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 phantom sounds.
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 commonly 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.
Damage to the middle or inner ear is a common cause of tinnitus.
Your middle ear picks up sound waves, and their conduction 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 damage, called ototoxicity, in some people. Drugs that may cause tinnitus include:
- very large doses of aspirin, such as more than 12 doses daily for a prolonged period
- loop diuretic medications, such as bumetanide
- antimalarial drugs, such as chloroquine
- certain antibiotics, such as erythromycin and gentamicin
- certain anti-cancer drugs, such as vincristine
Other medical conditions that can create ringing in your ears include:
- 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 you hear
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 CT or MRI scans, to see if you have deformities or damage to your ears. Standard plain film X-rays don’t always show tumors, blood vessel disorders, or other abnormalities that can affect your hearing.
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 anti-anxiety 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 be bothersome.
Side effects of medications used to treat tinnitus may include:
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 ear.
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 tinnitus.
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 set inserted into your inner ear.
The implant sends your auditory nerve the signals you need to process sound. Cochlear implants use electrical stimulation to help your brain interpret sounds properly.
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 heavy traffic noise.
Also, 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 ear.