SONITUS — feeling of noise or a ring which source is perceived sick in the ear.
Distinguish physiological and pathological Sh. in at.
The physiological sonitus arises in the absence of pathology of an ear if the person is in conditions of complete silence. The spontaneous acoustical feelings arising at the same time can have character of sounds of various frequency and intensity. This phenomenon, apparently, is connected with perception of a blood-groove in vessels and capillaries of a snail (see. Inner ear), perception of the movement hmolekul in liquids of a snail, and also the biochemical processes happening at the level of voloskovy cells of box-tiyeva of body (see) or neurons of an acoustical nerve (see. Before a door and cochlear nerve).
The diagnosis of a physiological sonitus is established on the basis of complaints and results of inspection of the patient, lack at it of the data confirming existence of pathology of an ear (see).
II and t about l about and h e with to and y divide a sonitus on objective and subjective.
Objective patol. the sonitus differs from subjective in the fact that it is heard not only by the patient, but also the doctor by means of objective methods of a research, napr can hear, listenings by a phonendoscope (see Auscultation). The objective sonitus can depend on myoclonic twitchings of the muscles covering a drum cavity, muscles of an Eustachian tube and a soft palate, changes of a blood-groove in vessels (e.g., at aneurism or a stenosis of a carotid artery, vegetonevrotichesky and sclerous changes in a basilar artery, etc.), pathologies of a temporal and mandibular joint, changes of pressure in a drum cavity, napr, at a catarral ev-stakhiit (see the Tubo-otitis) and change of atmospheric pressure. The objective sonitus meets seldom and is not followed by decrease in hearing.
The SONITUS 497
Diagnosis is based on data a wedge, inspections of the patient (see) and listening of noise at auscultation. The nature of noise can be various depending on the reason: vascular noise (see) usually have uncertain character, at pathology in a temporal and mandibular joint rough noise is heard during the movement of a mandible. Treatment and the forecast depend on character of a basic disease.
Subjective patol. the sonitus differs from objective in the fact that it is heard only by the patient. Noise can arise owing to patol. changes on average to fish soup (see Otitis, the Otosclerosis, the Tympanosclerosis) or in an inner ear (see the Labyrinthitis; Menyera disease; Before - a door and cochlear nerve, pathology), intoxications nek-ry pharmaceuticals (the antibiotics having ototoksichesky properties, quinine, salicylates) and the toxic connections containing arsenic, mercury. The sonitus can appear during a disease of flu, pneumonia, diphtheria, epidemic parotitis, malaria both others acute and chronic inf. diseases. According to many researchers, the sonitus which arose owing to the listed reasons is explained by the fact that in a labyrinth there are physical. - the chemical changes which are followed by increase in it in pressure and disturbance of electrolytic balance. These changes can be observed also in the most nervous tissue of the acoustic analyzer (see), leading to development in it of hypostasis, hemorrhages and the phenomena of destruction. Treat other reasons of emergence of a subjective sonitus (so-called reflex noise) existence of a foreign body in outside acoustical pass, patol. changes in a nasopharynx, throat, teeth.
Subjective patol. the sonitus can be constant or temporary, intensive or weak, unilateral or bilateral. According to the characteristic, to-ruyu patients give it, noise can remind chirring of a grasshopper, murmur of a stream, noise of the engine, the boiling samovar, a sea surf, etc.
At diagnosis patol. a subjective sonitus essential value has careful inquiry of the patient about the nature of noise, it. tonalities, intensity, reasons of emergence. The research by means of tuning forks or the audiometer can give an idea of a tonality of a sonitus (see Audiometriya). To the patient suggest to listen to various tuning forks or sounds of various height via air phone of the audiometer: the sound, height to-rogo matches height patol. noise, masks this noise, and the patient ceases to feel it.
Treatment patol. a subjective sonitus of reflex character it is directed to elimination patol. changes in other bodies, on normalization of activity of a nervous system, dream, on elimination of disbolism. According to indications appoint barbiturates, bromides, Tinctura Valerianae. Improvement of working conditions and life, a balanced diet, failure of the patient from smoking, the uses of alcoholic drinks are of great importance. If communication of noise with increase in intra labyrinth pressure is supposed, appoint the treatment directed to its normalization (diuretic and purgatives, intravenous administration of hypertensive solutions, etc.). At the same time the patient shall keep to a diet with restriction of salt and liquid. At the sonitus connected with disturbance of a tone of vessels appoint nicotinic to - that (at a vasospasm) or intravenous injections of Riboflavinum, B12 vitamin. In some cases the positive therapeutic effect occurs thanks to reflex impact on a nervous system of intranasal, extra ear or endaural novocainic blockade (see). With success apply also various methods of reflexotherapy (see) and electroacupuncture (see Acupuncture). Topical treatment is directed to elimination available patol. changes in an outside and middle ear for recovery of the mechanism of sound carrying out, elimination of inflammatory process, improvement of passability of an Eustachian tube.
At sharply expressed patol. a subjective sonitus sometimes resort to operational treatment, character to-rogo depends on features of the changes which caused patol. noise. For interruption patol. the nervous impulses going to the central departments of the acoustic analyzer make section or a resection of a drum string, circular, or economical (only in the field of the upper edge of a window of a snail), a resection of a drum texture, removal of a star-shaped node (see the Gangliectomy), an upper stashat-ektomiya with removal of the branches surrounding a carotid artery (see Denudation, With imp atekty iya).
The forecast depends on character patol. the processes which caused emergence patol. subjective sonitus. The reflex sonitus, and also the sonitus caused by an otosclerosis (see), adhesive average otitis (see the Tympanosclerosis), as a rule, decreases at timely treatment. In some cases the feeling of a sonitus does not manage to be eliminated.
Bibliography: It is white oho N. V lov.
Ear noise and bases of their therapy, in book: Disorders of hearing and the speech, under the editorship of I. A. Lopotko, page 90, L., 1947; Conducted also the Central Committee of N y A. P. Ear noise, L., 1978;
P about to r y in and l about in and K. P. K to a question of the mechanism and reversibility of subjective ear noise, the Works State. nauch. - issled. in-that Bol. fish soup, throat and nose, century 9, page 251, M., 1959; Soldatov I. B., M and republics and N and A. Ya. and X p and p p about N. S. Sonitus as symptom of pathology of hearing, M., 1984; T e m to both Ya. S. Glukhot's N and relative deafness, page 125, M., 1957; Relative deafness, under the editorship of N. A. Preobrazhensky, M., 1978; Hicguet G. et Van Eye M., Les bruits d'oreille spontanes, Acta oto-rhino-laryng. belg., t. 7, p. 439, 1953;
Lempert J. Tympanosympathectomy, surgical technique for the relief of tinnitus aurium, Arch. Otolaryng., v. 43, p. 199, 1946; O p i t z H. J. Tinnitus-Entstehung und Beeinflussung, Laryng., Rhynol., Otol., Bd 59, S. 485, 522, 1980; Scott — Brown's diseases of the ear, nose and throat, ed. by J. Ballantyne a. J. Groves, v. 2, p. 81, L. a. o., 1979.
H. A. Preobrazhensky.