What causes hissing in the ear: Tinnitus – Symptoms and causes

16.09.201807.04.2021 by alexxlab

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Tinnitus – Diagnosis and treatment

Diagnosis

Your doctor will typically diagnose you with tinnitus based on your symptoms alone. But in order to treat your symptoms, your doctor will also try to identify whether your tinnitus is caused by another, underlying condition. Sometimes a cause can’t be found.

To help identify the cause of your tinnitus, your doctor will likely ask you about your medical history and examine your ears, head and neck. Common tests include:

Hearing (audiological) exam. During the test, you’ll sit in a soundproof room wearing earphones that transmit specific sounds into one ear at a time. You’ll indicate when you can hear the sound, and your results will be compared with results considered normal for your age. This can help rule out or identify possible causes of tinnitus.
Movement. Your doctor may ask you to move your eyes, clench your jaw, or move your neck, arms and legs. If your tinnitus changes or worsens, it may help identify an underlying disorder that needs treatment.
Imaging tests. Depending on the suspected cause of your tinnitus, you may need imaging tests such as CT or MRI scans.
Lab tests. Your doctor may draw blood to check for anemia, thyroid problems, heart disease or vitamin deficiencies.

Do your best to describe for your doctor what kind of tinnitus noises you hear. The sounds you hear can help your doctor identify a possible underlying cause.

Clicking. This type of sound suggests that muscle contractions in and around your ear might be the cause of your tinnitus.
Pulsing, rushing or humming. These sounds usually stem from blood vessel (vascular) causes, such as high blood pressure, and you may notice them when you exercise or change positions, such as when you lie down or stand up.
Low-pitched ringing. This type of sound may point to ear canal blockages, Meniere’s disease or stiff inner ear bones (otosclerosis).
High-pitched ringing. This is the most commonly heard tinnitus sound. Likely causes include loud noise exposure, hearing loss or medications. Acoustic neuroma can cause continuous, high-pitched ringing in one ear.

Treatment

Treatment for tinnitus depends on whether your tinnitus is caused by an underlying health condition. If so, your doctor may be able to reduce your symptoms by treating the underlying cause. Examples include:

Earwax removal. Removing an earwax blockage can decrease tinnitus symptoms.
Treating a blood vessel condition. Underlying blood vessel conditions may require medication, surgery or another treatment to address the problem.
Hearing aids. If your tinnitus is caused by noise-induced or age-related hearing loss, using hearing aids may help improve your symptoms.
Changing your medication. If a medication you’re taking appears to be the cause of tinnitus, your doctor may recommend stopping or reducing the drug, or switching to a different medication.

Noise suppression

Many times, tinnitus can’t be cured. But there are treatments that can help make your symptoms less noticeable. Your doctor may suggest using an electronic device to suppress the noise. Devices include:

White noise machines. These devices, which produce a sound similar to static, or environmental sounds such as falling rain or ocean waves, are often an effective treatment for tinnitus. You may want to try a white noise machine with pillow speakers to help you sleep. Fans, humidifiers, dehumidifiers and air conditioners in the bedroom also produce white noise and may help make tinnitus less noticeable at night.
Masking devices. Worn in the ear and similar to hearing aids, these devices produce a continuous, low-level white noise that suppresses tinnitus symptoms.

Counseling

Behavioral treatment options aim to help you live with tinnitus by helping you change the way you think and feel about your symptoms. Over time, your tinnitus may bother you less. Counseling options include:

Tinnitus retraining therapy (TRT). TRT is an individualized program that is usually administered by an audiologist or at a tinnitus treatment center. TRT combines sound masking and counseling from a trained professional. Typically, you wear a device in your ear that helps mask your tinnitus symptoms while you also receive directive counseling. Over time, TRT may help you notice tinnitus less and feel less distressed by your symptoms.
Cognitive behavioral therapy (CBT) or other forms of counseling. A licensed mental health professional or psychologist can help you learn coping techniques to make tinnitus symptoms less bothersome. Counseling can also help with other problems often linked to tinnitus, including anxiety and depression. Many mental health professionals offer CBT for tinnitus in individual or group sessions, and CBT programs are also available online.

Medications

Drugs can’t cure tinnitus, but in some cases they may help reduce the severity of symptoms or complications. To help relieve your symptoms, your doctor may prescribe medication to treat an underlying condition or to help treat the anxiety and depression that often accompany tinnitus.

Potential future treatments

Researchers are investigating whether magnetic or electrical stimulation of the brain can help relieve symptoms of tinnitus. Examples include transcranial magnetic stimulation (TMS) and deep brain stimulation.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

Often, tinnitus can’t be treated. Some people, however, get used to it and notice it less than they did at first. For many people, certain adjustments make the symptoms less bothersome. These tips may help:

Use hearing protection. Over time, exposure to loud sounds can damage the nerves in the ears, causing hearing loss and tinnitus. To keep your tinnitus from getting worse, take steps to protect your hearing. If you use chain saws, are a musician, work in an industry that uses loud machinery or use firearms (especially pistols or shotguns), always wear over-the-ear hearing protection.
Turn down the volume. Listening to music at very high volume through headphones can contribute to hearing loss and tinnitus.
Use white noise. If tinnitus is especially noticeable in quiet settings, try using a white noise machine to mask the noise from tinnitus. If you don’t have a white noise machine, a fan, soft music or low-volume radio static also may help.
Limit alcohol, caffeine and nicotine. These substances, especially when used in excess, can affect blood flow and contribute to tinnitus.

Alternative medicine

There’s little evidence that alternative medicine treatments work for tinnitus. However, some alternative therapies that have been tried for tinnitus include:

Acupuncture
Ginkgo biloba
Melatonin
Zinc supplements

Coping and support

In addition to any treatment options offered by your doctor, here are some suggestions to help you cope with tinnitus:

Support groups. Sharing your experience with others who have tinnitus may be helpful. There are tinnitus groups that meet in person, as well as internet forums. To ensure that the information you get in the group is accurate, it’s best to choose a group facilitated by a physician, audiologist or other qualified health professional.
Education. Learning as much as you can about tinnitus and ways to alleviate symptoms can help. And just understanding tinnitus better makes it less bothersome for some people.
Stress management. Stress can make tinnitus worse. Stress management, whether through relaxation therapy, biofeedback or exercise, may provide some relief.

Preparing for your appointment

Be prepared to tell your doctor about:

Your signs and symptoms
Your medical history, including any other health conditions you have, such as hearing loss, high blood pressure or clogged arteries (atherosclerosis)
All medications you take, including herbal remedies

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:

When did you begin experiencing symptoms?
What does the noise you hear sound like?
Do you hear it in one or both ears?
Has the sound you hear been continuous, or does it come and go?
How loud is the noise?
How much does the noise bother you?
What, if anything, seems to improve your symptoms?
What, if anything, appears to worsen your symptoms?
Have you been exposed to loud noises?
Have you had an ear disease or head injury?

After you’ve been diagnosed with tinnitus, you may need to see an ear, nose and throat doctor (otolaryngologist). You may also need to work with a hearing expert (audiologist).

Feb. 04, 2021

Tinnitus causes: Could my antidepressant be the culprit?

Ringing in the ears (tinnitus) can be caused by a number of medications, including some antidepressants. Not all antidepressants cause tinnitus. If your antidepressant is the cause of your tinnitus, switching to another medication may solve the problem, but don’t quit taking your medication without medical guidance.

Antidepressants are a less common cause of tinnitus than are other types of medications — such as aspirin, anti-inflammatories or some antibiotics — or underlying health conditions.

Causes of tinnitus include prolonged exposure to noise, blood vessel disorders, diabetes, allergies and other medical, neurological or mental health problems. While caffeine has traditionally been thought to be associated with tinnitus, some research has found higher amounts of caffeine to be associated with a lower risk of tinnitus in some people. Tinnitus also can be caused by age-related hearing loss or a buildup of wax in the ear.

You’ll need to work with your doctor to determine whether your antidepressant or something else is causing your tinnitus. Your symptoms may go away when the underlying cause is treated.

If the underlying cause isn’t clear — or treatment doesn’t help — you may benefit from a device similar to a hearing aid that may help mask the ringing. A change in medication, counseling or certain relaxation techniques also may help you cope with tinnitus.

Oct. 07, 2020

Show references

Henderson MC, et al. Tinnitus. In: The Patient History: An Evidence-Based Approach to Differential Diagnosis. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.mhmedical.com. Accessed May 9, 2018.
Dinces EA. Treatment of tinnitus. https://www.uptodate.com/contents/search. Accessed May 9, 2018.
Sertraline. Micromedex 2.0 Healthcare Series. http://www.micromedexsolutions.com. Accessed May 9, 2018.
Paroxetine. Micromedex 2.0 Healthcare Series. http://www.micromedexsolutions.com. Accessed May 9, 2018.
Dinces EA. Etiology and diagnosis of tinnitus. https://www. uptodate.com/contents/search. Accessed May 9, 2018.
Tinnitus. American Academy of Otolaryngology-Head and Neck Surgery. http://www.entnet.org/content/tinnitus. Accessed May 10, 2018.
Glicksman JT, et al. A prospective study of caffeine intake and risk of incident tinnitus. The American Journal of Medicine. 2014;127:739.

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Ask the Doctors – What causes the hissing sound in my ear?

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Ask the Doctors – What causes the hissing sound in my ear?

By Ask the Doctors • June 27, 2018

Dear Doctors: Sometimes I get a sudden hissing sound in my right ear that lasts for a few minutes and then slowly goes away. What is it and is there anything I can do to make it stop?

Dr. Elizabeth Ko and Dr. Eve Glazier

Exposure to noise is a major cause of tinnitus, as is hearing loss. Both can result in damage to the sensitive hair cells that line the cochlea. This is the portion of the inner ear that translates vibrations into nerve impulses, which are then sent to the brain to be interpreted as sound.

Blockage due to earwax buildup, as well as changes to the ear bones as we age can contribute to tinnitus. Some medications, including certain antibiotics, cancer drugs, antidepressants and high doses of aspirin are known to play a role in tinnitus.

Although the most common form of tinnitus involves a ringing in the ears, people with this condition may also hear the hissing you describe, as well as buzzing, clicking, humming, whistling or a roaring sound, like wind. In rare cases, patients with tinnitus have even reported hearing music.

Tinnitus can affect one or both ears. It ranges in volume from a low, background noise that is bearable and even forgettable, to sounds that are so loud and persistent, they interfere with daily life. In many cases, tinnitus is temporary. In severe cases, the phantom sounds never go away.

It is estimated that up to 45 million Americans – that’s 15 percent of the population – report having some form of tinnitus on a regular basis. Like you, the vast majority of them have subjective tinnitus, which is sound that only the patient can hear. In objective tinnitus, which affects just one percent of the population, the sounds a patient hears are audible to others as well. The causes of objective tinnitus are most often internal conditions related to blood flow in vessels near the ear.

Men are more prone to tinnitus than women, and it becomes increasingly common as we age. Individuals who work in loud environments such as factories and construction sites are at increased risk. Recent studies suggest that earbuds, which sit so close to the delicate structures of the inner ear, may also put users at higher risk.

At this time, there is no single treatment for tinnitus. An examination by an ear specialist, known as an otolaryngologist, can pinpoint whether tinnitus is due to earwax buildup, medication, or, more rarely, a blood vessel condition. These are often treatable. If not, your doctor can help you explore noise suppression techniques such as using a white noise machine, or masking devices that are worn in the ears.

Meanwhile, you can take steps to lessen the impact of tinnitus. Make sure your blood pressure is under control, avoid loud noises, which can set off a tinnitus episode, and – this will improve your overall quality of life – be sure to get enough rest.

Eve Glazier, MD., MBA, and Elizabeth Ko, MD., are internists at UCLA Health. Dr. Glazier is an associate professor of medicine; Dr. Ko is an assistant professor of medicine.

Ask the Doctors is a syndicated column first published by UExpress syndicate.

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Symptoms, treatment, home remedies, and causes

A person with tinnitus often hears “ringing in the ears,” but they may also hear hissing, clicking, or whistling sounds. It can be temporary, or it can be chronic and persistent.

Tinnitus is thought to affect 50 million Americans. It usually occurs after the age of 50 years, but children and adolescents can experience it, too.

Common causes are excessive or cumulative noise exposure, head and neck injuries, and ear infections. It can occasionally indicate a serious underlying medical condition.

There is no cure for tinnitus, but there are ways of managing it. Most people with chronic tinnitus adjust to the ringing over time, but 1 in 5 will find it disturbing or debilitating.

For some, it can lead to insomnia, difficulty with concentration, poor work or school performance, irritability, anxiety, and depression.

Fast facts on tinnitus

Here are some key points about tinnitus. More detail is in the main article.

Around 50 million Americans experience some form of tinnitus.
Most tinnitus is due to damage to the cochlea, or inner ear.
Certain medications can cause or worsen tinnitus, for example, aspirin, particularly in large doses.
People with tinnitus may be over-sensitive to loud noise.
Most people learn to live with tinnitus, but help is available for those who find this difficult.

Tinnitus happens when we consciously hear a sound that does not come from any source outside the body. It is not a disease, but a symptom of an underlying problem.

The noise is usually subjective, meaning that only the person who has tinnitus can hear it.

The most common form is a steady, high-pitched ringing. This can be annoying, but it does not usually indicate a serious condition.

In fewer than 1 percent of cases, it may be objective. This means that other people can hear the noise. This type of noise may be caused by cardiovascular or musculoskeletal movements in the person’s body. This can be a sign of a medical emergency.

Tinnitus is a non-auditory, internal sound that can be intermittent or continuous, in one or both ears, and either low- or high-pitched.

The varying sounds have been described as whistling, chirping, clicking, screeching, hissing, static, roaring, buzzing, pulsing, whooshing, or musical.

The volume of the sound can fluctuate. It is often most noticeable at night or during periods of quiet. There may be some hearing loss.

The first step is to treat any underlying cause of tinnitus.

This may involve:

prompt care for an ear infection
discontinuing any ototoxic medications
treating any temporomandibular joint (TMJ) problems, which affect the joint betwen the jaw bone and the cheek bone

There is no cure for most cases of tinnitus. Most people become accustomed to it and learn to tune it out. Ignoring it rather than focusing on it can provide relief.

When this does not work, the individual may benefit from treatment for the effects of tinnitus, insomnia, anxiety, hearing difficulties, social isolation, and depression. Dealing with these issues can significantly improve a person’s quality of life.

Here are some other things a person can do to manage tinnitus and its effects.

Sound therapy uses external noise to mask the individual’s perception of tinnitus. Low-level background music, white noise, or specialized ear maskers can help.

The choice of sound should be pleasant to the individual. Masking devices offer temporary relief, and the awareness of tinnitus returns when the sound therapy is turned off.

Hearing aids are a common type of sound therapy. They amplify environmental sounds and redirect attention to those noises instead of the tinnitus.

Tinnitus retraining therapy (TRT) involves retraining the auditory system to accept the abnormal sounds of tinnitus as natural rather than disruptive.

It involves help from a trained professional and wearing a device that emits low-level white noise. Ongoing counseling sessions can help people cope with the tinnitus.

This therapy’s success is proportionate to the severity of the tinnitus and the individual’s overall mental health.

Follow-up studies suggest that TRT provides relief for around 80 percent of people with tinnitus.

Cognitive behavioral therapy (CBT) can help relieve depression in people with tinnitus, although it does not appear to reduce the sound.

Healthy lifestyle

One way to prevent tinnitus, and possibly hearing loss, is by avoiding exposure to loud noises.

To prevent hearing damage from developing or worsening:

use hearing protection, such as ear mufflers and earplugs, in noisy environments
play personal listening devices at a moderate volume

Improving wellness will not stop tinnitus, but overall wellbeing can help limit its intensity and provide physical and emotional benefits.

Exercise, healthy eating, good sleeping habits, avoiding smoking and excessive alcohol, recreational and social activities, and stress management and relaxation techniques can all help achieve optimum wellness.

Unfortunately, once the damage is done, there is no way to reverse it.

Anyone who is experiencing tinnitus should visit a doctor for an examination and evaluation to determine the underlying cause.

A medical evaluation can exclude any rare but life-threatening causes of tinnitus. A referral to an otolaryngologist, or ear, nose, and throat specialist, may be necessary.

Questions that a doctor might ask include:

How or when did it start?

Are the noises constant, intermittent, or pulsating?
Is there any hearing loss or dizziness?
Is there any pain or jaw clicking?
Have you had a recent illness or injury?
Has there been any exposure to loud noise, such as a rock concert or explosives?

Tests may include:

a complete examination of the ear, head, neck, and torso
hearing tests
laboratory blood tests
imaging studies

The most common cause of tinnitus is damage and loss of the tiny sensory hair cells in the cochlea of the inner ear.

This tends to happen as people age, and it can also result from prolonged exposure to excessively loud noise. Hearing loss may coincide with tinnitus.

Research suggests that the sensory loss of certain sound frequencies leads to changes in how the brain processes sound.

As the brain receives less external stimuli around a specific frequency, it begins to adapt and change. Tinnitus may be the brain’s way of filling in the missing sound frequencies it no longer receives from its own auditory system.

Some medications such as aspirin, ibuprofen, certain antibiotics, and diuretics can be “ototoxic.” They cause damage to the inner ear, resulting in tinnitus.

Other possible causes are:

head and neck injuries
ear infections
a foreign object or earwax touching the eardrum
eustachian tube (middle ear) problems
temporomandibular joint (TMJ) disorders
stiffening of the middle ear bones
traumatic brain injury
cardiovascular diseases
diabetes

If a foreign body or earwax causes tinnitus, removing the object or wax often makes the tinnitus go away.

Tinnitus that sounds like a heartbeat may be more serious. It could be due to an abnormal growth in the region of the ear, such as a tumor or an abnormal connection between a vein and artery.

It needs a medical evaluation as soon as possible.

Teens, loud music, and possible future hearing problems

One study found that out of 170 teenagers, over half had experienced tinnitus in the previous year. Research has proposed that “potentially risky leisure habits,” such as listening to loud music on personal devices, could trigger tinnitus.

However, the investigators found that those who were prone to tinnitus tended to keep their music volume down, suggsting they may already have a hidden susceptibility to hearing loss in the future.

They propose monitoring for tinnitus and a low tolerance for loud noise from an early age, as these could be early signs of future hearing loss.

Tinnitus is a common problem in the general population, especially among those with certain risk factors.

These include:

noise exposure from work, headphones, concerts, explosives, and so on
smoking
gender, as men are affected more than women
hearing loss
age, as older individuals are more susceptible