Tinnitus

What causes tinnitus?

Tinnitus can have many causes. Most often, it’s linked to changes in hearing or the ear itself.

To understand why tinnitus happens, it helps to know how your ear works.

Your ear has three main parts: the outer ear, the middle ear and the inner ear.

• The outer ear collects sound and sends it inward.
• The middle ear has tiny bones that pass sound vibrations along.
• The inner ear contains a small, spiral-shaped organ called the cochlea. Inside the cochlea are thousands of tiny hair cells that turn sound vibrations into signals your brain can understand.

When these hair cells are damaged or stop working the right way, they may send signals to the brain even when there is no sound. Your brain interprets these signals as ringing, buzzing or other noises. This is tinnitus.

Damage to these hair cells often happens from:

• Hearing loss from aging
• Exposure to loud noise over time
• A sudden loud sound

Other parts of the ear can also play a role. If the ear canal is blocked by earwax or fluid, pressure changes inside the ear can trigger tinnitus. Problems in the middle ear, such as infections or stiffening of the tiny bones, can also affect how sound moves through the ear.

Tinnitus can also be linked to issues outside the ear, including:

• Head or neck injuries that affect nerves
• Certain medications that affect hearing
• Problems with the jaw joint, also called TMJ
• Blood flow issues near the ear
• Stress or anxiety, which can make the sound seem louder or more noticeable

Because tinnitus can come from many different sources, a careful exam is important to find the cause and guide treatment.

Signs and symptoms of tinnitus

The main sign of tinnitus is hearing a sound that others can’t hear.

You may notice:

• Ringing
• Buzzing
• Humming
• Hissing
• Clicking
• Roaring

The sound may be steady or come and go. It may be soft or loud. You may hear it in one ear, both ears or in your head. Tinnitus is often more noticeable at night or in quiet rooms.

When to call a doctor

You should talk to a provider if:

• Tinnitus starts suddenly
• The sound is only in one ear
• You also feel dizzy or off balance
• You notice hearing loss
• The tinnitus follows a head or neck injury
• The sound is affecting your sleep, mood or daily life

These signs may point to an issue that needs medical care.

Diagnosing tinnitus

Your provider will start by asking about your symptoms, your health history and any recent noise exposure. They will look inside your ears to check for signs of infection, fluid or earwax buildup.

You will likely have a hearing test, also called an audiogram. During this test, you wear headphones and respond to different sounds and tones. This helps your care team see if hearing loss may be linked to your tinnitus.

Depending on your symptoms, your provider may also recommend other tests, such as:

• Tympanometry, which checks how well your eardrum moves and looks for fluid or pressure problems in the middle ear
• Speech testing to see how clearly you hear and understand words
• Balance testing if you feel dizzy or off balance
• Blood tests to check for conditions that may affect hearing, such as thyroid problems or vitamin deficiencies

In some cases, imaging tests are needed to rule out other causes. These may include:

• MRI, which creates detailed images of the inner ear, nerves and brain
• CT scan, which shows the bones and structures of the ear and head

These tests help your provider make sure nothing more serious is causing your symptoms and guide the best plan for treatment.

A careful and complete evaluation helps your Mount Nittany Health care team understand what is causing your tinnitus and how to help you manage it.

Treatments for tinnitus

There is no single cure for tinnitus, but many treatments can help reduce how much it bothers you.

Treatment depends on the cause and may include:

• Removing earwax
• Treating an infection
• Changing medications
• Hearing aids to improve hearing and reduce tinnitus
• Sound therapy, such as white noise machines or soft music
• Counseling or therapy to help you manage stress related to tinnitus
• Relaxation techniques

An audiology specialist at Mount Nittany Health will work with you to create a plan that fits your needs and helps you feel more in control.

You don’t have to live with constant noise in your ears. Help is available and relief is possible.

Preventing tinnitus

You cannot always prevent tinnitus, especially when it is linked to aging or medical conditions. However, there are steps you can take to protect your hearing and lower your risk.

Protect your ears from loud noise

Loud sounds can damage the tiny hair cells in your inner ear. This damage is one of the most common causes of tinnitus.

• Wear earplugs or noise-canceling earmuffs when using loud tools or equipment
• Keep the volume low when using headphones or earbuds
• Take breaks from noisy environments

Keep your ears healthy

• Avoid putting cotton swabs or objects into your ear canal
• See a provider if you feel ear fullness, pain or pressure
• Treat ear and sinus infections promptly

Manage your overall health

Your hearing is connected to your overall health.

• Keep blood pressure under control
• Stay active and exercise regularly
• Manage stress and anxiety
• Get enough sleep

Review your medications

Some medications can affect hearing. Talk with your provider or pharmacist if you notice ringing in your ears after starting a new medicine.

Taking these steps can help protect your hearing and reduce your chances of developing tinnitus or making existing symptoms worse.