Tinnitus: Symptoms, Causes, Treatment


Tinnitus, or ringing in the ears, is the sensation of hearing ringing, buzzing, hissing, chirping, whistling, or other sounds. It can arise in the outer ear, the middle ear, the inner ear and the brain. Tinnitus can be an acute condition or a chronic health disease. It is often a symptom of other underlying conditions such as age-related hearing loss, ear injury or a circulatory system disorder.

Tinnitus is very common, affecting an estimated 50 million adults in the U.S.


In general, there are two types of tinnitus:

  • Subjective Tinnitus. It is the most common type of tinnitus. Subjective tinnitus is usually caused by ear problems in the outer, middle or inner ear. It can also be caused by problems with the hearing nerves or part of the brain.
  • Objective Tinnitus. It is a rare type, registering less than 1% of total tinnitus cases. It is caused by a blood vessel problem, a middle ear bone condition or muscle contractions. The sounds triggered by objective tinnitus are usually produced by internal functions in the body’s circulatory and somatic systems.


The common cause of tinnitus is inner ear hair cell damage. If the hairs inside your inner ear are bent or broken, they can “leak” random electrical impulses to your brain, causing tinnitus. There are also many factors that lead to tinnitus:

  • Prolonged exposure to loud sounds
  • Earwax blockage
  • Ear bone changes
  • Age-related hearing loss
  • Meniere’s disease
  • Otosclerosis
  • High blood pressure
  • Injuries to the head and neck
  • Cardiovascular disease
  • Autoimmune disease
  • Circulatory problems
  • Diabetes
  • Anemia
  • Allergies
  • Certain medications (as a side effect)


The major symptom of tinnitus is a noise in the ears, such as ringing, roaring, buzzing, hissing, or whistling. The noise can be intermittent or continuous. In most cases, only the person with tinnitus can hear it, which is a subjective tinnitus. However, in some cases, the doctor can also hear it by putting a stethoscope in the ear, which is an objective tinnitus.


The diagnosis begins with a complete physical examination of the ear, head, neck, and torso to look for possible causes of tinnitus. Besides, the following tests and procedures may be ordered:

  • Hearing test. An audiogram or hearing test may be performed to look for associated hearing loss in one or both ears. The patients will sit in a soundproof room wearing earphones with specific sounds into one ear at a time. The patients will indicate what kind of sound they hear, and the results are compared with normal ones for the same age.
  • Movement. The doctor may ask the patient to move eyes, clench jaw, or move neck, arms and legs. If tinnitus changes or worsens, it may help identify an underlying disorder.
  • Imaging tests. Some imaging tests may be performed to check the head, neck and the structures of the ears. These tests may include CT scan, MRI and ultrasound.
  •  Blood tests. In some cases, the blood pressure and blood tests are conducted to evaluate thyroid gland function.


There are various treatment options depending on different underlying causes of tinnitus. In most cases, tinnitus may last for weeks or months, and then resolve spontaneously. For some people, it may last for years. Here are some measures a person can do to manage tinnitus and its effects:

  • Sound therapy. It uses external noise to mask the patient’s perception of tinnitus, such as low-level background music, white noise, or specialized ear maskers. Masking devices offer temporary relief, and the awareness of tinnitus returns when the sound therapy is stopped. Hearing aids are a common type of sound therapy. They amplify environmental sounds and shift attention to these sounds instead of the tinnitus.
  • Tinnitus retraining therapy (TRT). It restrains the auditory system to accept the abnormal sounds of tinnitus as natural rather than disruptive. Patients wear a device that emits low-level white noise.
  • Medications. Drugs can’t cure tinnitus, but they can help reduce the severity of symptoms or complications. Possible medications include tricyclic antidepressants, such as amitriptyline and nortriptyline. However, they are used for only severe tinnitus, as they can cause some troublesome side effects. Alprazolam may also help reduce tinnitus symptoms, but it can become habit-forming.

Keywords: Tinnitus.

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* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.