Tinnitus

What Is Tinnitus?

Tinnitus is a condition in which a person perceives sound that is not actually present in the environment. It's often described as a ringing in the ears, buzzing, whooshing, or hissing sounds. These perceived sounds and their loudness may vary from one person to another. In most cases, tinnitus is related to damage in the auditory system, which may or may not include hearing loss. Sometimes a single event, a medication, or a condition unrelated to the hearing system can trigger tinnitus. Tinnitus may or may not be accompanied by hearing loss.

What Causes Tinnitus?

The most common causes are age-related and noise-induced hearing loss. Earwax blocking the canal, middle-ear fluid or infection, certain medications (some antibiotics, high-dose NSAIDs, and chemotherapy drugs), Meniere’s disease, head or neck injury, and jaw joint problems can all produce it as well. In some patients no specific cause is found, which does not mean the tinnitus cannot be treated.

Tinnitus that pulses in time with your heartbeat, called pulsatile tinnitus, is a different situation. It can come from blood flow near the ear and deserves its own evaluation.

How Is Tinnitus Evaluated?

An evaluation starts with your history and an exam of the ears, since something as simple as impacted earwax can be the cause. The AAO-HNS tinnitus guideline recommends a hearing test for tinnitus that is in one ear only, that has persisted 6 months or longer, or that comes with hearing difficulty. Imaging such as MRI is not part of a routine workup; it is reserved for tinnitus in one ear, pulsatile tinnitus, uneven hearing between the ears, or neurologic symptoms.

Our audiologists will evaluate both your hearing and tinnitus to determine whether a treatable medical condition is present. If there is an underlying medical condition, you will then be evaluated by one of our ENT physicians for treatment, if necessary.

Can Tinnitus Be Cured or Managed?

Tinnitus can often be managed effectively. Options recommended in the AAO-HNS tinnitus guideline include treating any hearing loss with hearing aids, sound therapy that can be customized to each patient, and counseling-based approaches such as cognitive behavioral therapy. Sound therapy is available through many of today's advanced hearing aids. Our audiologists will explain this treatment and other options to you so you can choose the solution that is best for you.

The guideline is equally clear about what does not work. It recommends against routinely treating tinnitus itself with antidepressants, anticonvulsants, or anti-anxiety medication, and against dietary supplements such as ginkgo biloba, melatonin, or zinc, because studies have not shown a benefit. Protecting your hearing from further noise exposure remains worthwhile at every stage.

When Should I See an ENT or Audiologist for Tinnitus?

Make an appointment if tinnitus is new or persistent, is in one ear only, pulses with your heartbeat, or comes with hearing loss, dizziness, ear pain, or drainage. The same goes if it is interfering with your sleep, concentration, or mood, since those are the patients who benefit most from treatment.

Tinnitus that arrives with sudden hearing loss is urgent. Be seen as soon as possible, and definitely within two weeks, because treatment works best when it starts early.