Tinnitus is the medical term for a ringing or buzzing noise
in the ears. Most people refer to tinnitus as “ringing in the ears.” However,
you may hear more than just ringing. If you have tinnitus, you may also hear:
Although you hear sounds in your ears, there’s no external
sound source. This means there’s nothing close to your head that makes the
sounds you hear. For this reason, the sounds of tinnitus are sometimes known as
Tinnitus can be annoying and frustrating. Sometimes, the
sounds you hear can interfere with hearing real sounds around you. Tinnitus can
occur with depression, anxiety, and stress.
You may experience tinnitus in one or both ears. People of all
ages can develop tinnitus, but it’s more common in older adults.
Tinnitus can be either objective or subjective. Objective tinnitus means that
both you and other people can hear certain noises in your ears. This is usually
due to abnormal blood vessels in and around your ears. When your heart beats,
you and others can hear a distinct pulsing sound.
Objective tinnitus is rare. Subjective tinnitus is much more common. Only you can
hear the roaring, ringing, and other sounds of subjective tinnitus.
What Causes Tinnitus?
Damage to the middle or inner ear is a common cause of
tinnitus. Your middle ear picks up sound waves and prompts your inner ear to
transmit electrical impulses to your brain. Only after your brain accepts these
signals and translates them into sounds are you able to hear them. Sometimes,
your inner ear sustains damage, altering the way your brain processes sound.
Damage to your eardrums or the tiny bones in your middle ear
can also interfere with the proper conduction of sound. Tumors in the ear or on
the auditory nerve may also cause ringing in the ears.
Exposure to very loud sounds on a regular basis can cause
tinnitus in some people. Those who use jackhammers, chainsaws, or other heavy
equipment are more likely to have tinnitus. Listening to loud music through
headphones or at a concert may also produce temporary symptoms of tinnitus.
Medication use can also cause tinnitus and hearing loss
called ototoxicity in some people. Drugs that may cause tinnitus include:
- very large doses of aspirin, or more than 12 doses
daily for a prolonged period
- diuretic medications, such as bumetanide
- antimalarial drugs, such as chloroquine
- antibiotics ending in “-mycin,” such as
erythromycin and gentamycin
- certain cancer drugs, such as vincristine
Other medical conditions that can create ringing in your
- age-related hearing loss
- muscle spasms in your middle ear
- Meniere’s disease, which is an inner ear
condition that affects hearing and balance
- high blood pressure
- high cholesterol
- head and neck injuries
- temporomandibular joint disorders, which also causes
chronic pain in your jaw and head
- an overabundance of earwax, which alters the way
How Is Tinnitus Diagnosed?
Your doctor will examine your ears and conduct a hearing
test to diagnose tinnitus. An audiologist will transmit sounds through a set of
headphones to one ear at a time. You’ll respond visibly by raising your hand or
making a similar gesture when you hear each sound. Your doctor may be able to
diagnose the cause of your tinnitus by comparing what you can hear to what
people of your age and sex should be able to hear.
Your doctor may also use imaging tests, such as a CT or MRI
scans, to see if you have deformities or damage to your ears. CT and MRI tests
use X-ray and radio waves to create images of your internal organs. Standard
X-rays don’t always show tumors, blood vessel disorders, or other abnormalities
that can affect your hearing.
What Are the Treatment Options for Tinnitus?
Your doctor will treat any underlying medical conditions
causing your tinnitus. Your doctor will address any blood vessel abnormalities and
remove any excess earwax. If medications are contributing to your tinnitus,
your doctor may switch your prescriptions to restore normal hearing.
Drug therapy can also help reduce the sounds you hear in
your ears. Tricyclic antidepressants and antianxiety medications, including
Xanax, amitriptyline, and nortriptyline, can lessen the ear sounds in some
cases. However, not everyone responds to drug therapy and the side effects can
Side effects of medications used to treat tinnitus may
- blurry vision
In rare cases, these
medications can also cause heart problems.
Noise suppression machines can help dull the ringing,
buzzing, or roaring by providing relaxing noises to mask your ear sounds. You might
also try a masking device that’s similar to a hearing aid and inserts into your
You can also take steps to manage your tinnitus by reducing
stress. Stress doesn’t cause tinnitus but can make it worse. Engage in a hobby
or talk with a trusted friend or family member to reduce stress in your life. You
should also avoid exposure to loud noises to lessen the severity of your
Hearing aids can be beneficial for some people with
tinnitus. Sound amplification can help those who have trouble hearing normal
noises due to their tinnitus.
Cochlear implants to restore lost hearing may also be
effective. A cochlear implant is a device that allows your brain to bypass the
damaged part of your ear to help you hear more effectively. A microphone
implanted just above your ear works with an electrode inserted into your inner
ear. The implant sends your auditory nerves the signals you need to process
sound. Cochlear implants and other forms of electrical stimulation can help
your brain interpret sounds properly.
How Can I Prevent Tinnitus?
Protect your ears from loud noises to help prevent tinnitus.
Keep a close eye on the volume levels of your television, radio, and personal
music player. Wear ear protection around noises louder than 85 decibels, which
is the level associated with average traffic noise. Cover your ears if you’re
surrounded by loud music or construction noise and proper ear protection, such
as earplugs, isn’t available.
You should also avoid medications that may cause your
tinnitus symptoms to recur, and schedule regular hearing tests with your doctor
to promptly detect any problems with the structure of your inner and middle