Tinnitus (Ringing in the Ear)

Tinnitus is basically a ringing sound heard by the patient in the ear. The sound originates from within the patient and is not produced by any external stimulus. Patient may describe the sound as ringing, hissing, roaring, buzzing or clicking. It should be noted that this sound is not a disease. It is a symptom and not a condition in itself. It can affect one of the ears or both. Imagine hearing a ringing sound day and night. Thus it is easy to see that this sound is a great source of annoyance and irritation for the patient. Though it bothers the patient, tinnitus does not usually indicate a serious condition of the patient in most of the cases. Treatment of the patient can help improve the masking of the sound and if the underlying cause is treated, it can be eradicated completely.

The ringing sound may have variable pitch and loudness. It can vary between a soft click to high pitched ringing. The sound may be continuous without any interruption or it may come and go at certain times of the day.


Tinnitus can be classified into two types:

  • Subjective tinnitus is tinnitus felt only by the patient. This kind of tinnitus may originate from within the external ear, middle ear, internal ear or the hearing (auditory) nerve pathways. Systemic disturbances and disorders like anemia, hypertension and administration of certain drugs can also result in subjective tinnitus.
  • Objective tinnitus is tinnitus which can also be heard by the doctor when he examines patient’s ear. This is uncommon as compared to subjective type but may occur due to a blood vessel problem or muscle contractions.

Role of Doctor or Hearing specialist in Tinnitus

It is important that you report to your physician or a hearing specialist when you develop sudden ringing sound in the ear without any apparent cause. Any such sound which provides a source of disturbance to you or may occur along with some other condition should be reported to the health care professional.



  • Aging: People older than 60 start to develop hearing loss and this sometimes can give rise to tinnitus.
  • Wax in the ear can accumulate and irritate ear drum which can cause tinnitus.
  • Loud noises can produce temporary or permanent tinnitus depending on the intensity and duration of exposure
  • Ear bones in the middle ear can cause tinnitus if they undergo abnormal stiffening.


Some Other Causes Of Tinnitus

Less common but other important causes of tinnitus include

  • Meniere’s disease, arteriosclerosis, hypertension, Temperomandibular joint (TMJ) defects, tumors of head and neck, Head injuries and certain drugs e.g. antibiotics, anticancer drugs and even aspirin in high doses.



It should be remembered that tinnitus is a symptom and not a disease. So, for its treatment the cause of the disturbing sound should be investigated and treated. Sometimes though, even after the treatment of the cause tinnitus might not go away then comes the role of effective management of tinnitus. Health care professionals have developed several techniques and management strategies to counter or minimize tinnitus.

  • Reassurance:
    Sometimes if tinnitus cannot be eradicated, the patient need to be explained that the sound itself is harmless to the patient’s health.
  • Sedation:
    Sedation and tranquilizers may be useful in initial stages to help patient adjust to the symptom.
  • Relaxation
  • Masking:
    Patient feels the effect of tinnitus more severely in quiet surroundings.Avoiding silenceandincreasing the amount of ‘background noise’ in your home or workplace can help lessen your focus on your tinnitus tone. This noise could include pleasant low-level sounds from a television, radio, or recorded music, from a fan, a ticking clock or from outside through an open window. Alternatively, you could use sound generators that play natural sounds or white noise at a volume that is just below that of your tinnitus
  • Use of devices like Hearing aids and neuromonics:
    Use of Hearing aids and Neuromonics listening device may help to mask and reduce the tinnitus.
  • Tinnitus Retraining Therapy (TRT):
    This is a special kind therapy which helps you learn how to adapt to your tinnitus so that this sound is not realized consciously but moves to subconscious part of your brain. This is based on the theory that your brain prioritizes the sound of tinnitus. So, TRT helps you learn how to block out theses sounds even though they may still be occurring
  • Medications:
    There are at present no medicines for tinnitus but if the patient is suffering from depression because of tinnitus, antidepressants can be prescribed.