Some people have a ringing in their ears. Others might hear a roaring, buzzing, hissing or clicking inside their heads. The sounds may be intermittent, or they may be constant. They may be a minor annoyance or a major distraction. But if you’re one of the nearly 10 percent of adults who experience some form of tinnitus, there may be help.
What is Tinnitus?
Tinnitus is the perception of sound in the human ear in the absence of any external sound. It can be perceived in one or both ears, or in the head.
Tinnitus can be described in many different ways. Patients report hearing sounds such as a high-pitched ringing, buzzing, hissing, humming, whistling, ticking, roaring, clicking, crickets, tunes, songs, whooshing or the sound of wind or waves.
The American Tinnitus Association estimates the more than 50 million American experience tinnitus to some degree. Of these, about 12 million have severe enough tinnitus to seek medical attention. And about two million patients are so seriously debilitated that their daily living is affected.
Causes of Tinnitus
The exact physiological cause of tinnitus is unknown, says UH otolaryngologist Sarah Mowry, MD. “Several sources are known, however, to trigger or worsen tinnitus,” she says, such as:
Noise-induced hearing loss – This is the most common cause of tinnitus. Either a single intense event or long-term noise exposure such as factory or construction work, can damage hearing. With exposure to loud noise, hair cells in the inner ear become damaged or destroyed. Once damaged, these hair cells cannot be renewed or replaced. Up to 90 percent of all tinnitus patients have some level of hearing loss.
Wax build up – Everyone produces different amount of earwax. When a significant amount of earwax becomes built up in the ear canal, hearing can be compromised and tinnitus may seem louder. Earwax should not be removed with a cotton swab. You should speak to your physician or ear, nose and throat doctor.
Certain medications – Some medicines are toxic to the ears and can produce tinnitus as a side effect. Effects depend on the medicine’s dose and can be temporary or permanent.
Ear or sinus infections – Many people, including children, experience tinnitus along with an ear or sinus infection. This will generally lessen and gradually go away once the infection is healed.
Jaw misalignment – Temporomandibular jaw misalignment, or TMJ, can induce tinnitus.
Cardiovascular disease – About 3 percent of tinnitus patients experience pulsatile tinnitus, often in time with their heartbeat. This can indicate the presence of a vascular condition where the blood flow through the veins and arteries is compromised – like a heart murmur, hypertension or hardening of the arteries.
Certain types of tumors – Very rarely, a person will have a benign, slow-growing tumor on their auditory, vestibular or facial nerves. These tumors can cause tinnitus, deafness, facial paralysis and loss of balance.
Head and neck trauma – Physical injury to the head and neck can induce tinnitus.
Certain disorders – Hypo or hyperthyroidism, Lyme disease, fibromyalgia and thoracic outlet syndrome can have tinnitus as a symptom.
What To Do If You Think You Have Tinnitus
The first steps to take if you think you have tinnitus is to note the details surrounding your symptoms. Did you begin a new medicine or were injured or exposed to excessive noise right before it started? Is the tinnitus in one or both ears? Does it fluctuate or is constant? Do you have a hearing loss?
Next, visit your physician or make an appointment with an ENT (ear, nose and throat specialist). Also, have your hearing checked by an audiologist.
Living with Tinnitus
Most people who seek medical help for their tinnitus learn that no serious medical problem is causing their condition. This knowledge alone is often enough to allow some to adapt to the sounds they hear.
“Other people experience tinnitus as disruptive and stress-inducing and need help learning how to cope with the sounds,” Dr. Mowry says. She has these tips on coping with tinnitus:
Avoid silence – Tinnitus can sound louder when you are in total silence. Listening to soothing music or nature sounds can promote a comfortable state of relaxation. Other soothing sound suggestions are an aquarium, dehumidifier or electric fan.
Amplification – If you have hearing loss and tinnitus, a hearing aid will help you hear ambient sounds that can take the focus away from the tinnitus.
Maskers – This is a device that resembles a hearing aid and produces a “shhh” sound to cover the tinnitus. “These help your brain suppress the phantom noise so it’s less bothersome,” Dr. Mowry says.
Retraining therapy – You can try to retrain your brain to ignore the tinnitus sounds. This treatment can take more than one year.
Cognitive behavior therapy – This helps you identify and alter maladaptive thoughts and behaviors to achieve relief.
Biofeedback – This therapy teaches stress management and how to control your blood pressure, heart rate and skin temperature.
Drug therapy – Some medicines have been investigated for use in relieving tinnitus; however, medicines are primarily used to help with anxiety, depression and sleep difficulties that can be associated with tinnitus. Treating these problems can indirectly help.
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Our nationally recognized team of hearing and balance experts at University Hospitals, many of whom have advanced fellowship training in the ear, nose and throat subspecialties of otology and neurotology, provide specialized care for ear, hearing and balance disorders. Learn more about the Ear, Hearing and Balance Center at University Hospitals.
