Tinnitus is the medical term for "hearing" noises in your ears when there is no outside source of the sounds. The noises you hear can be soft or loud. They may sound like ringing, blowing, roaring, buzzing, hissing, humming, whistling, or sizzling. You may even think you are hearing air escaping, water running, the inside of a seashell, or musical notes.

Tinnitus is common. Almost everyone experiences a mild form of tinnitus once in awhile that only lasts a few minutes. However, constant or recurring tinnitus is stressful and can interfere with your ability to concentrate or sleep.

It is not known exactly what causes a person to "hear" sounds with no outside source of the noise. However, tinnitus can be a symptom of almost any ear problem, including ear infections, foreign objects or wax in the ear, and injury from loud noises. Alcohol, caffeine, antibiotics, aspirin, or other drugs can also cause ear noises.

Tinnitus may occur with hearing loss. Occasionally, it is a sign of high blood pressure, an allergy, or anemia. Rarely, tinnitus is a sign of a serious problem like a tumor or aneurysm.

• Tinnitus can be masked by competing sounds, such as low-level music, ticking clocks, or other noises. Tinnitus is often more noticeable when you go to bed at night because your surroundings are quieter. Any noise in the room, like a humidifier, white noise machine, or dishwasher, can help mask tinnitus and make it less irritating.
• Learn ways to relax. Feeling stressed or anxious can worsen tinnitus.
• Avoid caffeine, alcohol, and smoking.
• Get enough rest. Try sleeping with your head propped up in an elevated position. This lessens head congestion and noises may become less noticeable.

Call your doctor if:

• Ear noises start after a head injury.
• The noises are associated with other unexplained symptoms like dizziness, feeling off balance, nausea, or vomiting.
• You have unexplained ear noises that bother you even after self-help measures.

The health care provider will perform a physical examination, including a detailed ear examination. The provider ask questions such as:

• What does the sound resemble?
• Is the sound throbbing or rhythmic?
• Is it in one or both ears?
• What other symptoms are also present?

• Audiology/audiometry to test hearing loss
• Head CT scan
• Head MRI scan
• Blood vessel studies (angiography)
• X-rays of the head

TREATMENT

Usually, there is no known cure for tinnitus. If the underlying cause is determined, then fixing that problem may take away your tinnitus (for example, removal of ear wax). Otherwise, measures to help you lessen or live with the noises are taken.

A tinnitus masker, a device worn like a hearing aid, may help. This works by producing low-level sound directly into the ear to cover or disguise the ear noise so that it is less bothersome. A hearing aid may help lessen ear noise and amplify outside sounds.

Medications such as anti-arrhythmics (usually used for irregular heart rhythms), antidepressants, vasodilators, tranquilizers, and anticonvulsants may help. Antihistamines (e.g., meclizine) are also often effective.

Sometimes, counseling may help you learn to tolerate tinnitus. When appropriate, you may be encouraged to consider biofeedback training. This is a method that helps you learn to control body functions by monitoring specific responses (such as tightness of a muscle group) and altering this response through relaxation.

The American Tinnitus Association is a good resource center and support group.

Wear ear protection in any situations where ear damage is possible (such as loud concerts or jackhammers). If you have hearing loss, avoid further damage to your hearing by avoiding excessive noise.

Make sure your blood pressure is normal by maintaining proper body weight, exercising regularly, and seeing your doctor for yearly check ups.

Heller AJ. Classification and epidemiology of tinnitus. Otolaryngol Clin North Am. 2003; 36(2): 239-248.

Sismanis A. Tinnitus. Advances in evaluation and management. Otolaryngol Clin North Am. 2003; 36(2): xi-xii.