What is Tinnitus?

Over 50 million Americans have experienced tinnitus or ringing in the ears, which is the perception of sound without an external source being present. About one in five people with tinnitus have bothersome tinnitus, which negatively affects their quality of life and/or functional health. Tinnitus may be an intermittent or continuous sound in one or both ears. Its pitch can go from a low roar to a high squeal or whine, or it can have many sounds.

Tinnitus is often described as ringing in the ears. Some patients report whistling and chirping, but this is not the only sign of tinnitus. Tinnitus may be caused by an infection or blockage of the ear. Tinnitus is most commonly caused by long exposure to loud sounds. Tinnitus can also occur as people get older and the structures in the inner ear lose their health.

What Are the Symptoms of Tinnitus?

Tinnitus is not a disease per se, but a common symptom, and because it involves the perception of hearing sound or sounds in one or both ears, it is commonly associated with the hearing system. In fact, various parts of the hearing system, including the inner ear, are often responsible for this symptom. At times, it is relatively easy to associate the symptom of tinnitus with specific problems affecting the hearing system; at other times, the connection is less clear.

Common symptoms of tinnitus include:

• Constant high- or low-pitched ringing in ears
• Intermittent or constant roaring in ears
• Pulsation or beating noises in ears
• Associated with or without hearing loss

What Causes Tinnitus?

Primary tinnitus accounts for most tinnitus. This is where there is no other cause than hearing loss. Secondary tinnitus may be associated with an underlying cause that can be treated. Your ENT specialist can help you determine if your tinnitus may be secondary or primary.

Tinnitus can be caused by many parts of the hearing system. Tinnitus may also be caused by the ear canal and pinna. Tinnitus can be caused by excessive ear wax, particularly if it touches the eardrum. This causes pressure and changes in the way the eardrum vibrates.

Tinnitus can also be caused by middle ear problems, such as middle ear infections (common) or otosclerosis. Otosclerosis hardens the tiny bones and ossicles. Muscle spasms in the inner ear can also cause tinnitus, but they don’t usually result in hearing loss. This can cause tinnitus that is intermittent or may be heard by your doctor.

The inner ear is where most subjective tinnitus that is associated with the hearing system occurs. Tinnitus can also be caused by damage to the inner ear’s tiny sensory hair cells. This can be due to a variety of factors, such as age, noise, medication, and other factors.

Excessive noise exposure is one of the causes of tinnitus. Tinnitus can develop even before hearing loss occurs in some cases. Therefore, it is important to take extra precautions to protect your hearing and ears from the noise.
Tinnitus can also be caused by medication that damages inner ear hair cells. Non-prescription medication such as aspirin or acetaminophen can also cause tinnitus if taken in high amounts. Prescription medication includes certain diuretics as well as antibiotics. Tinnitus is more common as we age.

Tinnitus can also be caused by an abnormality in the hearing portion of your brain. These may include damage from head trauma or benign tumors called “vestibular Schwannoma” (acoustic neuroma).

Pulsatile Tinnitus is a type of tinnitus that sounds like your heartbeat or pulse. It can also be a sign of a narrowed artery, cardiovascular disease, or vascular tumors in the head, neck, or ears. For evaluation, consult your doctor immediately if you experience this type of tinnitus.

Tinnitus can also be exacerbated by lifestyle and non-auditory factors. Tinnitus can be caused by or exacerbated by medical conditions like temporomandibular joint arthralgia, depression, anxiety, insomnia, and muscular stress, and fatigue. Ringing in the ears is a sign of a medical condition. Ringing in the ears could be caused by a tumor or another abnormality in the blood vessels.

When to seek medical assistance?

When you are evaluated for tinnitus, the first thing your Century ENT provider will do is obtain a complete history and perform a thorough, targeted physical examination. If your tinnitus is one-sided (unilateral), associated with hearing loss, or persistent, a hearing test, or audiogram, should be ordered. There is typically no need for radiologic testing (X-ray, CT scan, or MRI scan) unless your tinnitus is pulsatile or associated with uneven, asymmetric hearing loss or neurological abnormalities. Your doctor will determine how bothersome your tinnitus is by asking you certain questions or having you complete a self-assessment questionnaire.

Unfortunately, there is no cure for tinnitus.  For specific types of tinnitus, new hearing technology may be able to mask the effects of tinnitus.  Your ENT Doctor or hearing specialist can offer more information, as well as possible therapies and lifestyle modifications to reduce the severity and impact of tinnitus.

Treatment Options May Include:

Hearing TestsHearing Aids