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Tinnitus

Tinnitus is the general name given to noises people hear in their ears or head. It may occur suddenly or come on gradually, and the sound may come and go. You may be able to ignore the sound some or all of the time. In most cases, tinnitus is not an emergency and is not life threatening.

Causes

Tinnitus can be caused by the following:

  • Wax in the ear canal, a stiffening of the middle ear bones, or a hole in the eardrum. These problems usually can be corrected and the tinnitus goes away.

  • Exposure to loud noises. This can cause tinnitus and permanent hearing loss. Hearing loss may be sudden or gradual, depending on the volume and length of exposure to the sound. Tinnitus is commonly associated with high frequency hearing loss. Tinnitus may occur at the same time as or after exposure to the loud sound.

  • Some medications cause tinnitus as a side effect. Aspirin and quinine are common causes.

  • Tinnitus can be a concomitant part of hearing loss that often comes with aging.

  • Less common causes of tinnitus and hearing loss include:

  • Trauma to the head

  • Problems with the temporomandibular (jaw) joint

  • Disorders of the neck vertebrae

  • Certain medications that in high doses can damage the ear

For many cases of tinnitus, the cause is unknown. Excessive caffeine, nicotine, salt, alcohol, and illegal drugs can make the symptoms of tinnitus worse. Stress and fatigue can also make tinnitus more noticeable.

Symptoms

You may experience tinnitus as a ringing or whistling sound. It can also sound like chirping, crickets, ocean noises, roaring, or hissing.

Subjective tinnitus means only you are able to hear the sound. Occasionally other people may be able to hear the same sound you hear. This is called objective tinnitus. Objective tinnitus occurs when there are abnormalities of the blood vessels in the outer or middle ear or because of muscle spasms in the middle ear. A clicking or crackling sound often occurs with objective tinnitus.

An ear, nose, and throat specialist can determine the cause of tinnitus. If you have tinnitus, a complete hearing evaluation can help identify any hearing loss that may be associated with the tinnitus and determine the severity of your symptoms.

Treatment

There are five different types of treatments for tinnitus. Treatment, however, does not mean cure since most tinnitus is not correctable. They include:

  • Amplification. Hearing aids will not cure or eliminate tinnitus but will make other sounds louder. The tinnitus may not be as loud or may not be heard at all.

  • Masking. Masking devices are often used to cover up the sounds a person with tinnitus is hearing. Masking devices create a different noise that is specially designed to cover up the ringing or buzzing sounds. One type of tinnitus masking device looks like a hearing aid and can be placed in the ear. Tabletop masking devices are also available. Household items such as fans, air conditioners, and radios (with the dial set between stations) can serve as masking devices. Of all treatments, masking appears to be the most effective.  However, even this is not satisfactory for most suffers.

  • Medications. There are no medications proven to eliminate tinnitus at this time. However, some prescription medications can reduce the symptoms.

  • Acupuncture. Acupuncture has brought some relief for tinnitus in some people.

  • Stress management. Biofeedback, counseling, or cognitive therapy may be helpful in reducing stress that aggravates tinnitus or occurs as a result of it.

Decision Guide for Tinnitus

Symptoms/Signs

Action

Noises in your ears

See Provider; Illustration of stethescope See provider

Symptoms that get worse or are accompanied by hearing loss or dizziness

See Provider; Illustration of stethescope See provider

Publication Source: Well Advised, Second Edition, Text copyright © 2003 Park Nicollet Institute
Online Editor: Rademaekers, Ed
Online Medical Reviewer: Godsey, Cynthia M.S., M.S.N., APRN
Online Medical Reviewer: Lambert, J.G. M.D.
Online Medical Reviewer: Ryan, Matthew W., MD
Date Last Reviewed: 2/13/2006
Date Last Modified: 2/13/2006