Tinnitus (Ringing in Ears) - Causes, Symptoms and Treatment

The sound in ear that people with tinnitus hear can be anything from a soft background sound to loud clear external noise. Usually, tinnitus sound can be categorised into 2 types:

1. Subjective tinnitus: It is the most common type where only the affected person can hear the noises in their ear. It usually results from exposure to excessive noise and temporarily lasts up to 3-12 months at a time. However, in severe cases, it may be permanent.
2. Objective tinnitus: It is a rare type caused by vascular deformities or involuntary muscle contraction, affecting mechanical structures near the ear. 

Almost 75% of all health conditions can affect your ears and cause tinnitus. The major tinnitus causes are: 

1. Earwax: The beep sound in ear could be due to anything as simple as an accumulation of earwax in your outer ear.
2. Head trauma: That ringing in ears you hear could be a sign of a jaw, neck, or head biomechanical issue if you've recently been in a car accident or hit your head.
3. Diseases: Sometimes, ringing in ears is a sign of a medical condition like Meniere's disease. It happens when an abnormal buildup of fluid pressure in your inner ear. Additionally, diabetes and hypertension can lead to tinnitus.
4. Medications: Some drugs may impact your hearing. High dosages of aspirin, some antibiotics, antidepressants, and chemotherapy medicines may cause you to hear a tinnitus sound.
5. Dental problems: A non-auditory issue with your jaw or teeth might occasionally be related to ringing in the ears. The Temporomandibular Joint Disorder (TMD) issue might make the jaw joint pop or click noises, which can result in tinnitus sound.

Tinnitus is a ringing in ears when no external sound is present. However, tinnitus can also produce other imaginary noises in your ears. The tinnitus symptoms include noises like:

1. Buzzing
2. Hissing
3. Humming
4. Clicking
5. Roaring

The doctor diagnoses ringing in ears by examining the symptoms. However, the doctor will perform some diagnostic tests to identify the cause and treat those symptoms related to the imaginary sound in ear. These tests include:

1. Blood tests : The doctor may take blood samples to check for conditions such as thyroid, heart disease, anaemia, or vitamin deficiencies.
2. Hearing exam (Audiometry) : In this procedure, the doctor will have you seated in a soundproof room with earphones transmitting sound in one ear at a time. You will be asked to inform your provider when you hear a sound, and the results will be compared with normal hearing for your age. 
3. Movement : You will be asked to move your eyes, arms, neck and legs and clench your jaw. The changes in ringing can help determine the underlying disorder. 
4. Tympanometry : The doctor will use a handheld device called Tympanometer to check your eardrum. 
5. Imaging tests : Depending on the cause of tinnitus, the doctor may perform imaging tests such as MRI and CT scan. An MRI scan can help discover a tumour near your ear. Imaging tests can also help reveal changes in the blood vessels near the ear to determine if an underlying medical condition is causing ringing in your ears. 

There are various options for treating ringing in ears based on the cause and symptoms of tinnitus. These treatment options include:

1. Medications
   Medications cannot treat tinnitus. However, they can reduce the severity of its symptoms. The doctor may prescribe medications to treat the underlying causes, such as anti-anxiety drugs or anti-depressive drugs. 
    
2. Behavioural Therapies
   Counselling and therapy help you live with tinnitus symptoms by changing your feelings about the symptoms. These treatment options include:
   1. Cognitive Behavioural Therapy (CBT): It is a form of counselling in which a psychologist or mental health professional helps you modify your reaction to the ringing in your ear. Counselling also helps with other tinnitus-related problems, like anxiety and depression. 
   2. Tinnitus Retraining Therapy (TRT): TRT is a treatment option for moderate to severe tinnitus involving a combination of sound therapy and counselling. The counselling session aims to change how you perceive the ringing. Sound therapy helps you habituate to the sound of tinnitus. For this therapy, you wear a device in the ear that plays a white noise covering up the ringing. You frequently habituate several auditory signals in the environment, such as refrigerators, air conditioners, etc. 
   3. Relaxation techniques: Relaxation techniques such as exercises, deep breathing, and biofeedback can help manage stress and anxiety, reducing tinnitus symptoms.  
3. Sound-based Therapies
   ​​​​​​​Some sound-based therapies can suppress the symptoms of tinnitus. A few therapies are:
   1. Masking device: Resembling hearing aids, these devices produce a continuous white sound noise that is more pleasant than the ringing produced by tinnitus. It helps suppress the symptoms of tinnitus.
   2. Hearing aids: If the ringing in your ear is accompanied by hearing loss due to noise or age, using hearing aids can improve the symptoms. 
   3. White noise machines: These devices produce environmental sounds like ocean waves as an effective treatment for ringing in the ear. Air conditioners and fans in the room also produce white noise, making the symptoms of tinnitus less noticeable at night.  
4. Lifestyle Changes​​​​​​​
   Lifestyle choices can help reduce your tinnitus symptoms. It can include:
   1. Earwax removal: Clearing blockage from the ear by removing wax can help relieve tinnitus symptoms.
   2. Exercise: Regular exercise could be beneficial for overall health and well-being. Yoga has been shown to lessen stress and the symptoms of persistent tinnitus in those who practise it.

Tinnitus (ringing in ears) is a problem that could be due to any underlying health condition, such as thyroid, anaemia, and migraine. Tinnitus can disrupt your everyday life and make it difficult to sleep and concentrate. As a result, you may feel depressed, angry, or frustrated.

If you experience ringing in ears, consult a healthcare professional at HexaHealth TODAY! Our team of 1500+ expert doctors can help you manage tinnitus symptoms.