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Tinnitus - Ringing Sounds in the Ears

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Tinnitus - Ringing Sounds in the Ears

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Tinnitus is the presence of noise or sound in the ear. It can occur due to diseases in the ear or any systemic diseases like high blood pressure. The management involves thorough hearing testing and further treatment based on the cause.

Medically reviewed by

Dr. Sneha Kannan

Published At May 4, 2014
Reviewed AtFebruary 6, 2024

What Is Tinnitus?

Tinnitus is ringing sounds in the ears. The person experiencing it may describe it as roaring, humming, or a hissing sound in the ears. This kind of noise can be very annoying and disturbing to the one facing this problem. A steady and high-pitched ringing sound in the ears is the most common form of tinnitus. Although annoying, this type of tinnitus does not indicate a severe complication. Sometimes it may be so intense as to disturb a person's sleep. Tinnitus can be temporary or permanent. Although tinnitus is associated with hearing loss, it is not the cause. Also, hearing loss does not bring about tinnitus. Tinnitus is not linked to hearing difficulty. True to this fact, some people with tinnitus might become overly sensitive to sounds, and this condition is called hyperacusis. These people require ways to keep them away from external noises.

What Is the Cause of Tinnitus?

Tinnitus can occur due to many reasons or no reason at all. If you have factors such as wax, infection, fluid in-ear, or middle ear diseases, you may experience sounds. The following are the causes of tinnitus:

  • When a sound wave is received, the delicate and tiny hair cells in the ear move, triggering electrical signals which move from the ear to the brain. With aging or increased exposure to excessive sounds, these hairs bend down or are broken, leading to leaving impulses.

  • Blockage of the ear due to earwax, fluid buildup, dirt, or foreign materials results in a change in pressure within the ear leading to tinnitus.

  • An injury to the head and neck impacts the hearing functions of the brain, inner ear, and hearing nerves resulting in tinnitus.

  • Exposure to loud noises and taking harmful medicines damaging the inner ear commonly results in tinnitus. Drugs like non-steroidal anti-inflammatory drugs (NSAIDs), antidepressants, diuretics, cancer drugs, antimalarial drugs, and certain antibiotics can cause or worsen tinnitus.

  • Meniere’s disease is an inner ear disorder characterized by abnormal internal ear pressure that indicates tinnitus at an early stage.

  • Eustachian tube dysfunction is characterized by tube expansion connecting the middle ear and throat.

  • Otosclerosis or stiffening of bones in the middle ear.

  • Inner ear muscle spasms.

  • Acoustic neuroma.

  • Tumors of the head and neck.

  • Malformed blood vessels, atherosclerosis, and other vascular disorders.

  • Temporomandibular joint disorders.

  • Thyroid disorders, autoimmune disorders, migraines, etc.

  • People who have high blood pressure, diabetes, and are anemic are also more prone to get tinnitus. Some diseases of the nervous system can rarely cause tinnitus.

  • More commonly, stress and anxiety play a role in causing or aggravating the existing sounds.

What Increases the Risk of Developing Tinnitus?

  • Exposure to loud noises from heavy equipment, firearms, chain saws.

  • Long periods of exposure to sound from portable music devices.

  • Men have an increased risk.

  • Increasing age

  • Smoking and drinking alcohol.

  • Obesity, cardiac diseases, history of trauma to head, hypertension, arthritis.

How Can We Diagnose Tinnitus?

  1. Audiological Examination: If you have tinnitus, getting a thorough ENT examination is essential. Your doctor will also advise you to undergo hearing tests called audiometry. This test is done in a soundproof room with earphones. Sound is played in one ear at a time, and the test results are compared with the typical results for each age group.
  2. Movement: Worsening of tinnitus with movements like moving the eyes, clenching the jaws, and moving the arms, neck, and legs help in identifying an underlying condition.
  3. Laboratory Investigations: The blood tests are taken to determine anemia, thyroid disorders, vitamin deficiencies, and cardiac diseases.
  4. Imaging Tests: Imaging tests like CT scan and MRI scan are taken to diagnose tinnitus.

How Is Tinnitus Treated?

1. Whenever possible, the cause of tinnitus needs to be rectified. The following are the causative treatments:

  • Earwax blockage is removed to minimize the symptoms of tinnitus.

  • Tinnitus caused by vascular disorders is treated by surgery or medication to treat the vascular problem.

  • If tinnitus is due to age-related hearing loss or noise-related, hearing aids are used in the treatment.

  • Tinnitus caused by drugs is treated by stopping the medication and replacing it with an alternative.

2. Your doctor may then put you on anti-anxiety medicines. The important thing would be to not concentrate on the sound and try relaxation techniques.

3. People, who have an associated hearing problem and tinnitus, will benefit from using a hearing aid. Patients who have disturbed sleep due to tinnitus will be advised to use a loud clicking clock/high-speed fan at night. These measures will help mask the existing sounds in the ear.

4. Also, there are some devices called tinnitus maskers that are available in the market, and they will mask the existing noises in the ear and help you.

5. For patients who have to live with tinnitus, behavioral therapies like tinnitus retraining therapy (TRT) and cognitive behavioral therapy (CBT) help in bringing about behavioral modifications.

How Can We Prevent Tinnitus?

  1. Use hearing protection aids when working or exposed to places that have loud noises.

  2. Keep low volume when using portable music devices.

  3. Restrict the intake of caffeine, alcohol, and nicotine.

  4. Prevent obesity and other cardiovascular disorders by taking a healthy diet and doing regular exercises.

What Are the Complications of Tinnitus?

The following are the complications of tinnitus:

  • Difficulty sleeping.

  • Stress.

  • Fatigue.

  • Anxiety and depression.

  • Fussiness.

  • Memory problems.

  • Difficulty in concentrating.

  • Headache.

  • Problems in family and work life.


Tinnitus is a disturbing condition that brings about problems in both personal and professional life. If you experience any of the symptoms, it is advisable to consult with your ENT specialist rather than sticking to home-treatment methods. With proper treatment, tinnitus can be managed.

Frequently Asked Questions


Why Do I Keep Hearing a Ringing Noise?

Constant ringing sounds within the ear in the absence of an external sound are known as tinnitus. Following are some potential causes of tinnitus,
- Hearing loss.
- Normal or abnormal blood flow near the ears.
- Meniere’s disease.
- Abnormal growths within the ear.
- Abnormalities in the brain.
- Blood vessel disorders in the brain.
- Fluid in the ears.
- Temporomandibular joint disorders.
- Constant exposure to high sound levels.


Should I Be Concerned About Tinnitus?

Most of the time, tinnitus is not due to a serious cause. But persistent tinnitus that worsens with time can be due to serious conditions like hearing loss, a tumor within the ear or problems with brain function and can severely impact an individual’s mental health, sleep, and ability to concentrate. Consult a physician or audiologist to make sure the tinnitus is of less severe origin.


Is Tinnitus Really Serious?

Tinnitus is often not serious and does not cause any serious health complications by itself. Still, the underlying cause for tinnitus must be ruled out to look for any underlying severe causative factor requiring immediate medical intervention.


Is Tinnitus a Disability?

While mild tinnitus does not affect one’s life and 80% of people with mild tinnitus learn to live with it, it certainly affects their daily lives in people with persistent tinnitus, making it a disability.


Is Tinnitus More Common?

Tinnitus is a common condition affecting approximately 10 to 20% of the population. However, it is more common in the elderly population.


What Factors Trigger Tinnitus Attacks?

- Stress.
- Alcohol.
- Nicotine products.
- Loud noises.
- Less sleep.


What Sounds Does One With Tinnitus Hear?

Below are the sounds that people with tinnitus experience:
- Heartbeat sounds (pulsatile tinnitus).
- Buzzing.
- Ringing.
- Hissing.
- Whizzing.
- Roaring.
- Whistling.
- Screeching.
- Ocean-wave sounds.


For What Duration Does Tinnitus Last?

Tinnitus can either be intermittent or persistent. It can last from a few minutes to hours or weeks and then vanish away or permanently remain throughout life.


How Should I Sleep if I Have Tinnitus?

- Arrange a sound device in your bedroom that can produce constant low-level soothing sounds while you sleep.
- Relax before you sleep.
- Avoid watching television or using electronic gadgets hours before your sleep time.
- Avoid alcohol and nicotine products.
- Limit caffeine intake in the evening or at night.
- Create a cool ambiance so that sleep can be induced easily.


What Medications Are Liable to Cause Tinnitus?

Ototoxic medications or medications that can lead to ear damage with increased doses can lead to tinnitus. Such medications are,
- Aspirin.
- Antibiotics (Gentamicin, Erythromycin, etc.).
- Diuretics (Furosemide, Bumetanide, etc.).
- Ibuprofen.
- Chemotherapy agents (Cisplatin, Vincristine, etc.).


Supplementation of Which Vitamin Resolves Tinnitus?

Vitamin B12 supplementation can help regulate neurologic and circulatory functions, which are essential for the proper functioning of the nerves and vessels of the ear.


Will Tinnitus Resolve?

In most conditions with unidentifiable causes, tinnitus does not go away. But treatment options can help mask the noise or reduce the intensities of the tinnitus and train an individual to live with it.


How to Get Relief From Tinnitus?

- Using hearing aids.
- Constantly hearing too low sounds to distract oneself from focussing on the tinnitus.
- Eliminating certain trigger factors like caffeine, alcohol, stress, etc.


How to Effectively Manage Tinnitus?

Tinnitus can be managed but not cured permanently. Treating an ear infection or temporomandibular joint problem if present and stopping the use of ototoxic medications are beneficial.
- Hearing Aids - Tinnitus due to hearing loss can best be managed with the use of hearing aids.
- Masking Devices - These small devices fit inside the ear and create constant sounds to mask the inner tinnitus. There are also tabletop sound masking devices available.
- Behavioral Therapy - Behavioral therapy can benefit people with insomnia, anxiety, and depression due to tinnitus.
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Dr. Vaishali Mehta
Dr. Vaishali Mehta

Otolaryngology (E.N.T)


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