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Why do people get tinnitus?

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We usually think that the sounds our ears hear come from our surroundings, not from our ears themselves. But sometimes even in a completely quiet room, we can still hear sounds that seem to come from inside our heads.

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Sometimes the sound is like the sound of a radio, and sometimes it is a continuous, shrill sound. Someone once described it as, “It sounded like a group of soldiers pacing my head in formation.”

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It seems that someone has put a bell in our ears, a phenomenon we call tinnitus. Tinnitus usually occurs after a loud stimulus to the ear, such as someone high-fiving in your ear, or firecrackers being set off around you. Tinnitus can also occur after watching a rock concert or after wearing headphones with the volume turned up. This tinnitus often goes away only after a night of sleep. However, if one stays in a loud noise environment for a long time, one’s hearing can be severely damaged and one can even lose hearing.

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So where does the sound heard in a quiet environment come from? Inside our ears there is a passage to the brain called the ear canal. Along the ear canal and inward, you can see a membrane called the ear drum – which crosses the ear canal and divides the ear into two parts: the middle ear and the outer ear. Sound travels through the air into the ear canal, causing the eardrum to vibrate in response.

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Behind the ear drum, there is a small bony cavity in which three small movable bones called auditory tuberosities are distributed. These are called the hammer bone, the anvil bone, and the stapes bone, and they conduct vibrations from the ear drum to the inner ear.

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Further in, there is a fluid-filled tube, about 30 mm long, called the cochlea. The vibrations of the auditory bones cause the fluid in the cochlea to form waves. Like water plants, the ciliated cells in the fluid oscillate in response to the fluctuating fluid.

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These cilia cells are vital to human hearing. When the waves pass through the cilia, they cause the cilia to produce electrical impulses, which are transmitted along the auditory nerve to the brain, which then converts these electrical signals into sound, and we hear a wide variety of sounds from all over the world.

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Loud sound stimulation and heavy blows to the head can cause damage to cilia cells. After damage, the cilia may become tangled, loosen and fall out, or even lose the ability to conduct electrical impulses through the auditory nerve altogether.

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Sometimes, however, damage to ciliated cells manifests itself in another way: they continuously send electrical signals to the auditory nerve, even when they have lost sensitivity to sounds in the surroundings. These ciliated cells work permanently, and the brain thinks it processes the electrical signal as a sound signal whenever it receives it. This is the cause of tinnitus and the reason why we can hear sounds even in the quietest of rooms.

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Besides loud noises and head injuries, other causes can trigger tinnitus. Otosclerosis is a common otologic disorder in which patients usually have spongy bone growth, which causes the hearing bones to be less responsive to normal sounds, yet conduct a lot of tinnitus signals. Colds and flu can cause swelling of the inner ear, which increases blood pressure. High blood pressure causes blood vessels to constrict, and cholesterol in the blood can block the flow of blood, leaving cilia cells with an inadequate supply of nutrients. This can also lead to tinnitus.

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Sometimes, tinnitus symptoms can also occur within a day or two after taking aspirin. Stimulants like caffeine and cocaine can also cause cilia to signal out of nothing. In addition, if tonic supplements are taken for a long time, the quinine in them can slowly build up in the body and this can also trigger tinnitus.

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There are various causes of tinnitus and tinnitus is common, with at least 50% of the population hearing strange tinnitus sounds on a regular basis. To protect our ears, in addition to staying away from noise sources, we should also try to avoid the above factors that may trigger tinnitus.

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