耳鸣

title: 耳鸣的分类.
content: 目前常将耳鸣分类为他觉性耳鸣及自觉性耳鸣两类:
title: 耳鸣机制及成因.
content: 耳鸣的神经机制尚不完全清楚,一般认为与听觉通道某一部分的异常变化有关。目前医生和生理学家正在耳蜗、听觉脑干、听觉皮层等不同部位寻找可能引起耳鸣的神经变化。医学界在70年代时已实证,真正严重导致听力丧失相关的耳鸣并不产生于耳蜗或听觉神经,因为在很多此类病人施行听觉神经切断手术,并不能缓和耳鸣,反而可能加重病情,所以也有耳鸣其实是「脑鸣」来自脑内讯号的说法,有些较老观念的医生会告知高频耳鸣是来自内耳、响久了听神经就坏死等等说法其实不尽正确,是一些非常古老似是而非的医学概念,在一些非正规医生圈流传,制造病人不必要恐慌和贩售高价无用的疗法,急性耳鸣多数六个月内痊愈,只有极少数演变成慢性。  耳鸣几乎是下列所有疾病都能发生的症状: 耳鸣成因分成耳鸣与脑鸣两类,脑部受损称为脑鸣、耳神经及听觉异常称为耳鸣。耳鸣感觉则分成单耳耳鸣与双耳脑鸣两类。耳鸣与耳中风成因完全无相关,常有患者混为一谈,然而中风是血管性病因,耳鸣是一种讯号,两者无关。  耳鸣可以是间断性,持续性或搏动性(与心跳同步)。性质可能是嗡嗡声、铃声、轰鸣声、哨声、嘶嘶声或500HZ~12000Hz鸣响(甚至更高)包括更复杂/复合的声音(例如:2000HZ 与 8000 HZ 同时鸣响),而这些声音始终在变,睡梦时可暂时获得舒缓,但是周而复始的吵杂声 (就像天天牙痛一样)压力可想而知。  一种阴谋论观点认为耳鸣是由于大脑被声波及电磁波辐射所导致的亦有可能是被暗中植入脑内的纳米射频识别芯片所发出的微波信号,是被脑控的典型症状。声音是由振动所产生,而振动不是无缘无故的——微波听觉效应。  耳鸣可能是一种频率,而与频率相关的是声波或电磁波。
title: 诊断.
content: 耳鸣诊断以病人主诉为主,病史询问应包括耳鸣性质:持续性或间接性?频率为高频或低频?有无脉动性?音量大小?耳鸣加剧及缓解因素等  耳鸣患者的诊断需要最低限度的全面的听力学评估以排除听力受损,若有需要则安排颞骨CT和头部MRI检查。查明感音神经性聋需用前述鉴别感音性和神经性聋的试验进行检查。搏动性耳鸣
title: 中医.
content: 中医学认为,耳鸣是肾虚导致,因「肾开窍于耳」,但中医的肾概念与西医的肾脏不同,两者无关,耳鸣也不会有肾亏,这些都是半知半解的误传。

Summary: 耳鸣(Tinnitus)是指外在环境没发出声音却听见声音的一种状况,常被形容成一种铃响声、轻敲声、轻嘶声或低吼声,偶见模糊的人声或音乐声;耳鸣所听见的声响可能轻柔,也可能震耳欲聋,音调或高或低,只有一耳听到或两耳皆有可能。 随时间过去,耳鸣常常会越来越严重,有些耳鸣者会因此情绪低落、焦虑或难以集中精神。 耳鸣并不是一种疾病,而是一种有许多原因的症状;最常见的原因是因噪音型听力损失,其他原因则有耳部感染、心血管疾病、美尼尔氏综合症(俗称耳水不平衡)、脑部肿瘤、心理压力、接触特定药物所致、头部曾有外伤、耳垢;尤其常见于忧郁症患者。 耳鸣的诊断通常是借由耳鸣者的描述,目前已有许多问卷评估耳鸣对于生活品质的影响。诊断通常借由听力图及神经学检查进行。若已找出某些特定病征,则可考虑进行医学照影,例如MRI。若听见与自己心跳同律的重复节奏的耳鸣者也需接受进一步的测试。偶见某些案例旁人可透过听诊器听到耳鸣声。内耳等耳内构造造成的自发性耳声传射有时也会造成耳鸣。 预防耳鸣的方法为避免置身噪音环境。在已知潜在原因的情况下,接受治疗可能有助改善症状; 一般的处置方式则是接受心理治疗,使用耳鸣罩或助听器则帮助有限。截至2013年为止,耳鸣尚无有效的根治方法。约 10-15%的人患有耳鸣,大部分耳鸣者的状况尚堪忍受,仅有1-2%的耳鸣者情况会严重恶化。耳鸣的英文「tinnitus」是来自拉丁语「tinnīre」,意指「摇铃作响」。

Tinnitus: Tinnitus is the perception of sound when no corresponding external sound is present. While often described as a ringing, it may also sound like a clicking, buzzing, hiss, or roaring. Rarely, unclear voices or music are heard. The sound may be soft or loud, low or high pitched, and appear to be coming from one or both ears. Most of the time, it comes on gradually. In some people, the sound may interfere with concentration or cause anxiety or depression. Tinnitus may be associated with some degree of hearing loss. Rather than a disease, tinnitus is a symptom that may result from various underlying causes. A common cause is noise-induced hearing loss. Other causes include ear infections, disease of the heart or blood vessels, Ménière's disease, brain tumors, exposure to certain medications, a previous head injury, earwax, and emotional stress. It is more common in those with depression. The diagnosis of tinnitus is usually based on the person's description. It is commonly supported by an audiogram and a neurological examination. The degree of interference with a person's life may be quantified with questionnaires. If certain problems are found, medical imaging, such as magnetic resonance imaging (MRI), may be performed. Other tests are suitable when tinnitus occurs with the same rhythm as the heartbeat. Rarely, the sound may be heard by someone else using a stethoscope, in which case it is known as objective tinnitus. Occasionally, spontaneous otoacoustic emissions, sounds produced normally by the inner ear, may result in tinnitus. Prevention involves avoiding loud noise. If there is an underlying cause, treating it may lead to improvements. Otherwise, typically, management involves talk therapy. Sound generators or hearing aids may help some. As of 2013, there were no effective medications. It is common, affecting about 10–15% of people. Most, however, tolerate it well, and it is a significant problem in only 1–2% of people. The word tinnitus comes from the Latin "tinnīre" which means "to ring".