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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Tinnitus

What is it?

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 It?

  • 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 (see these disorders for more information).
  • 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.
  • Drugs such as caffeine, aminoglycosides, aspirin, propranolol, levodopa, and quinidine can cause tinnitus.
  • In some cases no cause can be established.

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.

Diagnosis

  • 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 It

  • 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 (see Depression for more information).
  • 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.