Tinnitus

What is tinnitus?

Tinnitus is often described as ringing in the ears. It may also be described as:

• the sound of escaping air, running water, or the inside of a seashell
• a hissing, roaring, whistling, chirping, clicking, sizzling, musical, buzzing, or humming noise.

Over 50 million Americans have tinnitus.

How does it occur?

The exact cause of tinnitus is not known. Problems that can cause tinnitus or make it worse are:

• wax buildup or foreign objects in the ear canal
• ear or sinus infections
• Ménière's disease
• ear, head, or neck injury
• otosclerosis, which is growth of the bone surrounding the middle and inner ear
• exposure to loud noise
• hearing loss due to aging
• cardiovascular disease, such as blocked arteries or an aneurysm
• diseases of the central nervous system such as multiple sclerosis
• certain types of tumors
• anxiety, depression, or stress
• heavy smoking
• jaw misalignment, causing stress around the temporomandibular joint (TMJ)
• thyroid disorders.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. Depending on other symptoms you may have, you may have one or more of the following tests:

• hearing test
• X-rays of your head
• angiography (blood vessel studies)
• CT or MRI scan of your head.

How is it treated?

Tinnitus usually lessens or goes away with time. If it persists, treatments your healthcare provider may recommend are:

• Hearing aids if you have hearing loss.
• Biofeedback, which is a relaxation technique that teaches you to control certain body functions such as pulse, muscle tension, and brain wave activity.
• Medicines, including anti-anxiety drugs and antidepressants, which can help you adjust to the irritation of the tinnitus.
• Medicines, including antihistamines, anticonvulsants, an anesthetic such as lidocaine, or vasodilators, which in some cases can decrease the tinnitus.
• Masking the tinnitus with competing sounds, such as low-level music, clocks, or other noises. This may make it easier to ignore the tinnitus and help you concentrate and sleep better.
• Tinnitus retraining therapy (TRT), which combines low-level, steady background sounds with counseling. This combination helps you grow unaware of the sounds of tinnitus. TRT can take 12 to 24 months.
• Dental treatment if you have temporomandibular joint (TMJ) syndrome.

How long will the effects last?

There is no known cure for some causes of tinnitus. The sounds in your ears may go away after a time or they may continue constantly or occasionally throughout your life. Treatment may give some relief, but you may need to change your expectations of a cure. You may need to learn to live with the tinnitus or drown it out with competing sound.

How can I take care of myself?

• Stress and fatigue can affect tinnitus. Take time to relax.
• Alcohol, nicotine, caffeine, and certain foods can make tinnitus worse. Talk with your healthcare provider about this.
• If you have hearing loss, avoid further damage by protecting yourself with earplugs or earmuffs or by avoiding noisy events.
• Some medicines can cause tinnitus or make it worse. Aspirin is the most common example of such medicines. Be sure that you tell all healthcare providers who treat you about all medicines you are taking, including nonprescription products, vitamins, and natural remedies.

How can I help prevent tinnitus?

A common cause of tinnitus can be avoided by staying away from loud noises. Use ear protectors when you are in a noisy environment.