Ringing in the Ears

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Tinnitus is the perception of sound in the absence of an external source. The perceived sound is variously described as ringing, buzzing, hissing or even roaring, whistling or pounding. Almost everyone experiences intermittent tinnitus once in a while (especially in a quiet room), and it is nothing to be concerned about. Persistent tinnitus, however, can be distressing psychologically, may interfere with sleep, and is sometimes a sign of a more serious underlying disorder. Treatment depends upon identifying the underlying problem.

What Causes Tinnitus?

  • Tinnitus can be associated with all types of hearing loss and may be a symptom of almost any ear disorder, including labyrinthitis, Ménière’s disease, otitis media, otosclerosis, acoustic neuroma and presbycusis.
  • Certain conditions can produce an actual sound near the ear that an examiner can hear with a stethoscope. This phenomenon is known as objective tinnitus and can be caused by increased intracranial pressure, an aneurysm, temporomandibular jaw disorders, normal blood flow through an artery or vein, or a tumor pressing on a blood vessel or nerve.
  • Sometimes it is caused by the overuse of MP3 players and other personal audio devices.
  • Drugs such as caffeine, aminoglycosides, aspirin, propranolol, levodopa and quinidine can cause tinnitus.
  • In some cases no cause can be established.

Symptoms of Tinnitus

  • Persistent or intermittent noises in one or both ears (often described as ringing, buzzing, hissing, humming, whistling, roaring or pounding)
  • Hearing loss
  • Sleep disturbances
  • Emotional distress

Tinnitus Prevention

  • Prompt antibiotic therapy can avert the disorder in cases of otitis media or other ear infections.
  • Noise-induced tinnitus can be prevented by avoiding loud sounds or using ear plugs or muffs.
  • Drug-induced tinnitus can be prevented by avoiding the drugs mentioned above.
  • Avoid smoking and drinking alcohol and caffeine.

Diagnosis of Tinnitus

  • A patient interview and physical examination, including a detailed description of the sounds and when they occur, are conducted.
  • Audiometry (hearing tests) may be used to measure any hearing loss.
  • X-rays or ultrasound scans may be used to detect a tumor or other abnormality.

How to Treat Tinnitus

  • Background sound or static (white noise) from a radio or television may successfully mask tinnitus and help sufferers to fall asleep.
  • Sedatives may be prescribed to alleviate chronic sleep disturbance, although this is not recommended as a long-term solution.
  • Hearing aids can amplify ambient sound and drown out tinnitus.
  • In more severe cases tinnitus masking may be prescribed by an otolaryngologist (ear, nose and throat specialist). Masking utilizes white noise or a more pleasant sound that often successfully inhibits tinnitus for several hours after use.
  • Tinnitus and depression may co-exist. Consult your doctor if you develop any symptoms of depression.
  • Tinnitus clinics and support groups are available in most major cities. They offer programs that improve coping skills.
  • Surgery may be used to correct an underlying disorder, such as a tumor, but may be ineffective in eliminating the tinnitus.

When to Call a Doctor

Call a doctor if ringing, buzzing or other sounds disrupt daily activities or sleeping habits. Your physician may refer you to an otolaryngologist for further evaluation and treatment.


Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference

Simeon Margolis, M.D., Ph.D., Medical Editor

Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50

Updated by Remedy Health Media

Publication Review By: the Editorial Staff at HealthCommunities.com

Published: 24 Aug 2011

Last Modified: 13 Jan 2015