
Ringing in the Ears (Tinnitus)
What is tinnitus?
Tinnitus is a noise that you hear in one or both of your ears or in your head. It is a symptom, not a disease. Those who have it describe it as a ringing, buzzing, humming, heartbeat, or chirping noise.
What is the cause?
Tinnitus can be caused by damage, blockage, or an irritation of the hearing pathways. Or it may come from an area of the brain related to hearing. For example, it may be caused by:
- Wax buildup in the outer ear canal
- Fluid in the middle ear
- Damage or disease in the inner ear
- A tumor of the hearing and balance nerve
Some medicines can cause tinnitus.
Most cases of tinnitus are related to a hearing loss. If you have tinnitus, it should be evaluated by an ear, nose and throat doctor to find what is causing the tinnitus, whether it is related to a serious problem, and if it can be helped.
How is it diagnosed?
It is important to find the cause of tinnitus. Tests may include:
- Hearing tests
- CT scan of the ears or head
- MRI scan
How is it treated?
Tinnitus may be treated by treating the underlying cause. However, often no treatment is needed because, other than having some ear noise, you may not bothered by it and the underlying cause will not cause serious illness.
Treatment may include:
- Medicine to lessen or stop the tinnitus
- Sometimes surgery to treat hearing loss or possibly remove a tumor
When tinnitus is related to a hearing loss, hearing aids may reduce or stop the tinnitus.
Other possible treatments include masking devices, which make a noise that blocks the sounds of the tinnitus, and tinnitus retraining therapy (TRT). TRT combines low-level broadband noise, such as the sound of a shower, with counseling to help you get used to the unwanted sound.
Many times tinnitus will lessen over time without treatment. Sometimes despite treatment, tinnitus does not get better.
How can I prevent tinnitus or keep it from getting worse?
Tinnitus is often caused by a loss of hearing. One of the most common causes for hearing loss (and tinnitus) is too much exposure to noise. Use of devices that protect your hearing, such as foam ear plugs or special ear muffs, can help.
Stress and lack of sleep can also worsen tinnitus. They may be the main reasons that the tinnitus is bothersome. Some foods and nonprescription medicines can cause or worsen tinnitus. For example, caffeine in coffee, tea and soft drinks can cause or worsen tinnitus. The medicine that most often has this effect is aspirin.
Ringing in the Ears (Tinnitus): References
Langguth B, Krenzer PM, Kleinjung T, De Ridler D. Tinnitus: causes and clinical management. Lancet Neurol. 2013 Sep;12(19):920-930.
Bagulay D, McFerran D, Hall D. Tinnitus. Lancet. 2013 Nov 9;382(9904):1600-1607.
Hoare DJ et al. Systematic review and meta-analysis of randomized controlled trials examining tinnitus management. Laryngoscope 2011. 121(7): 1555 – 1564.
National Institute on Deafness and Other Communication Disorders: Tinnitus. NIH Publication 10 – 4896. National Institutes of Health. April 2010. Accessed December 4, 2010 from <http://www.nidcd.nih.gov/health/hearing/tinnitus.
Sismanis, A. Ed. Tinnitus: Advances in evaluation and management. Otolaryngologic Clinics of North America. 36:2 (2003): 235 – 408.
Zimmer, C. The Brain: Discover October 2010. 22 – 24.