Tinnitus is categorized as a symptom, similar to headache, pain, and fever. It is not a medical disorder itself. Patients frequently differ in their descriptions of the sounds they hear. At some point in their life, 96% of people experience tinnitus, although only 20% of those cases progress to chronic tinnitus, according to the British National Center for Diseases. Hearing loss, auditory function problems, and heightened sensitivity to sounds are some conditions that are frequently linked to tinnitus [1, 2, 3].
Neither a clear description nor a reliable method of measurement exists for tinnitus. Instead, patients typically limit their descriptions of the wide range of audible sounds to ringing, noises, buzzing, crickets, steam escaping, humming, or hissing. [4] Therefore, tinnitus can be defined as an auditory perception of a phantom stimulus by the patient. The source of the sounds that cause tinnitus to occur is what practically separates subjective tinnitus from objective tinnitus. Objective tinnitus has a real effect and can occasionally be heard by the examining physician, and the source of the sound may be due to blood circulation in the nearby major vessels, the spasm of the middle ear muscles, or even teeth grinding. However, this kind of tinnitus is typically curable. The subject is not addressed by this research. [1, 3]
Contrarily, subjective tinnitus, one of the clinical symptoms in more than 75% of ear-related illnesses, is only perceptible by the patient in the absence of any external sound effect. Regardless of the reason, patients who complain of hearing loss frequently develop Tinnitus. The study emphasized this category. [1, 5]
The groups most at risk of developing personal tinnitus problems [5] are those who are exposed to loud noises, particularly at a younger age, or violent explosions that inflict vocal injuries.[6, 7] In addition, there is a convenient relationship between presbycusis and the development of tinnitus, as the prevalence of tinnitus among people with presbycusis reaches 35%. [5] [8, 9, 10] NSAIDs consumption is marked as a reversible risk factor for auditory toxicity, unlike aminoglycosides which cause an irreversible auditory injury due to their aggressive effect on hair cells and supporting tissue. [11, 12, 13] Meniere's disease pathogenetic mechanisms were associated with tinnitus. the occurrence of edema within the endolymph, which leads to a disturbance in the auditory response to sounds, whether due to the difficulty of passing the transient wave through the ascites lymph, or due to an imbalance of the electrolyte around the hair cells. [14, 15]
The prevalence of tinnitus in society ranges from 15 to 30%, and 2% have severe symptoms that may lead them to suicide. [1, 16] Many researchers have tried to reach a link between tinnitus and various factors in groups most susceptible to it. Smoking, caffeine consumption, or alcohol did not appear to be directly related to the development of tinnitus [4], unlike pregnancy, which significantly increased the risk of developing tinnitus. A direct link has also been established between the severity of tinnitus and depression, stress disorder, and post-traumatic stress disorder. [4]
The current knowledge regarding the mechanism of tinnitus formation and development is simple and based on theoretical hypotheses supported by some simple clinical research. However, it has become evident that the auditory nerve pathway plays a very important role in the development of tinnitus, unlike what was common in the past when it was considered a problem in the peripheral auditory system only. [5, 17, 18]
Due to the difficulty of assessing tinnitus with precise direct examinations, a number of questionnaires and scales have been designed to approach tinnitus in patients [3, 19]. However, many of these methods and measures remain experimental. The treating physician will remain the last say based on the clinical experience. Physicians have employed a variety of approaches to treat tinnitus. [2] Pharmacological treatments like ginkgo-biloba, Betahistine, dexamethasone, lidocaine, and clonazepam were prescribed. [5] [21, 22] [23–28]
surgical procedures, behavioral audio therapy, tinnitus masking devices, transcranial magnetic stimulation, and psychotherapy were also suggested. [1, 3, 16, 19, 29]
The aim of this study is to investigate the use of clonazepam as an effective treatment for idiopathic tinnitus or to control the severity of its impact on patients’ quality of life.