What is Tinnitus

Tinnitus refers to hearing a sound when there is no actual source for that sound. This is often described as ringing in the ears. However, people with this condition may hear a variety of noises, in one ear or in both ears.

The sounds of tinnitus can be soft, loud, or somewhere in between. This can last for a few seconds or can be constant for days. It may go away without treatment and come back at various times.

When tinnitus is constant or happens often, it can lead to other problems, such as trouble sleeping and trouble concentrating.

Almost everyone experiences tinnitus at some point. The one that is long-lasting (chronic) or comes back often (recurs) may require medical attention.

What are the causes?

The cause of tinnitus is often not known. In some cases, it can result from other problems or conditions, including:

• Exposure to loud noises from machinery, music, or other sources.
• Hearing loss.
• Ear or sinus infections.
• Earwax buildup.
• An object (foreign body) stuck in the ear.
• Taking certain medicines.
• Drinking alcohol or caffeine.
• High blood pressure.
• Heart diseases.
• Anemia.
• Allergies.
• Meniere’s disease.
• Thyroid problems.
• Tumors.
• A weak, bulging blood vessel (aneurysm) near the ear.
• Depression or other mood disorders.

What are the signs or symptoms?

The main symptom of tinnitus is hearing a sound when there is no source for that sound. It may sound like:

• Buzzing.
• Roaring.
• Ringing.
• Blowing air, like the sound heard when you listen to a seashell.
• Hissing.
• Whistling.
• Sizzling.
• Humming.
• Running water.
• A musical note.
• Tapping.

Symptoms may affect only one ear (unilateral) or both ears (bilateral).

How is this diagnosed?

Tinnitus is diagnosed based on your symptoms, your medical history, and a physical exam. Your health care provider may do a thorough hearing test (audiologic exam) if your tinnitus:

• Is unilateral.
• Causes hearing difficulties.
• Lasts 6 months or longer.

You may work with a health care provider who specializes in hearing disorders (audiologist). You may be asked questions about your symptoms and how they affect your daily life. You may have other tests done, such as:

• CT scan.
• MRI.
• An imaging test of how blood flows through your blood vessels (angiogram).

How is this treated?

Treating an underlying medical condition can sometimes make tinnitus go away. If your tinnitus continues, other treatments may include:

• Medicines, such as antidepressants or sleeping aids.
• Sound generators to mask the tinnitus. These include:
  • Tabletop sound machines that play relaxing sounds to help you fall asleep.
  • Wearable devices that fit in your ear and play sounds or music.
  • Acoustic neural stimulation. This involves using headphones to listen to music that contains an auditory signal. Over time, listening to this signal may change some pathways in your brain and make you less sensitive to tinnitus. This treatment is used for very severe cases when no other treatment is working.
• Therapy and counseling to help you manage the stress of living with tinnitus.
• Using hearing aids or cochlear implants if your tinnitus is related to hearing loss. Hearing aids are worn in the outer ear. Cochlear implants are surgically placed in the inner ear.

Follow these instructions at home:

Managing symptoms

• When possible, avoid being in loud places and being exposed to loud sounds.
• Wear hearing protection, such as earplugs, when you are exposed to loud noises.
• Use a white noise machine, a humidifier, or other devices to mask the sound of tinnitus.
• Practice techniques for reducing stress, such as meditation, yoga, or deep breathing. Work with your health care provider if you need help with managing stress.
• Sleep with your head slightly raised. This may reduce the impact of tinnitus.

General instructions

• Do not use stimulants, such as nicotine, alcohol, or caffeine. Talk with your health care provider about other stimulants to avoid. Stimulants are substances that can make you feel alert and attentive by increasing certain activities in the body (such as heart rate and blood pressure). These substances may make tinnitus worse.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Try to get plenty of sleep each night.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your tinnitus continues for 3 weeks or longer without stopping.
• Your symptoms get worse or do not get better with home care.
• You develop tinnitus after a head injury.
• You have tinnitus along with any of the following:
  • Dizziness.
  • Loss of balance.
  • Nausea and vomiting.

Summary

• Tinnitus refers to hearing a sound when there is no actual source for that sound. This is often described as ringing in the ears.
• Symptoms may affect only one ear (unilateral) or both ears (bilateral).
• Use a white noise machine, a humidifier, or other devices to mask the sound of tinnitus.
• Do not use stimulants, such as nicotine, alcohol, or caffeine. Talk with your health care provider about other stimulants to avoid. These substances may make tinnitus worse.