Tinnitus evaluations

What causes ringing in my ears?

Tinnitus (ear noise) has been described as ringing, roaring, hissing, or sounding like “crickets” or “cicadas” and can be either constant, intermittent, or last for just a few seconds. It is most often heard in both ears or has the sensation of being in the middle of the head. It is most often associated with hearing loss, even if the loss is very slight. Hearing loss, especially from exposure to loud noise, is the leading cause of tinnitus. Hearing loss and tinnitus generally are the result of damage to the microscopic endings of the hearing nerve in the inner ear. Tinnitus is most often heard at night while trying to fall asleep as the room is quiet and the body is approaching a relaxed state, but the tinnitus is not “quieting.” In fact, most comment that tinnitus is the “loudest” at night. This is due to the absence of other environmental sounds or body noise which masks the tinnitus during the day.

It is more concerning when tinnitus is only heard in one ear as this may be related to an abnormality of the central nervous system, or when tinnitus is pulsatile like that of their heart rate (pulse), which may be related to vascular disease. An audiogram performed by an Audiologist can help determine if the tinnitus is possibly related to hearing loss or whether there are other medical conditions that should be explored by your primary physician, such as high blood pressure, thyroid problems, or an adverse reaction to medication.

How is tinnitus treated?

Sound is the most common treatment of tinnitus when hearing loss is minimal. The most commonly used device is a ceiling fan or oscillating fan in the bedroom. Other sources of sound generators include:            

  • white noise from a radio tuned in between stations
  • radio playing soft music
  • recordings of the ocean or rainforest

Home therapeutic devices can be purchased relatively inexpensively that offer a wide range of sounds and availability of a volume control. Apps may be downloaded on to a phone or personal device that are designed to generate low level noise for the specific purpose of masking tinnitus.

Hearing aids can be effective at reducing the awareness of tinnitus with hearing loss and can sometimes result in complete absence of the tinnitus while the hearing aid is worn. Avoiding exposure to loud sounds is recommended to prevent further hearing loss and to help prevent an increase in tinnitus symptoms.

Tinnitus that is reported to be extremely disturbing requires additional treatments that may include one or more of the following: cognitive based therapy, drug therapy, biofeedback, and alternative wellness (acupuncture, herbal supplements, and therapeutic massage). Those who experience anxiety and/or depression are more susceptible to suffering from their tinnitus. Excess use of stimulants such as coffee, tea, cola, and tobacco should be avoided. While these products do not cause tinnitus, they can interfere with the body’s ability to tolerate the noise. Daily exercise can improve circulation, which can help tinnitus; good sleep hygiene has also been shown to be helpful.

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