Which leads to the fact that the ears are constantly popping

Tinnitus and sudden hearing loss

Ringing in the ears is very common. According to the German Tinnitus League, every fourth person has had tinnitus at some point, although fortunately mostly only temporarily. Tinnitus is the name given to sudden noises in the ears that are caused in the patient himself. They can be whistling, humming, humming or similar, persistent or only occasionally occurring. They usually appear suddenly and can have a variety of causes. Noises in the ear themselves are harmless, but they are often very stressful for those affected. Tinnitus is not an emergency, but should be clarified with an ENT doctor within the first few days after it occurs.


Objective tinnitus

One speaks of objective tinnitus if it can be perceived not only by the person affected, but also by others. This comes about e.g. through flow noises of the blood when the blood vessels constrict. Damei it comes to a pulse-synchronous ear noise.

Clicking noises in the ears caused by involuntary muscle twitching in the middle ear or palate can also occur.

An open tube, i.e. a too wide or permanent opening of the connecting passage between the middle ear and the nasopharynx can also lead to noises in the ears

Further possible causes for an objective tinnitus can be heart valve diseases, anemia or in rare cases also vasodilatation or vascular tumors (glomus tumor) in the area of ​​the vessels supplying the brain.

Subjective tinnitus

Much more common than objective tinnitus is subjective tinnitus; it cannot be heard by other people, but can only be perceived by the person affected. The exact origin of subjective tinnitus has not yet been conclusively clarified. However, it is known that the noises in the ears are caused by incorrect information formation or processing in the hearing system.

So far known causes are:

  • Hearing loss: Often times, tinnitus and hearing loss go hand in hand. It is assumed that the brain tries to compensate for missing or weakly perceived signals from a certain frequency range due to the hearing impairment. To do this, it regulates the activity upwards in the corresponding frequencies, so that tinnitus develops.
  • Ear wax or foreign bodies in the ear:If the ear canal is obstructed by a wax plug or a foreign body, this can also result in ringing in the ears.
  • Noise and bang trauma: In the case of a pop trauma, there is a brief increase in pressure in the ear, which in extreme cases can even cause the eardrum to burst. The trigger can be, for example, a shot, a bursting tire, a firecracker, a triggered airbag or another suddenly occurring very loud noise. But even after a loud concert, hearing loss and tinnitus can occur due to insufficient supply and the associated damage to the sensory cells.
  • Sudden hearing loss: A sudden hearing loss occurs suddenly and manifests itself in an acute unilateral hearing loss with very often accompanying noise in the ear. The cause is suspected to be a circulatory disorder in the smallest vessels in the ear, which leads to a heart attack in the inner ear.
  • Acoustic neuroma: In rare cases, a benign tumor in the area of ​​the auditory or equilibrium nerve can also occur. Other possible signs may include dizziness and decreased hearing.
  • Inner and middle ear infections: Inflammation caused by bacteria or viruses can lead to the formation of so-called ototoxic substances (substances that damage the inner ear), which can lead to tinnitus and hearing damage.
  • Otosclerosis: This leads to ossification at the transition between the stapes and the inner ear. It can also provoke subjective tinnitus.
  • Eardrum perforation: Such injuries can occur, for example, through infections of the middle ear, through a blow to it, through sound waves or through manipulations in the ear, e.g. with cotton swabs. This also usually leads to hearing loss and sometimes also to a ringing in the ear.
  • Tube dysfunction: This leads to a disruption of the pressure equalization between the middle ear and the nasopharynx. This causes a feeling of pressure and a cracking sound in the ear when you swallow.
  • Meniere's disease: This disease of the inner ear is typically accompanied by acute vertigo attacks, ear pressure with acute hearing loss in the low frequency range and unilateral tinnitus.
  • Hardening of the arteries(Atherosclerosis): If there are calcium deposits, so-called plaques, in the blood vessels that supply the head, flow noises can occur due to the narrowing of the vessels. Risk factors for arteriosclerosis, which therefore also favor tinnitus, are high cholesterol levels, blood pressure and diabetes.
  • Cardiovascular diseases: In some cases, the tinnitus can be traced back to cardiovascular diseases such as low blood pressure or high blood pressure or cardiac arrhythmias.
  • Disorders in the hormonal balance: Hormonal changes (such as those caused by menopause) are also a possible cause of tinnitus.
  • Central nervous system disorders: In rare cases, multiple sclerosis, brain tumors and meningitis can also be accompanied by ringing in the ears.
  • Jaw problems and cervical spine complaints: Slipped discs or tension in the cervical spine, as well as tension in the jaw muscles caused by crunching or pressing at night (craniomandibular dysfunction, CMD) can trigger tinnitus.
  • Medication: Some medications such as certain antibiotics (e.g. genamycin), water tablets (diuretics), chemotherapy drugs, some psychotropic drugs and, for higher doses of the pain reliever acetylsalicylic acid (ASA), can also affect the inner ear and promote tinnitus.
  • Psychological stress: Very often tinnitus occurs in psychologically stressful situations.

Tinnitus: Investigations

First of all, in a conversation with the patient, the patient's exact symptoms, e.g. How long has the tinnitus existed? Was it sudden or creeping? Were there any possible triggers such as noise or stress? Can you describe the noises in your ears in more detail? Is the tone / noise in the ear steady or pulsating? Does it change during the day or depending on the position of the head? How badly does tinnitus bother you? Do you have any previous illnesses (diabetes, heart disease, high blood pressure, etc.)?

Various examinations can then follow:

  • Ear microscopy: The outer ear and eardrum can be examined using an ear microscope. It can be determined whether a wax plug is the cause of the disturbing noise or whether the eardrum is injured.
  • Hearing test: The hearing performance of the inner ear is examined as part of a so-called audiometry.
  • Tympanogram: This allows the mobility of the eardrums to be determined.
  • Reflection of the nasopharynx (Nasopharyngoscopy): The examination shows whether the area around the ear has been abnormally changed.
  • Brain stem audiometry (BERA): This is a special hearing test that checks the function of the auditory nerve.
  • Tinnitus matching: The volume and frequency of the tinnitus sound is determined.
  • Further tinnitus examinations: In addition to disorders of the hearing system, other physical problems can also trigger tinnitus (such as hardening of the arteries, high blood pressure, misaligned teeth or jaws, problems with the cervical spine, etc.). Depending on the suspicion, you will be referred to other specialists for further clarification.


Tinnitus: effects

For some people, tinnitus remains a lifelong companion. The level of suffering is very different - while some have little or no impairment of the whistling or humming in the ear (compensated tinnitus), in others it causes great stress and significantly reduces the quality of life. In extreme cases, those affected develop anxiety or depression with partial social isolation and disability.

Tinnitus: treatment

Since the causes of tinnitus are very diverse and very often no clear trigger can be identified, the treatment of tinnitus is often very difficult.

Acute tinnitus: treatment

This form of tinnitus has been around for a long time a maximum of three months. If the symptoms do not improve on their own within the first few days, drug therapy in the form of tablets or infusions should be started.

In addition, complementary therapies such as physical-medical or physiotherapy treatments for complaints in the cervical spine, treatment with a distraction splint for jaw tension or various relaxation techniques can represent a useful addition.

Chronic tinnitus: treatment

Keeps the ringing in the ears longer than three months one speaks of chronic tinnitus.

In this case, drug treatment approaches are often no longer promising. However, this does not mean that every patient with chronic tinnitus has to live with it forever.

In the treatment of chronic tinnitus, good results can be achieved, for example, with cognitive behavioral therapy, in which one learns to ignore the impairing tinnitus. Various forms of relaxation techniques such as autogenic training, muscle relaxation according to Jakobson and others also bring relief.

Another therapy option are so-called tinnitus masks. These are so-called noise generators. These create a uniform noise from different pitches. The tinnitus is masked by this permanent low noise. Similar to a hearing aid, the masker is worn in the ear canal or behind the ear. If the patient also has a hearing loss, the masker can be integrated into a hearing aid.


Tinnitus: What You Can Do By Yourself

Unlike the eyes, a person cannot close his ears. The sensory organ, the ear, is therefore always active, including during sleep. Nevertheless, everyone can develop strategies to cope better with the noises in their ears.

  • Avoid silence: The brain has the ability to learn sounds and classify them as important or unimportant. The more the patient listens to the noise in his ear, the more present it is represented in the brain. It is therefore important to hide the noise in the ear, for example when falling asleep, with soft music, the splashing of a fountain or nature noises.
  • Stay calm: If a noise in the ear is perceived as threatening by the person concerned, his consciousness will not block out the noise in the ear. If, on the other hand, the patient succeeds in developing a relaxed attitude towards tinnitus, he can push it out of consciousness.
  • Reduce stress: Anything that relaxes is also helpful. Because people are particularly overly sensitive to stress - including to noises. However, reducing stress does not mean that you should stop all your activities, because it is precisely this that means that your brain has more time to concentrate on the sound and perceive it as dangerous and therefore unopposed. Rather, stress reduction means learning relaxation methods such as autogenic training, muscle relaxation according to Jacobsen and yoga, in order to be able to apply them in stressful everyday situations that will occur again and again.


Sudden hearing loss

A sudden hearing loss is a hearing loss that occurs suddenly, usually on one side, and is sometimes associated with ringing in the ears, pressure in the ears and sometimes dizziness. The exact causes of a sudden hearing loss are unknown. Infections or circulatory disorders, but also stress or other previous illnesses, are suspected to be triggers.

Very often, however, diseases of the ear or simply an obstruction of the auditory canal with ear wax are the triggers of an acute unilateral hearing impairment. It is therefore important to carry out a thorough ENT medical examination and, depending on the findings, a diagnosis with various hearing tests, which can clearly make or rule out the diagnosis of sudden hearing loss.

If the diagnosis of sudden hearing loss is confirmed, we will discuss the existing therapy options with you and decide together which is the best therapy for you.