Noise and Tinnitus

Ear Nose | Otorhinolaryngology | Noise and Tinnitus (Symptom)


Ringing in the ears that does not improve or go away is called tinnitus. A person can hear a sound like a ringing or roaring, that does not come from the surroundings (nobody else can hear). The sound can go to the beat of his or her heart. The rhythm of the breathing can be constant or may come and go (intermittent). Tinnitus is most common in people over 40 years. Men have problems with tinnitus more often than women.

There are two main types of tinnitus. (i) The pulsatile tinnitus (such as heartbeat) is often caused by sounds created by muscle movements near the ear, ear canal changes or problems with blood flow (vascular) on the face or neck . (ii) Non-pulsatile tinnitus is caused by nerve problems that have to do with hearing.


Tinnitus is most commonly caused by damage that occurs inside the inner ear. Sounds pass from the outer ear through the middle ear and on to the inner ear, which contains the cochlea and the auditory nerve. The cochlea is a coiled, spiral tube that contains a large number of sensitive hair cells. The auditory nerve transmits sounds to the brain.

In older people, the most common cause of tinnitus is hearing loss that occurs with aging (presbycusis), but it can also be caused by living or working around loud noises (acoustic trauma). Tinnitus can occur with all types of hearing loss and may be a symptom of almost any ear disorder.

Several other possible causes of tinnitus include: build-up of earwax, middle ear infection, glue ear, otosclerosis (inherited condition where an abnormal bone growth in the middle ear), Ménière's disease (condition that affects a part of the inner ear known as the labyrinth and causes balance problems), Paget's disease, anaemia or a perforated eardrum.

Less common causes can develop because of: Less commonly, tinnitus may also develop because of: a head injury, exposure to a sudden or very loud noise, such as gunfire or an explosion, acoustic neuroma, adverse reactions to certain medications, solvent abuse, drug misuse and alcohol misuse, high blood pressure (hypertension) and narrowing of the arteries (atherosclerosis) or an overactive thyroid gland (hyperthyroidism).

Diagnosis and Treatment

The exact cause of tinnitus cannot always be identified, even after examination by a specialist. A hearing exam, movement of the eyes, clenching the jaw or moving the neck, arms and legs and imaging tests (CT or MRI) can help the doctor identify a possible underlying cause. Treatment of tinnitius depends on the underlying, treatable condition that may be associated with the symptoms.