What Is Tinnitus?

Tinnitus is a health condition involving phantom sound. A person with tinnitus will perceive sound in the ears, without an external source for that sound. Tinnitus is commonly referred to as “ringing in the ears” but actually encompasses a wide range of aural effects. It can have a variety of causes, but is rarely the sign of a serious underlying medical issue. In some cases, however, tinnitus can interfere with hearing and concentration, and is occasionally associated with anxiety and depression.

There are an estimated 50 million Americans with symptoms of tinnitus. If you have questions about tinnitus or want to have your hearing tested, contact your Baptist Health medical provider.

What Are the Symptoms of Tinnitus?

Tinnitus is marked by sounds in the ears that have no source outside the body. These sounds may include:

• Ringing
• Humming
• Clicking
• Hissing
• Whistling
• Buzzing
• Roaring

Tinnitus sounds may vary in pitch and volume, occur steadily or intermittently, and change their form over time. You can have tinnitus in one or both ears simultaneously. The volume of the sound can change throughout the day. The sound often becomes more noticeable during periods of silence, in quiet locations, or at night when there is typically less noise.

There are two types of tinnitus: objective and subjective. Objective tinnitus means that persons besides yourself can hear the sound. It will originate from inside the body, sometimes as a muscle spasm or as a noise associated with an unusual blood-vessel configuration. Far more common is subjective tinnitus. In the latter case, only you are aware of the noise in your ears. While there is an organic cause for the sound, no one other than you can hear what you’re hearing.

Causes

Tinnitus has a number of causes, some of which directly affect the functioning of the ears and others which are a consequence of particular medical conditions or treatments. Included are:

• Direct medical causes: Inner ear damage, old-age hearing loss, earwax buildup, Eustachian tube dysfunction, inner ear muscle spasms, and otosclerosis, or the hardening of the ear bones, which play a role in sound detection.
• Related medical causes: Meniere’s disease, temporomandibular joint (TMJ) disorder, head or neck injuries, and acoustic neuromas, which are benign tumors sometimes found on the cranial nerve.
• Environmental causes: Loud noise exposure, either on the job or through the use of portable music devices.  
• Blood-vessel disorders: Hypertension, arteriovenous malformation (AVM), blood flow problems, and hardening of the arteries (atherosclerosis). 
• Medications: Anticancer drugs, quinine, water pills (diuretics), large dosages of aspirin, some antidepressants, and certain antibiotics.

Risk factors for developing tinnitus include age, tobacco use, and cardiovascular problems. Sex is also a factor, as men are more likely to experience tinnitus than women.

How Is Tinnitus Diagnosed?

There are several steps your physician can take to diagnose tinnitus. The first is a hearing test in which you will use a pair of specially designed earphones to listen for a variety of sounds played first for one ear and then the other. The number and types of sounds that you can identify will be compared to a profile that is considered usual for your age. This will help your medical caregivers narrow down the possible causes of the “ringing in your ears”.

A second test might involve prescribed movements of your head, neck, jaw, shoulders, arms, or legs. Depending on how your tinnitus reacts, this can provide further clues as to the nature of the cause.

If your tinnitus is limited to a single ear, your doctor may order an imaging test of the inner ear and related structures. CT, ultrasound, or magnetic resonance imaging (MRI) technologies may be utilized. Imaging can sometimes provide insight on structural issues that have led to the development of tinnitus.

How is Tinnitus Treated?

Depending on the source of your tinnitus, there are several approaches your doctor can take in treating it. He or she might:

• Remove waxy buildup from the ears
• Change medications that are known to sometimes cause tinnitus
• Address a blood vessel condition that is impacting your hearing
• Prescribe a noise-suppression technology, such as a white noise machine, hearing aids, or a masking device

Certain medications have shown effectiveness in treating severe cases of tinnitus. These include alprazolam, an antianxiety drug, and tricyclic antidepressants, such as nortriptyline and amitriptyline.

Tinnitus is often difficult to treat. The source of your tinnitus will determine the approach your doctor takes to treating your condition.

Tinnitus treatment options:

• Clear ear passages—Your doctor may remove waxy buildup from the ears. This excess ear wax can reduce hearing. Clearing ear passages may alleviate some of the symptoms of tinnitus. 
• Medications—Your doctor might change your medications that are known to sometimes cause tinnitus. For some patients, swapping medications restores their hearing.
• Treat other conditions—Your doctor may address a blood vessel condition that is impacting your hearing. Narrowed blood vessels and blood circulating near your ears can cause tinnitus.
• Noise suppression—Your doctor might prescribe a noise-suppression technology, such as a white noise machine, hearing aids, or a masking device. These medical devices can reduce tinnitus symptoms and improve hearing.
• Lifestyle habits—Reducing stress and avoiding loud sounds are often helpful in reducing tinnitus symptoms. Sleep, moderate physical exercise, and spending time with friends are all common suggestions for reducing stress.

Is Tinnitus Preventable?

You can reduce the likelihood of developing tinnitus by protecting your ears from loud noises. Wear ear protection if you’re in an environment where the surrounding noise level is 85 decibels or higher, which is roughly equivalent to the sound of heavy automobile traffic. Don’t blast music in your earbuds and keep television, computers, tablets, and other audio sources at reasonable volumes.

Find Help at Baptist Health

Though not often a threat to health, tinnitus can become a source of frustration and anxiety. If you are experiencing tinnitus symptoms, we’re here to help. Contact your Baptist Health physician to get started.