Tinnitus

If you’ve got a noise in your ear and you’re not sure where it’s coming from, it’s likely you have tinnitus.

Tinnitus can manifest as a roaring, hissing, buzzing, ringing or pulsating sound that can affect one or both ears, and has no external source. You may notice that it appears suddenly, or builds gradually, (depending on the type of tinnitus you have, and what’s causing it), but however it appears, it can have a serious impact on your daily life.

Here, we’ll look at some of the key information about tinnitus, including how to minimise the distress it can cause.

Despite being a common hearing health condition, there’s still much we don't know and understand about tinnitus – including exactly what causes it. However, there are a few common contributing factors, such as:

• Earwax buildup

Too much earwax can block your ear canal, which can affect your hearing and eardrum, and cause tinnitus.

• Eardrum perforation 

Injuries to or infections in your outer or middle ear can result in a ruptured eardrum, and this can cause tinnitus.  

• Ear infection

You might experience temporary tinnitus as a result of an infection in your middle ear, as the increased amount of fluid can affect your hearing. Your tinnitus should ease once the infection has cleared up.

• Medication side effects

Some medicines, such as antibiotics, aspirin, chemotherapy medication and non-steroidal anti-inflammatory drugs (NSAIDs) can cause tinnitus.

• Prolonged exposure to loud noise

Listening to music at too high a volume, as well as sirens, machinery and traffic can all cause tinnitus if you’re exposed for a long period of time.

• Cholesteatoma

​Often caused by an ear infection, this growth of skin cells collects behind the eardrum, and can lead to hearing loss and tinnitus.

• Illness

Diseases and conditions such as multiple sclerosis and cancers in the throat, nose or brain can cause tinnitus that usually only affects one ear (unilateral tinnitus).

• Ménière’s disease

​This disease can cause a build-up of fluid in your inner ear, which can result in tinnitus, as well as dizziness and hearing loss.  

Some of these causes are temporary, and your tinnitus should subside a few days after your exposure, infection or condition has eased. However, if your symptoms are severe and persist for longer than a few days, make sure you speak to your GP or a hearing healthcare professional.

There are three types of tinnitus. While all cause sounds with no apparent external source, they are all distinct.

• Subjective tinnitus

This is the name given to the sounds you hear that don’t have a particular source (such as buzzing, hissing or ringing) that are typically associated with tinnitus. This is the most common type of tinnitus. It only affects the sufferer, and is usually caused by the way the nerves responsible for your hearing communicate with your brain, or by issues in your ear.

• Pulsatile tinnitus

With this type of tinnitus, the buzzing, hissing or ringing sounds usually come in time to the rhythm of your heartbeat. Usually brought on when blood flow around your head, neck and ears is constricted, pulsatile tinnitus can be a symptom of an underlying condition or illness, so it’s always best to get it assessed by your doctor or hearing healthcare specialist. 

• Objective tinnitus 

This is much more rare than subjective and pulsatile tinnitus as the buzzing, hissing and ringing sounds are heard not just by the sufferer, but by those who are in close proximity to them. Typically, objective tinnitus is caused by muscle contractions, or the blood vessels in the ear narrowing, which produces sound.

If you have any symptoms of tinnitus, it’s always best to speak to your doctor or a hearing specialist so they can make sure there are no underlying causes that need treatment, and so they can help you manage your symptoms.

Whether your tinnitus is new, has come on suddenly or been building for a while, or is getting worse, it’s important that you speak to your GP so that they can assess your ears and diagnose the issue.

They’ll review your symptoms, and ask: 

• Whether the sounds affect one or both ears 
• Whether the sounds are constant or intermittent 
• Whether your hearing is affected 

They’ll also talk through your medical history.

As well as this, your doctor will examine your ears using an otoscope, checking to see if there are problems such as earwax build-up or an infection that could be causing your tinnitus.

If only one ear is affected and there’s no obvious cause, your doctor may refer you for an MRI or CT scan to investigate further and determine any underlying cause.

Tinnitus has one main symptom: hearing sound that’s not associated with any external cause. This can be anything from hissing and waves crashing to full-on roaring, buzzing, whistling or ringing; what you hear varies from person to person.
 
The volume level of the phantom noises may vary or stay constant, and the noises themselves may come and go completely. 

• Secondary symptoms of tinnitus include:
• Hearing that’s not as good as before
• Sensitivity to everyday sounds (hyperacusis)

If you have persistent tinnitus, it’s only in one ear, or if your tinnitus is accompanied by dizziness and/or balance issues, make sure you speak to your doctor.

Treatment for tinnitus varies and there’s no single cure. 

If your tinnitus is due to an underlying cause, such as an ear infection, treating or eliminating the cause can sometimes make the tinnitus go away. Where your tinnitus has no discernible cause, treatment will focus almost exclusively on symptom relief and management.

Possible tinnitus treatments include:

• Earwax removal

Whether carried out by your doctor or a hearing care specialist, such as our team, earwax removal can help alleviate tinnitus symptoms.  

• Medication changes

If your doctor suspects your medication could be contributing to your tinnitus, they may suggest changing it and monitoring your tinnitus symptoms. 

• White noise or sound therapy

Background sound, such as the TV, radio or natural sounds, can help make your tinnitus much less noticeable.

• Hearing aids

If your tinnitus is intermittent, or if you don’t notice it all the time, you may benefit from hearing aids that can adjust the tinnitus sounds.

• Counselling and therapy

Tinnitus can be very distressing, particularly where it affects everyday life, so therapy such as Tinnitus Retraining Therapy (TRT) or Cognitive Behavioural Therapy (CBT) can be helpful for changing the way you think about and react to your tinnitus.

Your GP will be able to advise on the best methods of treatment for your tinnitus.

If you suffer from tinnitus, you might also find that your hearing is affected. If this persists once any underlying cause, such as an infection, has been treated and cleared up, it’s important that you speak to your GP.

They may refer you to an ear, nose and throat (ENT) specialist, who will be able to investigate further. They’ll also be able to suggest ways to deal with the issue, such as hearing aids, or help you manage the condition.

If your tinnitus comes and goes or isn’t always noticeable, hearing aids may be helpful in combating any disturbance.

Some hearing aids have tinnitus programmes that can mask your tinnitus sounds by emitting their own sounds. This can be set through a button, remote or through connecting to an app on your phone that you can use to adjust the sounds. This can help keep your brain ‘busy’ so that the tinnitus sounds are less noticeable.

If you’d like to find out more about how hearing aids can help you manage tinnitus, speak to one of our hearing healthcare professionals.