To be alone is to hear the silence – S. Tesson
Perhaps also this infernal parasitic noise which appears in the silence and which one names tinnitus.
What is tinnitus ?
Noises. Not my voice, nor my laughter, but unbearable sounds, parasites, buzzes, squeaks, noises of waterfalls, rockslides, engines – Extract of Acouphènes, G. Maillet
Céline, who was also a doctor, wrote it differently in Voyage au bout de la nuit :
Like steam whistles in each ear… He would deal with it all day and night… He had all the noises in him… Whistles, drums, purrs…
There are so many ways to describe them! Whistling, hissing, locomotive, it beats, it sounds, it taps, I have a heart in my ear…
Still called tinnitus, a term that all French people know so widespread is the condition. These, declined in all the languages of the world, known under the term of tinnitus, in 17 countries of different languages with Esperanto, shows to what point the tinnitus, which extends in oil spot in the whole world, constitutes perhaps one of the evils of the century, poses the problem of its treatment and (corollary) of its cause, far from being obvious if one excepts the consecutive tinnitus with a sound exposure. The aggressive and noisy environment in which we live is certainly not foreign to its genesis.
They pollute our lives, can make us aggressive, angry, in a bad mood or even unhappy. Sometimes they are well-constructed sentences that make the person concerned say : “I hear voices in my head…”. Our most famous Frenchwoman, our national star in the fifteenth century had known how to take advantage of it for the greater glory of France. This allowed her to drive the English out of France! Were they celestial voices that our maiden heard in Domremy while shepherding her sheep ? Were they tinnitus ? Who can say ? But if it was tinnitus, what a wonderful way to take charge of this handicap which, as we know, existed at that time (Martin Luther is said to have been affected). Beethoven suffered from a progressive deafness that would eventually make him totally deaf, with very incapacitating tinnitus, the latest hypotheses of which tend to support the idea that it was chronic lead poisoning, perhaps related to the excessive consumption of bad adulterated wines. But could this hypothesis be compatible with an onset of symptoms around the age of 24 ? In any case, although he was afflicted with such an unjust disease that made the end of his life difficult, it did not prevent him from writing magnificent symphonies.
What are the causes of tinnitus ?
They are numerous. Here again, we will put aside a cranial trauma which can cause tinnitus and whose cause seems obvious, as well as objective tinnitus, perceived by those around us and sometimes pulsatile, which can indicate a vascular anomaly or a neighbourhood arterial stenosis.
• Sources of noise, which are increasingly invading our world, are one of the major sources. Short and violent aggression or chronic aggression, often professional ;
• Certain ear diseases such as Menière’s disease (attacks of vertigo accompanied by progressive loss of hearing), otosclerosis (family disease that causes progressive ankylosis of an ossicle and is accompanied by progressive deafness) can cause it ;
• Arterial hypertension which can also cause pulsating tinnitus, but only perceived by the patient ;
• Numerous medications can be involved and one of the first precautions before adding a medication to try to stop them, is to look for an iatrogenic cause (medication in this case) in order to, if necessary, stop the triggering intake ;
• Neighborhood tensions and notably temporomandibular joint disorders sometimes exist. A visit to the speech therapist can make them disappear ;
• Earwax of course can give tinnitus !
• Any metabolic disease (hypercholesterolemia, diabetes), smoking which is the first cause of arteritis (blocked arteries) can trigger them. The decrease in the diameter of the arteries gives a pulsating noise which can propagate to the ear
But in many cases, no cause is found and the treatment is disappointing.
Before any attempt of treatment, we understand how they are born.
Many hypotheses are evoked. Schematically :
• Excessive release of a neurotransmitter at the level of the auditory hair cells in the event of sound aggression, damaging the tissue in which it bathes. This hypothesis leads to test new drugs ;
• Natural protection of the ear during a sound aggression and constitution of a “sound” of the same intensity as that which was aggressive in order to carry out a protective ghost curve ;
• Many unknowns remain in fact in the exact explanation of these sometimes unbearable noises, making, of this fact, the treatment often disappointing.
For the treatment, we can mention :
• Conventional drugs, especially corticosteroids, to try to revive damaged cells. This is aimed at recent tinnitus ;
• Sophrology, hypnosis, equipment with “masking” of tinnitus based on the principle of stimulating the ear for several weeks with white noise (mixture of continuous sounds at different frequencies) ;
• New therapeutics are emerging and this list is far from being exhaustive, the years bringing their share of new treatments giving hope in a more or less near future of convincing results.
One can therefore live – and even be happy – with one’s tinnitus as long as one manages to ignore these nuisances. And one can accomplish great tasks with one’s tinnitus while waiting for the treatment that will put everyone in agreement !
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