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Home > Services > Ear, Nose and Throat > ENT Conditions > Tinnitus (Ringing in the Ears)

Tinnitus (Ringing in the Ears)

Ringing in the Ears

Tinnitus is the perception of abnormal ear or head noises without any external sound. Noises may be high pitched, ringing, clicking or buzzing. The sound of blood flow that goes with your heartbeat causes pulsatile tinnitus. i

The Ear

The Ear

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What Causes Tinnitus

Causes include:

  • Cochlear damage from noise exposure
  • Hearing loss
  • Damage to the auditory system

Occasional episodes of tinnitus lasting at most a few minutes occur commonly in most people, especially after exposure to loud noises.

Risk Factors

Factors that may increase your chance of developing tinnitus include:

  • Occupations or activities that expose you to loud noises
  • Wax or a foreign body in the ear canal
  • Stress
  • Fatigue
  • Certain medications, such as aspirin, antibiotics or diuretics
  • Toxins, such as heavy metals, carbon monoxide or alcohol
  • Certain health conditions, such as:
    • Ear infection
    • Meniere's disease
    • Allergies
    • High or low blood pressure
    • Diabetes
    • Depression
    • Anxiety
    • Tumors
    • Thyroid problems
    • Temporomandibular joint disorder (TMJ)
  • Blood vessel disorders, such as an aneurysm, fistula or hardening of the arteries are associated with pulsatile tinnitus
  • Fluid in the ear
  • Ruptured membrane in the ear
  • Injury to the head or neck

Tinnitus Symptoms

The sensations of tinnitus may have the following characteristics:

  • Ringing, roaring, buzzing, whistling or hissing sounds
  • Intermittent, continuous or pulsatile quality
  • Same or varying intensity
  • Single or multiple tones
  • More annoying symptoms at night or when there are fewer distractions
  • Sensation of normal internal events, such as blood pulsing or muscles contracting

Sometimes hearing loss and vertigo occur with tinnitus.

When Should I Call My Doctor?

Call your doctor if you have tinnitus, especially if it:

  • Is associated with hearing loss, vertigo, change in personality, speech or weakness in any body area
  • Starts after head or neck injury
  • Happens with new medication
  • Pulses
  • Occurs with pain in the ear, fever, nausea or vomiting

Diagnosis

A doctor will pay special attention to your head, neck and ears and ask questions about the:

  • Sensations that you feel
  • Factors that may increase or decrease the sensation
  • Medications that you take
  • History of trauma

The doctor will look at your ear canal and eardrum using an instrument with a light that is held at the external opening of the ear. A tuning fork can help evaluate hearing. You should receive a complete hearing test. Imaging tests, such as a CT scan or MRI, may be ordered to rule out serious conditions.

A hearing test includes:

  • Tympanogram
  • Auditory brain response
  • Electrocochleoraphy — to test for Meniere's disease

Tinnitus Treatment

Treatment depends on causes. This may mean:

  • Wearing a specially made splint to help manage temporomandibular joint disorder
  • Taking antibiotics for a sinus or ear infection
  • Having the wax removed from your ear canal
  • Stopping or changing medications to see if tinnitus goes away

Therapy aims to eliminate or reduce bothersome sensations. Treatment may include:

Medication

No medication has been shown to be very effective in treating tinnitus. Your doctor may still try to use some medications to ease your symptoms. These may include antidepressants and sedatives.

If you have Meniere's disease, your doctor may prescribe medication to treat that condition.

Mechanical Devices

Devices include:

  • Hearing aid — sometimes relieves tinnitus and improves hearing in some people with hearing loss
  • Tinnitus masker — a device that emits a low level of white noise to help cover up the internal sensations and block out external noises

Lifestyle and Self-care Measures

Measures to discuss with your doctor if no cure or specific treatment is available include:

  • Stress management and relaxation techniques
  • Biofeedback
  • Repetitive transcranial magnetic stimulation
  • Cognitive behavioral therapy
  • Joining a support group.
  • Avoid anything that makes tinnitus sensations worse, such as:
    • Loud noises
    • Alcohol
    • Smoking
    • Salt
    • Caffeine
  • Exercise regularly to improve circulation
  • Make time to relax and get enough sleep
  • Playing a radio or a white-noise machine for about 30 minutes at bedtime may help relieve the ringing sensations at night

Surgery

Surgery may help relieve certain causes of tinnitus. These include:

  • Tinnitus caused by a tumor frequently subsides after the growth is removed
  • Abnormalities in blood vessels that lead to tinnitus can sometimes be corrected with surgery
  • Surgery may also be an option for patients with Meniere's disease, but it is usually done only for disabling vertigo

Preventing Tinnitus

To help reduce your chance of developing tinnitus, take these steps:

  • Avoid exposure to excessive noise.
  • Wear earplugs in noisy situations.
  • Wear earmuffs when mowing the grass.
  • Learn and practice stress management and relaxation techniques.
  • Limit use of medications that damage hearing. 

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Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.

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