11504 Health Library | Health and Wellness | Wellmont Health System
  • Ringing in the Ears

    (Tinnitus)

    Definition

    Tinnitus is the perception of abnormal ear or head noises. Tinnitus is unpleasant enough itself. It is also sometimes a symptom of other problems, including hearing loss, tumors, and narrowing of the blood vessels.
    Noises may be high pitched and “ringing,” or sound more like a clicking. Some tinnitus is pulsatile. This means that it may be caused by the flow of blood that accompanies each heartbeat. This type of tinnitus is a result of the narrowing of the blood vessels.
    The Ear
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Many diseases and conditions are associated with tinnitus, including:
    Occasional episodes of tinnitus lasting at most a few minutes are quite common in normal people, especially after exposure to loud noises.

    Risk Factors

    Your risk of tinnitus increases with:
    • Exposure to loud noises
    • Depression
    • Stress
    • Fatigue
    • Anxiety
    • Certain medicines:
      • Aspirin
      • Quinine and its derivatives
      • Some antibiotics (aminoglycosides)
      • Some diuretics (water pills)
      Toxins:
      • Heavy metals
      • Carbon monoxide
      • Alcohol

    Symptoms

    The sensations of tinnitus may have the following characteristics:
    • Ringing, roaring, buzzing, whistling, or hissing sounds
    • Intermittent, continuous, or pulsatile quality
    • Same or varying intensity
    • Single or multiple tones
    • Ringing that comes and goes
    • More annoying symptoms at night or when there are fewer distractions
    • Sensation of normal internal events, such as blood pulsing or muscles contracting
    Sometimes tinnitus is accompanied by hearing loss and vertigo.

    When Should I Call My Doctor?

    Call your doctor if you have tinnitus, especially if it:
    • Is associated with hearing loss, dizziness, change in personality, speech, or weakness in any body area
    • Starts after head or neck injury
    • Is associated with new medicine
    • Is pulsatile
    • Is associated with pain in the ear, fever, nausea, or vomiting

    Diagnosis

    The doctor will ask about your symptoms and medical history, and perform a physical exam. Special attention will be paid to your head, neck, and ears.
    You will be asked questions about:
    • The sensations that you have
    • The factors that may increase or decrease the sensation (eg, breathing, dizziness)
    • The medicines that you take
    The doctor will look at your ear canal and eardrum using an instrument with a light that is held at the external opening of the ear. A tuning fork can help evaluate hearing. You should receive a complete hearing test. Other tests, such as a magnetic resonance imaging (MRI) scan, may be ordered to rule out serious conditions.

    Treatment

    Tinnitus treatment depends on what is causing the symptoms. This may mean, for example:
    • Wearing a specially made splint to help manage temporomandibular joint disorder
    • Taking antibiotics for a sinus or ear infection
    • Having the wax removed from your ear canal
    Therapy aims to eliminate or reduce bothersome sensations. Treatment may include:

    Medication

    No medicine has been shown to be very effective in treating tinnitus. Your doctor may still try to use some medicines to help your symptoms, though. Examples of medicines often tried include antidepressants and sedatives.
    If you have Meniere's disease, your doctor may prescribe medicine to treat that condition.

    Mechanical Devices

    Devices include:
    • Hearing aid—sometimes relieves tinnitus and improves hearing in some people with hearing loss
    • Tinnitus masker—a device that emits a low level of white noise to help cover up the internal sensations and block out external noises

    Lifestyle and Self-care Measures

    Measures to discuss with your doctor if no cure or specific treatment is available include:
    • Learn and practice stress management and relaxation techniques.
    • Biofeedback may help. Biofeedback teaches people how to control body functions they normally do not think about.
    • Consider seeing a counselor to develop new coping skills and relaxation techniques.
    • Consider joining a support group .
    • Avoid anything that makes tinnitus sensations worse, such as:
    • Exercise regularly to improve circulation.
    • Make time to relax and get enough sleep.
    • Playing a radio or a white-noise machine for about 30 minutes at bedtime may help relieve the ringing sensations at night.

    Surgery

    Surgery may help relieve certain causes of tinnitus if the cause of the tinnitus is treated.
    • Tinnitus caused by a tumor frequently subsides after the growth is removed.
    • If the tinnitus is due to wax build-up, it can be relieved by cleaning the ears.
    • Abnormalities in blood vessels that lead to tinnitus can sometimes be corrected with surgery.
    • Surgery may also be an option for patients with Meniere's disease, but it is usually done only for disabling dizziness.

    Prevention

    You may be able to prevent tinnitus from developing with a few simple measures:
    • Avoid exposure to excessive noise.
    • Wear earplugs in noisy situations.
    • Wear earmuffs when mowing the grass.
    • Learn and practice stress management and relaxation techniques.
    • Limit use of drugs that damage hearing.

    RESOURCES

    American Academy of Otolaryngology—Head and Neck Surgery http://www.entnet.org/

    American Tinnitus Association http://www.ata.org/

    CANADIAN RESOURCES

    The Canadian Hearing Society http://www.chs.ca/

    Canadian Society of Otolaryngology http://www.entcanada.org/

    References

    Acute otitis media. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/ . Updated December 13, 2011. Accessed January 7, 2012.

    American Tinnitus Association website. Available at: http://www.ata.org . Accessed July 7, 2009.

    Conn HF, Rakel. Conn’s Current Therapy. 54th ed. Philadelphia, PA: WB Saunders Company; 2002.

    FAQ's about tinnitus. American Speech-Language-Hearing Association website. Available at: http://www.asha.org/default.htm . Accessed July 7, 2009.

    Goroll A, Mulley A. Primary Care Medicine. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2000.

    Tinnitus. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/ . Updated December 15, 2011. Accessed January 7, 2012.

    Tinnitus. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/tinnitus.cfm . Accessed July 7, 2009.

    Tinnitus. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/tinnitus/ds00365 . Updated June 2009. Accessed July 7, 2009.

    10/16/2009 DynaMed Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Baldo P, Doree C, Lazzarini R, Molin P, McFerran D. Antidepressants for patients with tinnitus. Cochrane Database Syst Rev. 2009;(4):CD003853.

    Revision Information

  • Join WellZones today.

    Make a Change For LifeLearn more

    Wellmont LiveWell is creating a new tradition of wellness in the mountains by providing individuals with tools and encouragement to live healthier lifestyles.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease early and prevent heart attacks with HeartSHAPE® - a painless, non-invasive test that takes pictures of your heart to scan for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.


  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.