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Tinnitus

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What is Tinnitus?

Tinnitus is the perception of ringing or other noises in one or both ears when no external sound is present. Patients often describe these sounds as continuous or intermittent buzzing, whistling, chirping, or hissing. Some patients may hear whooshing, humming, or other sounds. The volume and pitch of these noises can vary and may be more noticeable in quiet environments. While tinnitus does not directly cause hearing loss, it can impair concentration and listening abilities, potentially leading to psychological issues if left untreated.

A woman sits with her head in her hands, expressing distress or frustration
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What’s Happening in the Brain with Tinnitus?

Tinnitus isn’t just a problem with your ears—it also involves your brain and emotions. When your ears don’t send clear sound signals to the brain, often due to hearing loss, your brain tries to fill in the gap. It starts “guessing” what it should be hearing and ends up creating its own sound—this is what we experience as ringing, buzzing, or other phantom noises. At the same time, areas of the brain that control emotions, like the amygdala and hippocampus, can become too active. This overactivity makes the sound feel more intense, stressful, or upsetting than it actually is. Research has also shown that in people with tinnitus, the parts of the brain responsible for hearing and emotions are more strongly connected. This makes it harder to ignore the sound and can increase feelings of distress or anxiety.

Types of Tinnitus

Type of Tinnitus

What It Feels Like

How It’s Treated

Subjective Tinnitus

Only you can hear the ringing, buzzing, or hissing sound.

Hearing aids, sound therapy, avoiding loud noise, stress management.

Objective Tinnitus

A doctor can also hear the sound using a stethoscope.

Treating the muscle or blood vessel issue, sometimes surgery.

Pulsatile Tinnitus

You hear a beat or pulse, like a heartbeat or whooshing.

Managing blood pressure, treating vein or artery issues, medical tests may help.

Somatic Tinnitus

The sound gets louder or changes when you move your head or jaw.

Physical therapy, jaw treatment (TMJ), posture correction, stress relief.

Causes of Tinnitus

  • Ear infection
    Inflammation or fluid buildup in the ear can disturb hearing and cause ringing sounds.
  • Sinus infection
    Blocked sinuses can affect ear pressure and trigger temporary tinnitus.
  • Blockage due to earwax
    Built-up wax can press against the eardrum and cause muffled hearing or buzzing.
  • Meniere’s disease
    A disorder in the inner ear that leads to episodes of vertigo, hearing loss, and tinnitus.
  • Age-related hearing loss
    As people grow older, damage to the inner ear can lead to persistent ringing.
  • Continuous exposure to loud sounds
    Listening to loud music or machinery can damage hearing and lead to long-term tinnitus.
  • Sudden loud noise exposure
    Explosions or gunshots near the ear can cause instant hearing trauma and ringing.
  • Head or neck injury
    Trauma can affect nerves, blood flow, or the auditory system, resulting in tinnitus.
  • Tumor affecting the VIII cranial nerve
    Growths like acoustic neuromas can press on hearing nerves and cause buzzing sounds.
  • Side effects of medications
    Some drugs can harm the ear or nerves and trigger tinnitus as a side effect.
  • Temporomandibular joint disorder (TMJ)
    Jaw joint problems can affect nearby ear structures and cause tinnitus.
  • Otosclerosis (immobile bones in the inner ear)
    Abnormal bone growth in the ear can disrupt hearing and lead to ringing.
  • Medical conditions
    Diseases like diabetes or high blood pressure can affect circulation and nerve function, causing tinnitus.
  • Extreme stress and fatigue
    Mental strain can heighten awareness of body sensations, including phantom sounds.
  • Excessive alcohol or caffeine intake, smoking
    These substances can affect blood flow and nerve sensitivity, worsening tinnitus.

Migraine headaches
Changes in blood vessels and brain activity during migraines can bring on temporary or recurring tinnitus.

  • Ear infection
  • Sinus infection
  • Blockage due to earwax
  • Meniere’s disease
  • Age-related hearing loss
  • Continuous exposure to loud sounds
  • Sudden loud noise exposure
  • Head or neck injury
  • Tumor affecting the VIII cranial nerve
  • Side effects of medications (e.g., aspirin, quinine, chloroquine, sedatives, antidepressants, painkillers, antibiotics, diuretics)
  • Temporomandibular joint disorder (TMJ)
  • Otosclerosis (immobile bones in the inner ear)
  • Medical conditions (e.g., hypothyroidism, diabetes, high blood pressure, anemia, cardiovascular diseases, autoimmune disorders, circulatory disorders)
  • Extreme stress and fatigue
  • Excessive alcohol or caffeine intake, smoking
  • Migraine headaches

Tinnitus may also be linked to disorders causing vertigo or dizziness and can be an indicator of an underlying medical condition.

Objective and Subjective Tinnitus

  • Subjective Tinnitus: Only the patient hears the noise.
  • Objective Tinnitus: The noise can also be heard by a doctor using a stethoscope.
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Diagnosis

  • Visual Analogue Scale: Patients rate the loudness of internal noise on a scale of 0-10.
  • Audiometry: Assesses hearing ability and identifies hearing loss type and severity.
  • Tinnitus Matching: Patients identify sounds that resemble the tinnitus they experience, helping determine the frequency level.
  • Loudness Match Test: Patients match the intensity of perceived tinnitus sounds, aiding in understanding the range of tinnitus.
  • Impedance Audiometry with Eustachian Tube Function Tests: Determines middle ear pressure, stapedial reflexes, and ET function.


Connection Between Tinnitus and Other Conditions

  • Hearing Loss: One of the most common causes of tinnitus is hearing loss. When the ear’s hearing ability is reduced, the brain tries to compensate by creating sound signals — leading to the perception of ringing. Using hearing aids or other forms of sound therapy can sometimes reduce these phantom sounds.

  • Cardiovascular Diseases: Conditions like high blood pressure, narrowed arteries, or irregular blood flow can affect the blood vessels near the ears. This may create pulsating tinnitus (a rhythmic sound in sync with your heartbeat). Treating these heart-related issues can sometimes reduce or eliminate the noise.

  • Migraines: Migraines don’t just cause headaches — they can also affect the ears and balance system. Some people with migraines experience tinnitus during or between attacks. Managing migraines with lifestyle changes and medication can help reduce tinnitus in these cases.
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Treatment

Tinnitus (ringing or buzzing in the ears) can be caused by different things, so treatment depends on what’s triggering it. Here are some ways to manage and reduce tinnitus:

1. Treat the Underlying Cause

Sometimes tinnitus is a symptom of something else. Treating that problem can reduce or stop the ringing:

  • Earwax Build-up
    If too much wax is blocking your ear, an ENT (ear, nose, throat) doctor can clean it out safely.

  • Ear Infection
    If an infection is causing the problem, antibiotics can help reduce the swelling and clear it up.

  • TMJ Disorder (jaw joint problem)
    This can be treated by dentists, orthodontists, or ENT doctors with exercises, bite guards, or jaw treatments.

2. Mindfulness and CBT (Cognitive Behavioral Therapy)

These techniques help you feel more in control and less stressed about the ringing:

  • Focused Breathing
    Inhale for 4 seconds, exhale for 6 seconds. Repeat 10 times. It helps calm anxiety.

  • Body Scan Meditation
    Slowly focus on each part of your body and relax it. Notice the tinnitus without judging or reacting to it.

  • Sound Acceptance
    Pair the ringing with soft background sounds like rain or music. This helps your brain stop thinking of the sound as a threat.

  • Cognitive Restructuring
    Change negative thoughts like “This will never stop” to “It changes, and I’ve handled it before.”

  • Behavioral Activation
    Do activities you enjoy—like playing sports, hanging out with friends, or listening to music—to stay positive and distracted.

3. Nutrition for Ear and Brain Health

Tinnitus is often worse when your body is low on certain nutrients like iron and zinc. Eating better can help:Taking both iron and zinc together can reduce damage inside the ear and improve hearing over time.

 

Nutrient

Why It Helps

Good Food Sources

Iron

Carries oxygen to the inner ear

Red meat, spinach, lentils (Pair with vitamin C for better absorption)

Zinc

Supports brain and hearing pathways

Oysters, pumpkin seeds, yogurt (Soak lentils/beans before cooking)

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