Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

Tinnitus is the perception of abnormal ear or head noises. Tinnitus is unpleasant enough itself. It is also sometimes a symptom of other problems, including hearing loss, tumors, and narrowing of the blood vessels.

Noises may be high pitched and “ringing,” or sound more like a clicking. Some tinnitus is pulsatile. This means that it may be caused by the flow of blood that accompanies each heartbeat. This type of tinnitus is a result of the narrowing of the blood vessels.

The Ear

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Causes

Many diseases and conditions are associated with tinnitus, including:

Occasional episodes of tinnitus lasting at most a few minutes are quite common in normal people, especially after exposure to loud noises.

Risk Factors

Your risk of tinnitus increases with:

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
  • Ringing that comes and goes
  • More annoying symptoms at night or when there are fewer distractions
  • Sensation of normal internal events, such as blood pulsing or muscles contracting

Sometimes tinnitus is accompanied by hearing loss and vertigo.

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

  • Is associated with hearing loss, dizziness, change in personality, speech, or weakness in any body area
  • Starts after head or neck injury
  • Is associated with new medicine
  • Is pulsatile
  • Is associated with pain in the ear, fever, nausea, or vomiting

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Special attention will be paid to your head, neck, and ears.

You will be asked questions about:

  • The sensations that you have
  • The factors that may increase or decrease the sensation (eg, breathing, dizziness)
  • The medicines that you take

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. Other tests, such as a magnetic resonance imaging (MRI) scan, may be ordered to rule out serious conditions.

Treatment

Tinnitus treatment depends on what is causing the symptoms. This may mean, for example:

  • 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

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

No medicine has been shown to be very effective in treating tinnitus. Your doctor may still try to use some medicines to help your symptoms, though. Examples of medicines often tried include antidepressants and sedatives.

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

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

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

Surgery may help relieve certain causes of tinnitus if the cause of the tinnitus is treated.

  • Tinnitus caused by a tumor frequently subsides after the growth is removed.
  • If the tinnitus is due to wax build-up, it can be relieved by cleaning the ears.
  • 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 dizziness.

Prevention

You may be able to prevent tinnitus from developing with a few simple measures:

  • 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 drugs that damage hearing.