Tinnitus - Ear Ringing Causes and Treatments

Tinnitus is the perception of sound within the human ear when no external sound is present. It is common, affecting about 10-15% of people. Most however tolerate it well, with it being a significant problem in only 1-2% of people.

Tinnitus is not a disease, but a condition that can result from a wide range of underlying causes. The most common cause is inner ear cell damage; the portion of the ear that allows us to hear, the cochlea, becomes damaged. 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.

The most common causes of tinnitus are:
  • Age-related (around age 60) hearing loss.
  • Long-term exposure to loud sound or noise.
Other causes include:
  • Neurological damage such as multiple sclerosis
  • Meniere's disease, a swelling of a duct in the ear
  • Ear and sinus infections
  • A perforated eardrum
  • Earwax blockage
  • Extreme stress or trauma
  • Withdrawal from benzodiazepines
  • Ototoxic medications, especially antibiotics in the aminoglycoside class, such as gentamicin and tobramycin
  • Brain tumor known as an acoustic neuroma (Rarely)
  • Otosclerosis - an inherited condition where an abnormal bone growth in the middle ear causes hearing loss
  • High blood pressure
  • Anemia
Although there is no cure for tinnitus, the condition often becomes less noticeable and more manageable over time.
There are several options available that can help patients with tinnitus, the most effective ones are behavioral strategies and sound-generating devices:
  • Hearing aids often are helpful for people who have hearing loss along with tinnitus. However, tinnitus can actually worsen if the hearing aid is set at an excessively loud level.
  • Masking devices - a masking device emits sound that obscures, though does not eliminate, the tinnitus noise. The usefulness of maskers is based on the observation that tinnitus is usually more bothersome in quiet surroundings
  • Tinnitus retraining therapy (TRT) - this technique habituate the auditory system to the tinnitus signals, making them less noticeable or less bothersome.
  • Consideration of Diet - often high levels of salt and caffeine, as well as nicotine, can cause an increase in tinnitus.
  • Stress management - tinnitus is stressful, and stress can worsen tinnitus. Many strategies aimed at reducing stress can be very effective at controlling tinnitus

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