Ringing in the Ears

  • Basics

    Ringing in the ears, or tinnitus, is a condition in which people hear constant or periodic sound not caused by an outside source. The sound can also be described as a ringing, buzzing, or clicking noise that occurs inside the head. Ringing in the ears can be heard in one or both ears, and in the head, and its pitch may be low or high.

    Almost everyone has had a form of ringing in the ears where ringing is heard for several minutes, such as after a firecracker explodes. While this ringing usually goes away in a few minutes or a few hours, it may come back as persistent ringing in the ears years later. Of the 30 to 36 million Americans who have ringing in the ears, seven million cases are so severe that those affected have difficulty performing the activities of daily life. However, most cases of tinnitus are mild.

    Tinnitus is usually a symptom of another physical or psychological problem. It can be a symptom of ear conditions, such as infections or foreign objects or wax in the ear, heart disease, chronic stress, or persistent allergies. Additionally, it may represent a side effect from certain medicines (such as aspirin) or be a manifestation of excessive caffeine, nicotine, or alcohol intake.

    Tinnitus is also linked to hearing loss, although not everyone who has tinnitus experiences a loss of hearing.

    The mechanism that causes tinnitus is not known. Younger people tend to have tinnitus as a result of exposure to loud noise. Older people who experience tinnitus often have a certain amount of hearing impairment related to the natural aging process.

    Currently, there is no cure for tinnitus. Tinnitus is usually treated by addressing the underlying cause. Because it cannot be cured, treatments are offered to help the patient tolerate the noise.

  • Causes

    Exposure to a loud noise may predispose people to tinnitus Table 01. Long exposure to loud noise may cause people to hear sounds that do not exist in the external environment. Loud noises that contribute to tinnitus may be from a rock concert, a firecracker, a gunshot, a lawnmower, or an explosion. The sound may be either a single exposure (such as an explosion) or a continuous one (such as working in a woodworking shop or at a construction site) that damages the hair cells and nerves in the ear.

    Existing physical conditions, such as ear infections or allergies, may cause tinnitus. Ear conditions such as wax build-up, infection, or a hole in the eardrum, as well as heart conditions, allergies, tumors, and injury to the head or neck can cause tinnitus, although researchers still do not understand why. Because tinnitus may be the first sign of a serious illness (for example, a tumor or aneurysm), it is important to discover the underlying physical condition that may be causing it.

    Tinnitus may be a side effect of certain medications or alcohol. Tinnitus may be a side effect of drugs, including alcohol, aspirin, sedatives, antibiotics, antidepressants, stimulants, or anti-inflammatories. When tinnitus occurs as a drug side effect, it may cease when you stop taking the medication; however, it sometimes persists.

    Table 1.  Causes of Tinnitus

    Environmental noise Physical conditions Drugs
    Construction machinery Allergies Alcohol
    Power tools Anxiety/stress Antidepressants
    Lawn mowers Diabetes Anti-inflammatories
    Woodworking tools Ear conditions (ear wax, hole in eardrums) Aspirin
    Explosions Heart disease Sedatives
    Firecrackers Injury to head or neck Stimulants (e.g., coffee, tea, cola, tobacco)
    Gunshots Thyroid condition ?
    Rock concerts/ loud musical events Tumor ?

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I'm Shereen A. Gharbia, PharmD. Welcome to PDR Health!

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