Conditions: Tinnitus

Tinnitus is the perception of sound when no corresponding external sound is present. While often described as a ringing, it may also sound like a clicking, buzzing, hissing, or roaring. Tinnitus is usually, but not always associated with hearing loss, and may be considered as a low signal-to-noise ratio from the ears. When tinnitus is pulsatile, or like a heart beat, additional evaluation to exclude a treatable problem is undertaken.

Types of tinnitus

While people may experience various types of phantom sounds in their ears, including humming, buzzing, clicking, sound of crickets, etc., the two main categories are pulsatile tinnitus and non-pulsatile tinnitus. Pulsatile tinnitus has a rhythm that corresponds to one’s heartbeat. Taking one’s pulse can be tested at home, as shown in this video. Non-pulsatile tinnitus includes all other types of tinnitus (ringing, humming, whooshing, etc.), and is more common.

Tinnitus and hearing loss

About 70% of people with tinnitus have hearing loss, and about 70% of people with hearing loss have tinnitus. In large part, hearing loss and tinnitus may be considered two sides of the same coin, as they often relate to dysfunction of the inner ear/cochlea. Tinnitus is thought to result from an attempt at compensation for hearing loss by the brain.

tinnitus from EAR PRESSURE, EAR INFECTION, OR EAR FLUID

Many people have a low level of tinnitus that goes unnoticed unless something occurs to reduce hearing. When outside sounds are diminished, any low level of tinnitus may then become more apparent. Placing ear plugs or going to an especially quiet environment are scenarios this may be demonstrated. If an individual were to have fluid behind the tympanic membrane or even if the air pressure behind the tympanic membrane were significantly different from the surrounding air pressure, decreased conduction of sound waves temporarily leads to less hearing, which also can “unmask” or reveal tinnitus that is no longer out-competed by other environmental sounds.

A complete audiological examination should be obtained when tinnitus meets any of the following criteria:

1. In one ear only

2. Present for greater than six months

3. Associated with hearing difficulties

Differentiating abnormal Tinnitus from Transient Ear Noise

Transient Ear Noise is a sudden whistling or tonal sound occurring with a perception of hearing loss that happens randomly in one ear and lasts for less than a minute. Often, the ear feels blocked during the event. Transient Ear Noise, also called Brief Spontaneous Tinnitus, is normal.

Drugs and tinnitus

Certain medications may induce tinnitus. While the duration of drug associated tinnitus is usually brief (1-2 weeks), it may be permanent, especially with aminoglycoside antibiotics or cisplatin or carboplatin chemotherapy. Aspirin, especially in high doses, can cause temporary tinnitus. Non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen, loop diuretics such as furosemide, and quinine may cause temporary tinnitus. Medications for mental health and sleep conditions may cause or worsen tinnitus.

Tinnitus after loud noise exposure

A given episode of loud noise exposure may cause temporary tinnitus and hearing loss. After a few days, the problem may seem to resolve, but repeated episodes of loud noise create a cumulative injury that may make hearing loss and tinnitus permanent.