Ear Center: Tinnitus
Tinnitus is ringing of the ears. Patients describe tinnitus as ringing, buzzing, motor-like sounds, night insect noises, etc. Tinnitus is very common, especially the high pitched variety that is often heard at night in a quiet environment. Tinnitus may be heard in one or both ears or may sound as if it is simply located inside one's head. It may be constant or pulsatile, low or high pitched, and may fluctuate in loudness during the day or night. Tinnitus may be subjective (only the person himself can hear the sound(s)), or it may be objective (another person may be able to hear the sound(s) by listening to the ear canal.
Tinnitus has many causes. Subjective tinnitus is most often caused by hearing loss. The frequency that is perceived is often they same frequency as the hearing loss. The most common form of tinnitus is the bilateral, high pitched, non-pulsatile form that is heard at night. Generally, tinnitus becomes louder as hearing loss increases. This type of tinnitus is often a nuisance rather than a problem. Most patients adapt over time, use various masking techniques, and learn to live with their tinnitus.
Some tinnitus can become very loud and cause trouble concentrating, falling asleep, or remaining asleep.
Causes of tinnitus, include by are not limited, to:
- Hearing loss, either progressive or sudden
- Noise and acoustic trauma
- Ear disease such as middle ear fluid, infection, cholesteatoma, middle ear tumors, perilymph fistulas, etc.
- Meniere's disease (endolymphatic hydrops) & autoimmune inner ear disease
- Tumors of the hearing or balance nerves (acoustic neuromas, etc.)
- Wax impactions (cerumen) of the ear canals
- Vascular conditions (dural venous malformations, arterial-venous malformations, fibromuscular dysplasia, etc)
- Benign intracranial hypertension
- Medication side effects, especially ototoxic medications, high dose aspirin, and some water pills (diuretics)
- Caffeine (coffee, chocolate, soft drinks, etc.)
- Psychiatric conditions (depression, obsessive compulsive disorder, etc)
There are no blood tests to diagnose tinnitus. Tinnitus is evaluated by a careful history and physical examination, including amplified listening to each ear canal. Diagnostic testing includes: hearing testing, acoustic reflex testing, acoustic reflex decay testing, and auditory brainstem response testing. Imaging for tinnitus may include magnetic resonance imaging with and without contrast (MRI), magnetic resonance angiography/venography (MRA and MRV), computerized tomography angiography (CTA), and carotid angiography.
Tinnitus treatment includes
- Masking devices
- Avoidance of caffeine and medications that may cause tinnitus
- Treatment of primary ear disease (wax removal, fluid, infection, Meniere's disease)
- Noise protection
- Removal of tumors & treatment of vascular anomalies
- Treatment of underlying psychiatric conditions
- Biofeedback, central adaptation/habituation therapy (Neuromonics Treatment Device)
For tinnitus training and therapy, we work in conjunction with the University of North Carolina-Greensboro (UNC-G), UNC-G Speech and Hearing Center.
- The UNC-G phone number is: (336) 334-5939
- Click here for the UNC-G Department of Communications web site
If you are experiencing tinnitus in one or both ears, we recommend that you seek a thorough medical evaluation. Please call us at (336) 273-9932 if you would like to schedule an appointment.