Tinnitus is the perception of noise or ringing in the ears, affecting about 15 to 20% of people. 

Tinnitus is not a condition in itself – it is a symptom of an underlying condition, such as age-related hearing loss, ear injury, or circulatory system disorder.

Although bothersome, tinnitus is generally not something serious. 

Although it can get worse with age, for many people, tinnitus can get better after treatment. 

Treating the identified underlying cause sometimes helps. Other treatments reduce or mask noise, making tinnitus less noticeable.

Symptoms

Tinnitus involves the sensation of hearing sound in the absence of external sound. Tinnitus symptoms can include phantom noises in the ears, such as:

• A ring
• A buzz
• A roar
• A click
• A whistle

Phantom noise can range from a low-pitched roar to a high-pitched squeal, which can be heard in one or both ears. In some cases, the sound may be so loud that it may interfere with the ability to concentrate or hear external sound. Tinnitus can be present all the time or intermittently.

There are two types of tinnitus.

• Subjective tinnitus is the most common type of tinnitus. Ear problems in the outer, middle, or inner part can cause it. Disorders with the auditory (auditory) nerves or the amount of your brain that interprets nerve signals as sound (auditory pathways) can cause issues.
• Objective tinnitus is tinnitus that your doctor can hear during an exam. A blood vessel disturbance, a bone condition in the middle ear, or muscle twitching can cause this rare tinnitus.

Not confused with auditory hallucinations.

Tinnitus Diagnosis

The doctor examines the ears, head, and neck to look for possible causes of tinnitus. The tests include:

·       Hearing test (audiological). The patient sits in a soundproof room with headphones. It indicates when he can hear the sound, and the results are compared to those considered normal for his age. This test can help rule out or identify possible causes of tinnitus.

·       Movement. The doctor may ask to move the eyes, clench the jaw, or move the neck, arms, and legs. If the tinnitus changes or worsens, it can help identify an underlying disorder that needs treatment.

·       Imaging tests. Depending on the suspected cause of the tinnitus, the patient may need imaging tests (CT scans or MRIs).

The sounds heard can help the doctor identify a possible underlying cause.

·       Clicks. Muscle contractions in and around the ear can cause sharp clicks to be heard in bursts. They can last from a few seconds to a few minutes.

·       Humming. These sound fluctuations are generally of vascular origin and occur, for example, when exercising or changing position, for example, when lying down or getting up.

·       Heartbeat. Blood vessel problems, such as high blood pressure, aneurysm or tumor, and blockage of the ear canal or eustachian tube, can amplify the heartbeat sound in the ears.

·       Low ringtone. Conditions that can cause severe ringing in one ear include Ménière’s disease. Tinnitus can become very loud before an attack of vertigo – a feeling that the environment is spinning or moving.

·       High-pitched ringing. Exposure to loud noise or a knock in the ear can cause a high-pitched ringing or buzzing sound that usually subsides after a few hours. However, tinnitus may be permanent if there is also hearing loss. Long-term noise exposure, age-related hearing loss, or medication can cause continuous, high-pitched ringing in both ears. Acoustic neuroma, also called vestibular schwannoma, can cause constant, high-pitched ringing in one ear.

·       Other sounds. Stiff bones in the inner ear (otosclerosis) can cause severe tinnitus that may be continuous or come and go. Earwax, foreign bodies, or hair in the ear canal can rub against the eardrum, causing a variety of sounds.

Often, it is challenging to determine the cause of tinnitus.