Tinnitus

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What is tinnitus?

When someone experiences the sensation of a noise in the ear which is not actually audible to other people, this is called tinnitus. This is a very common sensation and many experience it at some time.

There are two main types:

• Pulsatile tinnitus is a noise which is pulsating in time with the heartbeat. It is caused by a person hearing blood flowing through their own head
• The other type of tinnitus is a continuous ringing, hissing, or humming noise

In either case the noise may apparently come from one ear, from both ears, or not apparently from any ear. All tinnitus seems louder when the person experiencing it is in quiet surroundings.

Pulsatile tinnitus may seem louder by exposure to loud noise and occasionally stress, though it is heard most loudly when the patient is subsequently in quiet surroundings.

What causes tinnitus?

It is usually regarded as the result of a minor degenerative change in the ear or as the result of noise damage to the ear. It may be neither of these things and is often heard when nothing is wrong with the ear. There are, however, certain specific conditions affecting the ear which may cause tinnitus. People experiencing tinnitus for the first time may think that it is a sign of serious ear disease, but this is extremely unlikely to be so.

If the person has deafness, giddiness, pain or discharge from the ear, then it makes it more likely that there is a treatable problem in the ear and they should seek medical advice.

What is the treatment for tinnitus?

People who experience tinnitus may fear that it is a symptom of a serious problem inside their head. Once they are reassured that this is not the case they may not require any further treatment. If they still find the noise troublesome then distraction from the tinnitus is probably the best initial treatment. As all tinnitus seems louder in quiet surroundings, it is better to leave some background noise, such as a radio playing in the room. This is well tolerated by day but may be more difficult at night when trying to get to sleep. In this circumstance a constant background noise is better, such as an electric fan or white noise which is produced by a radio tuned off of a station. If a radio is used as a noise source then the volume of the noise can be adjusted until it is just softer than the tinnitus which the person is then trying to ‘mask’. This technique of sound enrichment to suppress the tinnitus is the principle behind the supply of tinnitus white noise generators. These are small noise generators which resemble hearing aids and which are worn behind the ear. They are, however, only appropriate for a small number of patients with tinnitus. It is common for people to find that tinnitus eases with time.

Some people who experience tinnitus will also have some associated deafness. In these patients it may be helpful to provide them with a hearing aid. The hearing aid will help the deafness and also amplify ordinary sounds of life and this will provide a distraction from the tinnitus. This is an alternative to provide masking sound.

Drug treatments for patients with tinnitus is seldom necessary or helpful. It may, however, be helpful for a short time for patients to use a sleeping tablet if the tinnitus is causing great problems in getting to sleep. Occasionally patients who find the tinnitus stressful or very depressing may require appropriate help to cope with these problems. Please ask the hearing therapist if you feel this is the case.

Where can I get further information?

Who can I contact with any concerns or questions?

If you have any problems or are worried, please do not hesitate to contact us in the Ear, Nose and Throat Outpatient Department.