ear. Objective tinnitus accounts for less than 5 percent of overall tinnitus cases and is often associated with vascular or muscular disorders. 耳鸣常被描述为搏动性，或与患者的心跳同步. 在很多情况下, 客观耳鸣的原因是可以确定和治疗的, 内科或外科, 可能是规定的.

主观性耳鸣

这种形式只有病人才能听到，而且更为常见, 占耳鸣病例的95%. Subjective tinnitus is a symptom that is associated with practically every known ear disorder and is reported to be present in over 80 percent of individuals with sensorineural hearing loss, 哪一种是由神经和/或毛细胞损伤引起的.

因为耳鸣, 像痛苦, 是主观的, two individuals may demonstrate identical tinnitus loudness and pitch matches yet be affected in significantly different ways. 耳鸣的严重程度很大程度上取决于个人对这种情况的反应. 也就是说，许多耳鸣患者:

• 难以入睡或注意力不集中
• 感到沮丧或焦虑
• 报告工作或家庭中可能导致耳鸣的其他问题
• 描述耳鸣感觉与压力的关系
• 通常很难确定病人的情绪状态是否预先存在, 或者是耳鸣的结果.

原因

虽然耳鸣的确切机制尚不清楚, 很可能有很多相关的因素. 耳鸣通常(但并非总是)与听力或神经系统异常有关.

引起耳鸣的原因有很多，包括:

• 外耳疾病, 比如耳垢, 接触鼓膜的头发, 异物或穿孔的耳膜
• 中耳疾病, 如负压所致的咽鼓管功能障碍, 流体, 感染, 耳硬化症, 过敏或良性肿瘤
• 内耳疾病, 如因噪音暴露而引起的感音神经性听力损失, 老化, 内耳感染或梅尼埃氏病常伴有听力丧失和头晕

某些药物也可能暂时引起耳鸣，例如:

• 抗炎药，如阿司匹林、布洛芬、非甾体类抗炎药和奎宁
• 镇静剂
• 抗抑郁药
• 某些抗生素和化疗药物

其他原因包括:

• 全身性疾病，如高血压或低血压, 贫血, 糖尿病。, 甲状腺机能障碍, 糖代谢异常, 血管疾病, 颈静脉生长, 听性肿瘤和头颈部动脉瘤
• 非听觉障碍，如头部或颈部创伤, 颞下颌关节紊乱和颈部错位

目前的研究表明，尽管耳鸣最初可能是由耳朵受伤引起的, 最终，一种听觉模式在大脑中建立. 因此，许多治疗方法针对的是大脑，而不是耳朵.

虽然大多数耳鸣患者也有听力损失, 耳鸣的出现并不表明听力正在丧失.

诊断。

如果你认为你有耳鸣, 咨询你的十大赌博平台排行榜，以确定是否可以找到耳鸣的原因，并随后治疗. 如果治疗不合适, 询问你所在地区是否有耳鸣治疗知识的听力学家.

The audiologist will assess a patient's hearing and counsel them regarding non-medical treatment options. Becoming educated about the nature of tinnitus may be extremely useful in relieving 焦虑 and seeking ways of coping with the condition.

治疗

重要的是要记住，耳鸣是一种症状，而不是疾病. 像这样, 最佳的治疗策略应该是针对消除疾病, 而不是简单地缓解症状. 也, 因为耳鸣可能是更严重疾病的症状, 在决定治疗之前，找出病因是很重要的.

预防和减少耳鸣

以下是患者可以做的一些事情来帮助预防和减少耳鸣:

• 减少接触非常大的噪音
• 避免完全沉默
• 减少盐的摄入量
• 监测自己的血压
• 避免咖啡因和尼古丁等兴奋剂
• 锻炼
• 减少疲劳
• 管理压力
• 教育你自己

虽然大多数形式的耳鸣没有已知的治疗方法, there are many management options available and most tinnitus sufferers can find varying degrees of relief from one or a combination of the following.

药物

没有一种药物对所有耳鸣患者都有效. Some of the antidepressants and anti-焦虑 medications available are helpful for certain tinnitus patients, 然而，这一领域还需要更多的研究.

听觉习惯化或耳鸣再训练疗法

These techniques consist of two main components — directive counseling and low level sound generators.

• 指导咨询提供了, 关于耳鸣的原因和影响的个体化教育, 大脑, 以及应对机制.
• Low-level sound generators produce broadband noise via hearing aid type devices at a soft enough level so that 大脑 perceives both the noise and the tinnitus. 最终，大脑可能会重新学习一种模式，从而淡化耳鸣的重要性. 这些设备也可能有助于对声音过度敏感的患者脱敏.

声治疗

The use of an externally produced sound to either cover up or in some way inhibit or alter production of tinnitus can offer relief for some. 声刺激主要有六种方法.

• 声音发生器, sometimes called tinnitus masker: an ear-level electronic device housed in a hearing aid case that produces a white noise.
• 一种耳鸣仪器:助听器和发声器的组合.
• Hearing aids: help to amplify speech as well as environmental noise and thus stimulate areas of the ear and brain that otherwise may not be receiving adequate stimulation because of the hearing loss.
• A tabletop or portable sound generator: these can be purchased at certain electronic suppliers such as the Sharper Image.
• 家用遮蔽:如使用电风扇、收音机或电视.
• 音乐疗法(见下文).

不幸的是, some tinnitus sufferers find that masking noise may merely be a substitute of one annoying sound for another. It is thus better to try to relegate the annoyance of tinnitus to the background of one's consciousness through habituation or retraining methods.

音乐疗法

许多病人发现这种音乐, particularly classical passages that don't contain wide variations in loudness (ampliltude) can be both soothing to the limbic system (the emotional processor in 大脑 that is commonly negatively linked to a patient's reaction to tinnitus) and stimulating to the auditory cortex. 如果有听力损失, 可能有必要改变音乐的频谱，使皮层神经元.

放大

The use of hearing aids and a combination of hearing aids and maskers are often effective ways to minimize tinnitus. While it is not clear whether hearing aids help by amplifying background sounds that can mask out the tinnitus or by actually altering the production of tinnitus, 大多数佩戴助听器的人报告他们的耳鸣至少有所减少. 这可能是由于耳鸣和沉默之间的对比减少, 或者是因为给大脑提供了新的刺激.

神经细胞声学脱敏方案

神经细胞声学脱敏方案 is a process that uses counseling as well as a body worn processor connected to high fidelity earphones that present pleasant music that is filtered in accordance with an individuals hearing loss.

心理咨询或认知行为疗法

不管耳鸣的原因是什么, 如果一个人没有受到耳鸣的困扰, 这不再是一个问题. 心理干预旨在成功减轻压力, distress and distraction associated with the tinnitus can be very productive and often produces the most attainable goals.

压力管理

The very high correlation between stress and tinnitus disturbance underscores the need to maintain one's composure and logic when trying to cope with tinnitus. 放松, 引导意象和自我催眠是用来帮助对抗压力的自助方法的例子, 焦虑和睡眠障碍与耳鸣有关.

其他治疗方案

其他可能帮助耳鸣患者的选择包括:

• 支持团体 Local peer support groups offer emotional support to patients and a place to discuss and share treatment techniques.
• 牙科治疗 下颌关节紊乱，称为颞下颌关节紊乱(TMD)，可加重耳鸣. 夹板和锻炼可以缓解这些问题.
• 营养咨询 所有耳鸣患者都应保持均衡饮食.
• 生物反馈 生物反馈 is a technique of making unconscious or involuntary bodily processes detectable by the senses in order to manipulate them by conscious mental control. 生物反馈 with counseling can help relieve stress patterns that can worsen the perception of tinnitus.
• 替代的方法 尽管没有科学数据表明催眠之类的方法有一致的好处, 针灸, 物理疗法, 脊椎治疗和许多草药制剂, 一些病人确实感觉到了好处.