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Symptoms and Signs of Tinnitus (Ringing, Clicking, in the Ears)

Doctor's Notes on Tinnitus Sounds, Symptoms, Causes, and Remedies

Tinnitus is an abnormal sensation in the ear that can be due to a number of different diseases and conditions. Tinnitus may be described as a buzzing, ringing, clicking, humming, roaring, or pulsating noise. It can occur in one or both ears and may be intermittent or constant. Tinnitus can arise from disturbances in any part of the ear. Some of the possible causes of tinnitus include muscle spasms, Meniere’s disease, problems with the temporomandibular (TMJ) joint, damage to the nerves of the ear, increases in blood flow, or trauma to the head or ear.

Symptoms and signs associated with tinnitus are variable and depend on the exact cause of this symptom. Other symptoms can include ear pain, problems with hearing, sleep disturbances, problems with balance, anxiety, depression, and difficulty concentrating.

Medical Author:
Medically Reviewed on 3/11/2019

Tinnitus Sounds, Symptoms, Causes, and Remedies Symptoms

Most newly noticed tinnitus should be evaluated by a doctor or other health care professional. Because tinnitus usually is a symptom of something else, if it begins suddenly, see your doctor. This is particularly important if the tinnitus is only heard on one side.

Although the majority of cases of tinnitus are not caused by any acute medical problems, certain symptoms and signs need to be evaluated to determine whether or not a more serious medical condition is causing the symptoms.

If you begin having any of these issues call your doctor or other health care professional for evaluation.

  • Any time tinnitus or ringing in the ears comes on suddenly, particularly in one ear, or is associated with hearing loss. Sudden hearing loss is often accompanied by tinnitus, and there are medications that may help to restore hearing. Also certain types of tumors can cause sudden hearing.
  • Tinnitus that is pulsatile (in rhythm with your heartbeat) and comes on suddenly should also be checked relatively rapidly. In very rare instances, this sort of tinnitus can develop because of an aneurysm (a bulging of the wall of a blood vessel) near the ear or because of the sudden onset of very high blood pressure.
  • Any time the problem is noticed in association with changes in personality, difficulty speaking or walking, or with any other movement problem, you should be evaluated for the possibility of a stroke.
  • If you have constant ringing in the ears and it's affecting your daily life, see a doctor or other health care professional.
  • Subjective tinnitus: This is the most common type of tinnitus because you hear a sound, but no one else can hear it.
  • Clicking or pulsatile tinnitus: The noise it produces usually is a buzzing or ringing type sound, but it may be a clicking or rushing sound that goes along with your heartbeat.
  • Objective tinnitus: This is a much more uncommon sort of tinnitus. With this type your doctor may sometimes actually hear a sound when he or she is carefully listening for it.

Most cases of tinnitus should be evaluated by an ear, nose, and throat doctor before home treatment begins to be sure that the tinnitus is not caused by another treatable problem.

Herbal home remedies (ginkgo biloba, melatonin), and the vitamin zinc are not recommended by the American Academy of Otolaryngology. Lipo-flavonoid is a supplement being marketed as a way to relieve tinnitus, but there is no current evidence it is effective for most cases of the condition; however, it may be helpful for symptoms of Meniere's disease. Check with your doctor or other health care professional before taking any herbal or over-the-counter (OTC) natural remedies.

Most cases of tinnitus should be evaluated by an ear, nose, and throat doctor before home treatment begins to be sure that the tinnitus is not caused by another treatable problem.

Herbal home remedies (ginkgo biloba, melatonin), and the vitamin zinc are not recommended by the American Academy of Otolaryngology. Lipo-flavonoid is a supplement being marketed as a way to relieve tinnitus, but there is no current evidence it is effective for most cases of the condition; however, it may be helpful for symptoms of Meniere's disease. Check with your doctor or other health care professional before taking any herbal or over-the-counter (OTC) natural remedies.

Tinnitus Sounds, Symptoms, Causes, and Remedies Causes

Tinnitus is not a disease in itself but rather a reflection of something else going on in the hearing system or brain.

Hearing loss: Probably the most common cause for tinnitus is hearing loss. As we age, or because of trauma to the ear (through noise, drugs, or chemicals), the portion of the ear that allows us to hear, the cochlea, becomes damaged. Current theories suggest that because the cochlea is no longer sending the normal signals to the brain, the brain becomes confused and essentially develops its own noise to make up for the lack of normal sound signals. This then is interpreted as a sound, tinnitus. This tinnitus can be made worse by anything that makes our hearing worse, such as ear infections or excess wax in the ear.

Trauma: If tinnitus is caused by trauma to the ear it usually is noticed in both ears, because both ears generally are exposed to the same noises, drugs, and other influences.

Exposure to loud noise: Loud noise exposure is a very common cause of tinnitus today, and it often damages hearing as well. Unfortunately, many people are unconcerned about the harmful effects of excessively loud noise from firearms, high intensity music, or other sources. Twenty-six million American adults have suffered noise-induced hearing loss, according to the NIDCD.

Medications: Drugs such as aspirin (if overused), aminoglycoside antibiotics (a powerful form of infection-fighting drug), and quinine. More than 200 different drugs are known to have tinnitus as a side effect.

Meniere's disease: Symptoms include dizziness, tinnitus, and fullness in the ear or hearing loss that can last for hours, but then goes away. This disease is actually caused by a problem in the ear itself. The tinnitus is merely a symptom.

Acoustic neuroma: This is a rare subjective cause of tinnitus, and includes a certain type of brain tumor known as an acoustic neuroma. The tumors grow on the nerve that supplies hearing and can cause tinnitus. This type of the condition usually are only noticed in one ear, unlike the more common sort caused by hearing loss usually seen in both ears. Causes of objective tinnitus are usually easier to find.

Pulsatile tinnitus: This problem usually is related to blood flow, either through normal or abnormal blood vessels near the ear. Causes of pulsatile tinnitus include pregnancy, anemia (lack of blood cells), overactive thyroid, or tumors involving blood vessels near the ear. Pulsatile tinnitus also can be caused by a condition known as benign intracranial hypertension (an increase in the pressure of the fluid surrounding the brain).

Clicking types of objective tinnitus can be caused by TMJ misalignment problems, or "twitching" of muscles of the ear or throat.

  • The initial medical evaluation for tinnitus will include a complete health history and physical examination of the head and neck including the various nerves in the area.
  • A complete hearing test (audiogram) will also be performed. Depending on the type of tinnitus, either a special audiogram known as an auditory brainstem response (ABR) or a brain scan such as a computerized tomography (CT) scan or magnetic resonance imaging (MRI) may also be required.
  • In some cases, your blood pressure and possibly some blood tests to evaluate thyroid gland function may be taken.
  • In very rare instances, a spinal tap may be performed to measure the fluid pressure in the skull and spinal cord.

Tinnitus Why Are My Ears Ringing? Slideshow

Tinnitus Why Are My Ears Ringing? Slideshow

A ringing, swishing, or other noise in the ears or head when no external sound is present is called tinnitus. Usually, it's more of a nuisance than a serious medical problem. In rare cases, it can be a sign of an underlying medical condition that needs attention. About 10% of adults in the U.S. have experienced tinnitus lasting more than five minutes.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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