Ringing in the ears, medically called Tinnitus, is a condition in which the individual hears a certain sound continuously in the ears.

The nature of this sound varies with different individuals. The sound may be whistling, buzzing or bell-like; it might be low or high; seeming to come from a far point or from inside of one's body.

Tinnitus in most cases is subjective where only the affected individual is able to hear the sounds. In some cases, the condition might also be objective wherein the doctor/examiner might be able to hear the sounds on examining.

Understanding the most common cause:

The process of sound waves travelling from the ear to the brain is facilitated by hair cells. When these hair cells are damaged, the brain does not receive signals which cause dysfunction in the activity of neurons. This dysfunctional neuron activity results in the illusion of sounds in the said individual. This illusion is referred to as Tinnitus.

Other causes that might result in Tinnitus are:

Damage around the hearing sections of the brain also might result in ringing sounds / tinnitus. Excessive noise might result into Tinnitus and if not prevented might even progress to hearing loss. There are also some drugs that may cause or worsen the condition.

When to seek help:

In the case of a sudden episode of Tinnitus, it may be associated with hearing loss. Such an episode should be followed by visiting the doctor immediately to prevent any further damage.

Sometimes, the ringing sound occurs rhythmically with your heart beat. It might be because of a pulsating blood vessel and/or because of a sudden hike in blood pressure. This condition would also be relatively easy to cure if reported immediately to the doctor.

If ringing sound occurs with a certain movement, it might be associated with stroke in some cases. In such incidents, conveying the exact symptoms and seeking help sooner would help in treating the underlying cause effectively.

With the first episode of Tinnitus, a regular medication that you intake should be shown to the doctor to rule out medication as the cause or to discontinue a certain medication if found to the causative agent.

Ringing In Ears - What Does it Mean and When to Seek Help

The infection of the bone of the ear is Mastoiditis. This may be an acute infection needing hospitalisation and injectable drugs or may be in the form of slow bone eroding processes like cholesteatoma.

Let us learn more about this condition and its treatment

Understanding the mastoid bone: The mastoid bone is made up of air sacs and it looks a lot like a sponge. In this sense, it is different from the other bones that can be found in the human body. In order to function properly, this bone requires air from the other parts of the ear, including the Eustachain Tube which connects the middle part of the ear with the portion that lies at the back of the throat. If this tube gets infected due to any reason, the infection and bacteria can also travel to the Mastoid bone, leading to an infection in this area. Another form of the infection starts from the ear drum and a slowly progressive bone eroding process starts which spreads into the air sacs and can potentially spread to the brain.

Symptoms: Acute mastoiditis will present with earache, ear discharge and onset of fever and chills, as well as redness and inflammation behind the ear. Pain in the ear may be experienced along with headaches and swelling that may be experienced behind the eyes. At the very earliest sign, these symptoms must be reported to an ENT or ear throat nose specialist so that the treatment can happen at the earliest. Chronic mastoiditis may be due to repeated infections and bone eroding cholesteatoma which presents with repeated episodes of ear discharge which may be foul smelling and may even have blood.

Diagnosis: The diagnosis is mostly made on ear examination and may involve imaging tests like a CT scan as well as an MRI scan of the head and the ear. A simple X-ray of the mastoids can help in detecting the severity of the infection, and it spread.

Treatment: After diagnosing the problem with imaging tests as well as a detailed ear examination, the doctor will usually start the treatment by admitting the patient in the hospital. Antibiotic medication will be administered through intravenous methods, after which oral antibiotics will be prescribed for many days after the patient has been discharged from the hospital. Surgery may be required if the infection has not cleared up even after the use of antibiotics and is also done in cases of bone erosion. This surgery will be done to drain the infected fluid from the ear and remove a part of this Mastoid bone. Complications like facial paralysis and vertigo need to be discussed with the surgeon before the surgery.

Acute Mastoiditis - Symptoms, Diagonisis & Treatment

The human ear is divided into three parts, namely the outer, middle and inner ear. All these parts function in coherence with each other and help us in converting vibrations into sound and information. The middle ear consists of the air space between the inner ear and the outer ear and contains the bones that transmit the vibrations of the outer ear and translate them into information. This area is prone to infections, especially among children and thus may cause discomfort or pain. 

Symptoms of middle ear infections
Middle ear infections primarily tend to manifest themselves as inflammation of the tissues and buildup of fluids. Some of the symptoms are mentioned below.

1. Infections in children - middle ear infections primarily occur in children although it can occur in adults as well. Some of the common symptoms could be:
A. Ear pain either sitting or standing up and especially while lying down
B. Irritability and crying, which in infants could translate to more than usual crying 
C. Problems with sound and difficulties in hearing
D. Fluid buildup causing balance related problems
E. Discharge of fluid in certain cases
F. Unable to sleep and also loss of appetite
G. In some cases children may have high fever

Causes of middle ear infections 
The primary cause of middle ear infection is due to the presence of bacteria or virus in the area. The eustachian tube, which runs from the middle ear to the back of the throat, is connected to nasal passages as well. Any infection that affects the throat or the nose may also affect the middle ear through this tube. Primary causes for the infections could be
A. Cold or flu like symptoms, which then infect the middle ear as well
B. Otitis media, which is the buildup of fluid and inflammation either due to the presence of bacteria and viruses or even without it
C. Seasonal infections, which are common during late autumn or winters
D. Air pollution is also known to be a factor
E. Infection from others, especially in the case of children when they are part of a group care
F. Children from 6 months to 2 years are also susceptible to middle ear infections as their immune systems are much less developed.

Treatment of middle ear infections
Usually, middle ear infections resolve on their own within a day or so. You can try warm compress with a soft piece of cloth to ease the pain. However, if pain persists for too long then antibiotic medications may be required to fight the infection with pain relief medications to lessen the pain and discomfort.

All About Middle Ear Infections

Ear aches are a common complaint for many children. An ear infection can be explained as an inflammation of the middle ear. Unlike other aches, this one cannot be soothed by scratching or applying pressure and hence makes children cranky. Ear infections are usually triggered by bacteria or viruses. 
This causes inflammation that narrows the tube in the ear and allows fluid to build up. This fluid buildup is responsible for the pain.

However, not all ear infections need to be treated with medication. When it comes to treating ear aches in children, picking a natural remedy is a much better option ,since it has no side effects and can address the root cause of the infection. Here are a few natural remedies for earaches:

1. Compress: Hot and cold compresses are very effective ways of treating pain and can be used for earaches as well. Place an ice pack or a warm, moist compress over the ear to soothe the ache. Heat relaxes the muscles and stimulates blood flow while ice controls inflammation and swelling. Hot and cold compresses should not be applied for over 20 minutes at a time. 

2. Water: Some actions can help open up the eustachian tube to the middle ear. Swallowing is one such action. To encourage your child to swallow, offer him lots of fluids. 

3. Oil: Before using oil to treat an earache ensure that your child is not suffering from a ruptured eardrum and there is no fluid leaking from the ear. Pouring a few drops of warm olive oil or sesame oil can help soothe the pain by opening up the eustachian tube. It can also prevent the buildup of excessive ear wax and form a protective layer on the outer ear against bacteria and other infections. 

4. Elevate the head: Elevating a child's head can help improve sinus drainage. When it comes to children, instead of using a pillow below their head, place the pillow below the mattress to create a gradual slope. 

5. Onion: Onions can be used in many different ways to treat earaches. You could either juice an onion and put a few drops of the same in the ear or slice an onion in half and heat it before placing it over the ear like an ear muff. Onion contains anti inflammatory and antibacterial properties that help soothe earaches effectively and quickly. 

If the earache does not reduce or if there is a discharge from the ear, do not continue to self treat it and consult a doctor immediately.

Natural Remedies for Ear Infections in Children

Tinnitus is a disorder which is characterized by a constant perception of a ringing noise in the ears. This is not the condition in itself, rather it signals some other underlying condition such as an ear injury or age related hearing loss. It is not a serious condition, although the symptoms can worsen with age. If you are affected by this disorder, you might experience or  hear  a constant ringing sensation in the ears, even if there are no external sources of noise. These sounds could range from being a buzzing, ringing, to a hissing sound. This condition has mighty chances of interfering with your daily routine.

It is classified into two types:

Objective tinnitus: This disorder is caused by muscle contractions or a blood vessel problem.
Subjective tinnitus: The more commonly occurring type, it is caused by damage to the auditory nerves or regions of the brain that interpret sound.
The causes of this disorder are:

Exposure to loud noise: If you are exposed to loud noises such as the ones emanating from firearms or heavy machinery over a prolonged period, it can lead to tinnitus.
Aging: Aging can cause progressive loss of hearing, thus triggering tinnitus.
Blockage of the ear: There is earwax present in the ears, the function of which is to trap dirt and bacteria. Excessive earwax accumulation leads to loss of hearing, resulting in tinnitus.
Modifications of the ear bone: Any stiffening of the middle bone in the ear could impair your hearing and result in this condition.
Certain factors such as smoking, age, sex (men are prone to this disorder) and heart related disorders increase the risks of being affected by this condition.

Treatment
The treatment of this condition begins with the identification of the underlying condition, if any. The various treatment options are  

Removal of earwax: Excess earwax has gotten rid of which can relieve symptoms of tinnitus.
Suppression of noise: Certain machines, known as white noise machines, produce random sounds such as the sound of rain or the sounds of waves, thus eliminating the  hearing  of sounds which are common to this condition.
Medications: Certain medications such as alprazolam and nortriptyline can help reduce the severity of the symptoms.

Constant Ringing in Ears - Causes + Treatment

BAHA Implant
Bone Anchored Hearing Aid (BAHA) is a device surgically implanted to help people suffering from a loss of hearing. Most conventional hearing aids transmit sound through air conduction. The BAHA device is suitable for conductive or mild-moderate mixed hearing loss.

Problems with hearing in the middle or outer ears can be helped with the BAHA device. The sound waves received by the BAHA device bypass the middle ear and get delivered straight to the functioning cochlea in both ears.

A BAHA device comprises of two parts:
a) The processor 
b) A fixture which is surgically implanted behind the ear in the bone.

The implant is embedded in the bone. The processor, which remains outside, is attached to the implant. There is a microphone on the processor that picks up sounds. The sounds are passed on to the implant. The implant vibrates which triggers the Cochlear. You can consider wearing a BAHA implant if other conventional hearing aids do not work for you. BAHA implants are also given to people with collapsed or irritated ear canals.

Cochlear Implant Surgery

A complex, small electronic device that helps hearing in people with severe hearing loss or deafness is used in the Cochlear Implant Surgery. The cochlear implant comprises of an external piece behind the ear and another piece that is surgically implanted under the skin. A cochlear implant comprises of four parts:
1. A microphone which picks up sounds from the surroundings
2. A speech processor which chooses and arranges the sounds the microphone picks up
3. A receiver/stimulator and transmitter that picks up signals from the speech processor and changes them into electric impulses
4. An electrode ray, a bunch of electrodes, receives impulses the stimulator sends and transmits them to different areas of the auditory nerves.
The implant does not cure deafness; it only gives you a useful portrayal of sounds in the environment and considerable aid in understanding speech.

The surgery is done in the following way:
i. The area around the site of the implant is shaved or cleaned
ii. The patient's vital signs are monitored through cables, patches and monitors attached to him or her
iii. General anaesthesia is administered through IV or through a face mask
iv. After the device is implanted, the patient is taken to the recovery room for the anaesthesia effect to lessen.

BAHA Implant and Cochlear Implant Surgery

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