Ringing in the Ear (Tinnitus)

Overview

Tinnitus – or ringing in the ear – affects around 20 percent of people. There are two types of tinnitus:

• Subjective tinnitus, caused by problems with the auditory nerves or pathways, and only you can hear the ringing.
• Objective tinnitus, caused by a blood vessel problem, a muscle contraction or a middle ear bone condition, and both you and your doctor can hear the ringing during an ear examination.

Ringing in the ear causes

Ringing in the ear has many potential causes, including:

• Age-related hearing loss
• Certain medicines, such as antibiotics, cancer medicines, water pills (diuretics), aspirin and antidepressants
• Changes to the ear bones
• Circulatory system disorder
• Ear injury, such as damage to the inner ear hair cells
• Earwax buildup
• Exposure to very loud noise
• Meniere’s disease

Ringing in the ear risk factors

Risk factors for developing ringing in the ear include:

• Being exposed to loud noises, such as music speakers or occupational (job) noises
• Being male
• Having a heart problem, such as high blood pressure (hypertension) or narrowed arteries (atherosclerosis)
• Smoking

Ringing in the ear symptoms

Ringing in the ear takes place when a person hears a sound in the ear when no external sounds are present. If you have the condition, you may experience one or more of the following types of sounds:

• Buzzing
• Clicking
• Hissing
• Humming
• Ringing
• Roaring

You may experience these noises in one or both of your ears.

Ringing in the ear diagnosis

Your ENT doctor may use one or more of the following diagnostic tools to diagnose ringing in the ears:

• Physical examination. Your ENT doctor will perform a complete physical exam, and ask you questions about your health history in general and your ringing in the ears specifically.
• Hearing test. A hearing test can evaluate the sensitivity of your hearing.
• Movement test. Your ENT doctor may ask you to perform various movements – such as moving your eyes, clenching your jaw or moving your neck, arms or legs – to assess whether movement affects your tinnitus.
• Imaging tests. A computerized tomography (CT) or magnetic resonance imaging (MRI) scan can check for the underlying cause of your tinnitus.

Ringing in the ear treatment

Treatment for ringing in the ear will be different depending on the type and cause of the condition. It’s important to talk to your doctor about any concerns you have about ringing in the ear.

An ENT doctor may use one or more of the following treatments to help manage your tinnitus:

• Treating the underlying health condition — If an underlying condition – such as excessive earwax, problem with your blood vessels or side effects from medicine is causing your tinnitus, your doctor will work to treat the underlying issue.
• Noise suppression — One of several noise suppression strategies can be used to help you “tune out” the unwanted noise. There are several devices that can help suppress noise, including white noise machines, hearing aids and masking devices.
• If your tinnitus is severe, you may be given medicine such as a tricyclic antidepressant to help reduce symptoms. Other medicines can also be used to help manage symptoms.

When to seek care

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing an ENT doctor for more specialized treatment.