What is Tinnitus?

Tinnitus (TIN-i-tus) is noise or ringing in the ears. A common problem, tinnitus affects about 1 in 5 people. Tinnitus isn't a condition itself — it's a symptom of an underlying condition, such as age-related hearing loss, ear injury or a circulatory system disorder.

Although bothersome, tinnitus usually isn't a sign of something serious. Although it can worsen with age, for many people, tinnitus can improve with treatment. Treating an identified underlying cause sometimes helps. Other treatments reduce or mask the noise, making tinnitus less noticeable.

Causes

A number of health conditions can cause or worsen tinnitus. In many cases, an exact cause is never found.

A common cause of tinnitus is inner ear cell damage. Tiny, delicate hairs in your inner ear move in relation to the pressure of sound waves. This triggers ear cells to release an electrical signal through a nerve from your ear (auditory nerve) to your brain. Your brain interprets these signals as sound. If the hairs inside your inner ear are bent or broken, they can "leak" random electrical impulses to your brain, causing tinnitus.

Other causes of tinnitus include other ear problems, chronic health conditions, and injuries or conditions that affect your auditory nerves or the hearing center in your brain.

Age-related hearing loss. For many people, hearing worsens with age, usually starting around age 60. Hearing loss can cause tinnitus. The medical term for this type of hearing loss is presbycusis.Exposure to loud noise. Loud noises, such as those from heavy equipment, chain saws and firearms, are common sources of noise-related hearing loss. Portable music devices, such as MP3 players or iPods, also can cause noise-related hearing loss if played loudly for long periods. Tinnitus caused by short-term exposure, such as attending a loud concert, usually goes away; long-term exposure to loud sound can cause permanent damage.Earwax blockage. Earwax protects your ear canal by trapping dirt and slowing the growth of bacteria. When too much earwax accumulates, it becomes too hard to wash away naturally (cerumenal impaction), causing hearing loss or irritation of the eardrum, which can lead to tinnitus.Ear bone changes. Stiffening of the bones in your middle ear (otosclerosis) may affect your hearing and cause tinnitus. This condition, caused by abnormal bone growth, runs in families.Other causes of tinnitusSome causes of tinnitus are less common. These include:

Meniere's disease. Doctors think this inner ear disorder is caused by abnormal inner ear fluid pressure or composition.Stress and depression. These conditions are commonly associated with tinnitus and seem to aggravate it.TMJ disorders. Problems with the temperomandibular joint, the joint on each side of your head in front of your ears, where your lower jawbone meets your skull, can cause tinnitus.Head injuries or neck injuries. These neurological
disorders can affect the inner ear, hearing nerves or brain function linked to hearing. Head or neck injuries generally cause tinnitus in only one ear.Acoustic neuroma. This noncancerous (benign) tumor develops on the cranial nerve that runs from your brain to your inner ear and controls balance and hearing. Also called vestibular schwannoma, this condition generally causes tinnitus in only one ear.Blood vessel disorders linked to tinnitus. In rare cases, tinnitus is caused by a blood vessel disorder. This type of tinnitus is called pulsatile tinnitus. Causes include:

Head and neck tumors. A tumor that presses on blood vessels in your head or neck (vascular neoplasm) can cause tinnitus and other symptoms.Atherosclerosis. With age and buildup of cholesterol and other deposits, major blood vessels close to your middle and inner ear lose some of their elasticity — the ability to flex or expand slightly with each heartbeat. That causes blood flow to become more forceful and sometimes more turbulent, making it easier for your
ear to detect the beats. You can generally hear this type of tinnitus in both ears.High blood pressure. Hypertension and
factors that increase blood pressure, such as stress, alcohol and caffeine, can make tinnitus more noticeable.

Turbulent blood flow. Narrowing or kinking in a neck artery (carotid artery) or vein in your neck (jugular vein) can cause turbulent blood flow, leading to tinnitus.Malformation of capillaries. A condition called arteriovenous malformation (AVM), which occurs in the connections between arteries and veins, can result in tinnitus. This type of tinnitus generally occurs in only one ear.Medications that can cause tinnitus

A number of medications may cause or worsen tinnitus. Generally, the higher the dose of medication, the worse tinnitus becomes. Often the unwanted noise disappears when you stop using these drugs.

Symptoms

Tinnitus involves the annoying sensation of hearing sound when no external sound is present. Tinnitus symptoms include these types of phantom noises in your ears:

Ringing
Buzzing
Roaring
Clicking
Whistling
Hissing

The phantom noise may vary in pitch from a low roar to a high squeal, and you may hear it in one or both ears. In some cases, the sound can be so loud it can interfere with your ability to concentrate or hear actual sound. Tinnitus may be present all the time, or it may come and go.

There are two kinds of tinnitus.

Subjective tinnitus is tinnitus only you can hear. This is the most common type of tinnitus. It can be caused by ear problems in your outer, middle or inner ear. It also can be caused by problems with the hearing (auditory) nerves or the part of your brain that interprets nerve signals as sound.Objective tinnitus is tinnitus your doctor can hear when he or she does an examination. This rare type of tinnitus may be caused by a blood vessel problem, an inner ear bone condition or muscle contractions.

Western Medicine:

To treat your tinnitus, your doctor will first try to identify any underlying, treatable condition that may be associated with your symptoms. If tinnitus is due to a health condition, your doctor may be able to take steps that could reduce the noise. Examples include:

Earwax removal. Removing impacted earwax can decrease tinnitus symptoms.Treating a blood vessel condition.

Underlying vascular conditions may require medication, surgery or another treatment to address the problem.

Changing your medication. If a medication you're taking appears to be the cause of tinnitus, your doctor may recommend stopping or reducing the drug, or switching to a different medication.Noise suppression In some cases "white noise" may help suppress the sound so that it's less bothersome. Your doctor may suggest using an electronic device to suppress the noise. Devices include:

White noise machines. These devices, which produce simulated environmental sounds such as falling rain or ocean waves, are often an effective treatment for tinnitus. You may want to try a white noise machine with pillow speakers to help you sleep.Hearing aids. These can be especially helpful if you have hearing problems as well as tinnitus.

Masking devices. Worn in the ear, similar to hearing aids, these devices produce a continuous, low-level white noise that suppresses tinnitus symptoms.Tinnitus retraining. A wearable device delivers individually programmed tonal music to mask the specific frequencies of the tinnitus you experience. Over time, this technique may accustom you to the tinnitus, thereby helping you not to focus on it. Counseling is often a component of tinnitus retraining.

Drugs can't cure tinnitus, but in some cases they may help reduce the severity of symptoms or complications.


Adopted from Wei Laboratories, Inc. and the Mayo Clinic