Noise in the ears (tinnitus): causes and methods of treatment

Many people occasionally hear some kind of noise in their ears (it could be ringing, squeaking, buzzing, or something else) in the absence of any actual sound. Most often, this phenomenon passes quickly and does not cause us much concern. But if tinnitus is heard constantly and causes severe discomfort, it is important to determine the cause in time and begin treatment.

Persistent and severe tinnitus can be caused by many different diseases: including hearing disorders, and disorders of the brain and cardiovascular system. Let’s take a closer look at the possible causes of tinnitus, methods of diagnosis, treatment and prevention of this disorder.

What is tinnitus?

Noise in the ears (tinnitus): causes and methods of treatment

The word “tinnitus” comes from the Latin tinnere, which means “to ring.” Tinnitus is the subjective perception of sound in the absence of real sound stimuli (the sound is heard only by the patient himself, but not by others). Often this noise is perceived as ringing, squeaking, or buzzing, but other types of sounds are also possible. Tinnitus can occur sporadically (which may be normal) or be chronic.

Types of tinnitus

Depending on the cause and nature of the sounds heard, tinnitus is divided into several types:

Subjective tinnitus The most common type of disorder is that sounds are audible only to the patient himself; they are not heard by others or by the doctor during examination.
Objective tinnitus With this type of tinnitus, the noise that the patient hears actually exists and is associated with vascular pathologies or other disorders. The doctor may hear this noise during the examination.
Neurological tinnitus This disorder is associated with disruption of the auditory nerves (such as Meniere’s disease)
Somatic tinnitus This type of tinnitus is associated with abnormal nerve impulses that irritate the auditory organs. With somatic tinnitus, tinnitus may increase with certain movements or touching certain areas of the face and body.

Causes of noise in the ears and head

Tinnitus can be caused by problems directly in the hearing organs or by disturbances in the functioning of the nervous or cardiovascular system.

1. Mechanical damage

Tinnitus can be caused by mechanical damage to certain parts of the auditory system – this can occur, for example, as a result of traumatic brain injury or acoustic trauma caused by exposure to too loud sounds.

2.Stress and anxiety

Increased anxiety can cause not only psychological discomfort, but also physiological symptoms. Research shows that people with anxiety disorders are much more likely to experience tinnitus [1]. Anxiety and stress can also aggravate tinnitus symptoms.

3. Damage to the auditory nerve

The auditory (cochlear) nerve carries sensory information from the inner ear to the brain. Damage to the auditory nerve due to infection, inflammation, or injury can result in “phantom” sounds.

4. High blood pressure

High blood pressure , as well as atherosclerosis and other vascular diseases, can cause tinnitus due to increased and uneven blood flow to the inner ear and other hearing organs [2].

5. Meniere’s disease

This is the name of a disease of the inner ear caused by the accumulation of excess fluid (endolymph) in its cavity. In most cases of this disorder, patients also complain of noise or ringing in the ears [3].

6. Otosclerosis

This disease is associated with degenerative processes in the bone tissue of the inner ear. Most people with otosclerosis experience symptoms of tinnitus.

7. Neoplasms

Both benign and malignant tumors of the ear, auditory nerve, and brain can put pressure on the hearing organs and also impair circulation, causing tinnitus.

8. Wax plugs

Earwax is produced by the glands of the external auditory canal. It lubricates the ear canal, protects it from moisture and has antibacterial properties. However, excess accumulation of earwax can lead to the formation of wax plugs. Earwax can cause hearing loss, a feeling of fullness in the ear, and tinnitus.

9. Side effects of medications

Some medications have ototoxic properties and may interfere with normal hearing function. Tinnitus as a side effect can be caused by antibiotics, non-steroidal anti-inflammatory drugs, drugs used to treat cancer, psychotropic drugs, and drugs for the treatment of hypertension.

Which doctor should I contact for tinnitus?

When tinnitus appears, it is important to understand that it can very often be combined with sensorineural hearing loss, and in order for its treatment to be effective, it is important to start it as early as possible, so it is necessary to seek qualified medical help as soon as possible. An audiologist-otoneurologist directly diagnoses and treats tinnitus and sensorineural hearing loss. For an initial consultation, you can also contact an otolaryngologist (ENT doctor).

Diagnosis of tinnitus

To make a correct diagnosis, the doctor will need to collect an anamnesis of the disease and conduct an examination; if necessary, he may also prescribe certain tests, for example:

  • tone threshold audiometry (allows you to check hearing acuity);
  • blood tests;
  • MRI of the brain;
  • Ultrasound of the vessels of the skull base with rotation tests (during the examination, the patient alternately turns his head in different directions);
  • other studies to assess the condition of the hearing organs (video-otoscopy, impedance measurement, tympanometry, etc.).

How to get rid of tinnitus: treatment of tinnitus

Treatment options for tinnitus primarily depend on the cause of the symptom. Correct diagnosis of the disorder is important to prescribe effective therapy. Here are the main treatments for tinnitus:

1. Tablets and medications

In some cases, drug treatment is indicated for tinnitus. Anti-anxiety medications and antidepressants can reduce the discomfort of tinnitus, thereby reducing anxiety and stress, which themselves worsen tinnitus symptoms. In this way, they help the patient break the “vicious circle” (tinnitus causes stress, which further increases the discomfort of tinnitus, which causes even more stress).

The doctor may also prescribe medications that reduce increased nervous activity in the auditory system or drugs to improve cerebral circulation.

At the same time, certain medications (some antibiotics, antitumor drugs, nonsteroidal anti-inflammatory drugs, etc.) themselves can cause tinnitus as a side effect, and discontinuation of these medications may be sufficient to eliminate tinnitus.

2. Ear drops

If tinnitus is caused, for example, by inflammatory diseases of the ear (otitis media, etc.) or accumulation of earwax, the doctor may prescribe ear drops to eliminate the cause of tinnitus.

3. Surgically

Some conditions that cause tinnitus may require surgery to treat the underlying cause of tinnitus (for example, Meniere’s disease, otosclerosis, or tumors affecting the hearing organs).

4. Hearing aids

If tinnitus is accompanied by hearing loss, using a hearing aid can help amplify external sounds, which in itself masks the tinnitus. Some hearing aids can also generate white noise, drowning out “phantom” sounds [4].

5. Psychotherapy

Cognitive behavioral psychotherapy (CBT) can help reduce the discomfort of tinnitus, improve the patient’s quality of life, and reduce anxiety and depressive symptoms caused by tinnitus [5].

What can you do for tinnitus at home?

The symptoms of tinnitus can often be dealt with on your own (which, of course, does not exclude medical examination and possible treatment). Maintaining a healthy lifestyle and minimizing stress plays an important role. Here are some tips to help reduce the discomfort of tinnitus:

  • Try to eliminate factors that aggravate symptoms . In some cases, drinking alcohol, caffeine, salty foods, or certain medications can worsen tinnitus symptoms.
  •  If possible, stop smoking . Smoking increases the risk of developing hearing disorders, including tinnitus.
  •  Avoid complete silence . In silence, tinnitus is usually subjectively felt more strongly. In this case, some kind of background sound can help – you can, for example, turn on the radio, a fan, or use a special white noise generator (this method is also effective if tinnitus makes it difficult to fall asleep).
  • Practice relaxation techniques . Anxiety and stress make tinnitus worse. Various relaxation methods can help – for example, yoga, meditation practices, walks in nature, relaxing baths, etc.

 Possible complications if left untreated

If left untreated, severe tinnitus can lead to complications, including:

  • decreased performance and quality of life;
  • irritability;
  • constant fatigue;
  • impaired concentration;
  • problems with memory and sleep;
  • frequent headaches;
  • inexplicable fears;
  • development of anxiety and depressive disorders.

Prevention of tinnitus

The risk of developing tinnitus (and many of the chronic diseases that cause it) can be reduced by following a healthy lifestyle and taking care to protect your hearing. 

  • To prevent tinnitus, it is first of all important to maintain hearing hygiene – avoid exposure to too loud sounds, and if necessary (for example, when there is a high noise level at work), use protective equipment (anti-noise headphones, etc.).
  • It is important to adhere to a proper diet. Eating a healthy diet helps control cholesterol and triglyceride levels in the blood. Increased levels of “bad” cholesterol and triglycerides increase the risk of developing diseases of the cardiovascular system (hypertension, atherosclerosis, etc.), which can lead to the development of tinnitus [6].
  • You should try to minimize your stress level . It is important to maintain a balance between work and rest, establish quality, restful sleep, and eliminate other stress factors. Various relaxation and stress-relieving exercises can also help.

Reviews from an otolaryngologist

Anton Rizaev, an otolaryngologist at the SM-Clinic medical center, spoke about the diagnosis and treatment of tinnitus :

“Tinnitus is a subjective noise in the ears that a person hears in the absence of an external sound stimulus. There are different types of tinnitus: there is a classification according to the degree of severity from mild, which does not significantly affect the patient’s quality of life and performance, to severe, which constantly bothers, significantly complicates sleep and sharply reduces performance. There are also acute (up to 3 months), subacute and chronic (more than 1 year) tinnitus.

Diagnosis of tinnitus, in addition to collecting an anamnesis, must necessarily include pure tone threshold audiometry, MRI of the brain, ultrasound of the vessels of the base of the skull with rotation tests (this way they check whether there is an effect on the blood flow in the vertebral arteries from the spine).

In the treatment of tinnitus, the primary role is played by eliminating, if possible, the causes that led to it; these can be neurological, endocrinological, oncological and other diseases, as well as the use of ototoxic (damaging to the hearing organs) drugs.

For vascular disorders, appropriate medications are used, and in some cases, endovascular surgical interventions cannot be avoided when there are pronounced disturbances in vascular patency. Sometimes manual therapy techniques are used if the cause of tinnitus is associated with diseases of the spine.

Treatment to reduce the impact of tinnitus on quality of life is important. For this purpose, in particular, hearing aids are used. Some have special modes that mask the sound of tinnitus with white noise. Cognitive-behavioral psychotherapy shows good effectiveness in treating tinnitus.”

Reminder: what to do if you experience tinnitus

  •  Tinnitus is an audible noise in the ears (ringing, squeaking, buzzing or other sound) in the absence of an actual sound stimulus.
  • Many people occasionally experience tinnitus; in most cases, this phenomenon goes away quickly and does not cause much discomfort.
  • If tinnitus is felt constantly, causes significant discomfort, interferes with normal life, and is accompanied by other symptoms (dizziness, headaches, throbbing sensation), you should consult a doctor – an otolaryngologist or audiologist.
  • You can fight the symptoms of tinnitus on your own – it is important to avoid too loud sounds (use protective equipment if necessary), maintain a healthy lifestyle (proper diet and sleep, regular physical activity), try to minimize the level of stress in everyday life, and eliminate irritating factors (for example , caffeine, alcohol, smoking, salty foods).