Tinnitus

Summary

Tinnitus is hearing a sound that has no corresponding external source. It may be described as ringing, buzzing, hissing, whistling or another sound and can be constant or intermittent, in one ear, both ears or the head. Its impact ranges from minor awareness to major problems with sleep, concentration, mood and daily life.

Tinnitus is a symptom rather than a disease. It often accompanies hearing loss or noise exposure, but can also be associated with ear disease, jaw or neck problems, certain medicines, stress and other medical conditions. Frequently no single cause is identified.

Assessment

An ENT or hearing assessment may include examination of the ears and a hearing test. Tell the clinician whether the sound is one-sided, pulsates with the heartbeat, started suddenly or is accompanied by hearing loss, dizziness, pain or neurological symptoms. Medication and noise exposure should also be reviewed.

Seek urgent assessment if tinnitus begins with sudden hearing loss, severe vertigo, facial weakness or other sudden neurological symptoms. Pulsatile tinnitus, persistent one-sided tinnitus or tinnitus with asymmetric hearing also requires medical evaluation.

Treatment and support

If a treatable cause is found—such as earwax, middle-ear disease or a medication effect—it is addressed where possible. Hearing aids can reduce the contrast between tinnitus and surrounding sound when hearing loss is present. Background sound or sound generators may make tinnitus less noticeable, particularly in quiet settings.

Reliable information, sleep support, relaxation and gradual return to valued activities can reduce distress. Cognitive behavioural therapy has evidence for reducing the burden of tinnitus even when it does not remove the sound. Specialist tinnitus or audiology rehabilitation can combine education, hearing care and psychological support.

Be cautious with supplements and alternative treatments that promise a cure; evidence is often limited and products may interact with medication. Progress is individual. The aim is to reduce the attention and distress attached to tinnitus and help the person regain control of daily life.