Tinnitus refers to unpleasant auditory sensations that occur in the absence of an external sound source.


  •                Tinnitus in diseases of the middle ear, cochlea and cochlear part of the vestibulo-cochlear nerve is usually described as ringing, roaring, buzzing, or as the “sound of the sea surf”. The nature of the noise does not indicate the location of the lesion.    
  •                Possible causes of tinnitus may be acoustic trauma presbyacusia Meniere’s syndrome , tympanosclerosis, schwannoma of the vestibulo-cochlear nerve . All these disorders are usually accompanied by hearing loss. With the appearance of noise in the ear, first of all, the schwanny vestibular cochlear nerve is excluded . In more than half of patients with tinnitus, hearing is not reduced, and it is rarely possible to establish the cause of noise in this case.    
  •                Medicines n For example, salicylates, quinidine , aminophylline, indomethacin and caffeine can cause tinnitus, not accompanied by hearing loss. With such complaints, these funds are canceled whenever possible.   
  •                A pulsating tinnitus, synchronized with a pulse, is often associated with turbulent blood flow. Patients may hear noise arising in a stenotic or convoluted carotid or vertebral artery. Vascular malformations and vascular tumors (e.g., jugular glomerular paraganglioma can also cause pulsating noise Correction of vascular abnormality usually eliminates such noise     


Tinnitus is extremely unpleasant and sometimes makes life unbearable. The noise is usually more pronounced at night and often causes insomnia.
With ongoing noise, chronic anxiety and depression often develop.
Treating emotional disorders can improve your condition.
1. Medicines for chronic tinnitus are usually ineffective. There is no specific treatment. Sometimes temporary improvement is achieved by iv administration of lidocaine , however it is not suitable for long-term therapy. It is necessary first of all to cure the primary disease that caused tinnitus. 2. Offer noise masking by external sounds. Unfortunately, such techniques do not always help.


Fainting is a sudden short-term loss of consciousness, accompanied by a weakening of the heart and breathing and resulting from the rapidly developing anemia of the brain, a decrease in cerebral cortex . The cause of acute onset of anemia of the brain is usually a temporary violation of the tone (natural tension) of the blood vessels, especially those innervated by the celiac nerve, which leads to the accumulation of large masses of blood in the organs of the abdominal cavity, to its outflow from the brain, skin, muscles, and a drop in blood pressure. 

A decrease in the tone of blood vessels can occur with a strong nervous shock, fear, a quick transition of a weak patient from a lying position to a sitting or standing position, with prolonged stay in a stuffy room, with overwork, starvation. 

Many patients describe the feeling of impending loss of consciousness as dizziness, others as a feeling of emptiness in the head, light intoxication, lightheadedness. The same sensations occur with vestibular dizziness. Pre-syncope can be accompanied by other symptoms characteristic of vestibular dizziness: nausea, pallor, sweating, a sense of fear, a veil before the eyes. Therefore, complaints of dizziness are sometimes difficult to interpret. In such cases, provocative tests are especially useful. Although falls may occur with vestibular dizziness due to a sudden loss of balance, a transient loss of consciousness is not characteristic of this condition.

A. Reflex fainting occurs as a result of reflex autonomic reactions that cause mainly vasodilation. As a result, there is a decrease in OPSS, insufficient filling of the right parts of the heart and a drop in cardiac output. An attack usually occurs in a standing position, less often in a sitting position. Loss of consciousness is often preceded by nausea, pallor, sweating, sensation of lightheadedness, or dizziness.  

  •                Vasovagal syncope is usually triggered by fear, stress, or pain. This is the most common type of fainting in healthy young people.  
  •                Situational syncope ( vasovagal or visceral reflex syncope) a. Fainting during urination and bowel movements. b. Fainting on coughing. in. Swooning when swallowing. of arterial hypotension after meals (one of the common causes of syncope in older people who have impaired baroreflex is not able to compensate for increase in splanchnic blood flow after a meal). 
  •                Carotid sinus syndrome. Dizziness and fainting in this condition may be due to bradycardia , vasodilation, or a combination thereof.  
  •                Orthostatic hypotension is caused by a lack of reflex sympathetic mechanisms that ensure the maintenance of blood pressure when moving to a standing position. 1. Primary autonomic failure is observed in Shay-Draeger syndrome and idiopathic orthostatic hypotension. 2. Secondary orthostatic hypotension develops as a result of: – Vegetative polyneuropathies (with diabetes mellitus, alcoholism, amyloidosis). – Drug treatment (antihypertensives and vasodilators, nitrates, tranquilizers, antidepressants, phenothiazines , etc.). – Hypovolemia (with blood loss, vomiting, increased diuresis, dehydration). – Prolonged bed rest that detoxifies the cardiovascular system. 

B. Cardiogenic syncope due to a decrease in ejection of the left ventricle. With cardiogenic fainting, in contrast to reflex, loss of consciousness often occurs suddenly, without previous symptoms.   

  •                Obstructive cardiogenic syncope is caused by narrowing of the outflow tract of the left ventricle (with aortic stenosis, hypertrophic cardiomyopathy , pulmonary hypertension, cardiac tamponade, atrial myxoma , etc.). 
  •                Arrhythmic cardiogenic syncope occurs with ventricular tachycardia, AV blockade, sinus node weakness syndrome, QT interval lengthening syndrome, etc.  
  •                Since cardiogenic syncope is life threatening, repeated syncope of unclear origin must first exclude heart disease. In most cases, this can be done on the basis of an anamnesis, examination and conventional instrumental methods of research. However, sometimes to determine the cause of syncope, an electrophysiological examination, tests on an orthostatic table, Holter ECG monitoring may be required .

B. For stenotic lesions of the cerebral arteries, fainting conditions are not characteristic, and therefore it is a mistake to explain these conditions with transient brain ischemia. However, occasionally fainting can occur with common stenosis or occlusion of extracranial arteries. This happens with the following diseases:   

  •                Atherosclerotic bilateral occlusion of several extracranial arteries: in this case, primary orthostatic cerebral ischemia (isolated cerebral orthostatic hypotension) is possible.  
  •                Aortoarteritis Takayasu’s disease ). 
  •                Subclavian theft syndrome.

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