What Is Tinnitus?
Tinnitus is the perception of sound (ringing, buzzing, hissing, clicking) without an external source. It can be constant or intermittent, in one or both ears, and ranges from mildly bothersome to severely life-limiting.
Types of Tinnitus
| Type | Description |
|---|---|
| Subjective (most common) | Only the patient hears it — neurological origin |
| Objective (rare) | Can be heard by examiner — vascular or muscular cause |
| Pulsatile tinnitus | Synchronised with heartbeat — requires urgent investigation for vascular cause |
Common Causes
- Noise-induced hearing loss (most common)
- Age-related hearing loss (presbycusis)
- Earwax blockage
- Middle ear infections
- Menière's disease
- Medications (NSAIDs, aminoglycosides, loop diuretics, quinine)
- Anxiety, depression, stress (worsens perception)
Blood Tests Worth Ordering
| Test | Reason |
|---|---|
| Full Blood Count | Anaemia — cardiovascular turbulence can cause pulsatile tinnitus |
| Thyroid (TSH) | Both hypo- and hyperthyroidism can cause or worsen tinnitus |
| Lipid profile | Cardiovascular risk; atherosclerosis in arteries near the ear |
| Fasting glucose | Diabetes is associated with hearing loss and tinnitus |
| Vitamin B12 | B12 deficiency causes cochlear nerve dysfunction |
Management
- Treat underlying cause if identified
- Sound therapy (white noise, sound enrichment — reduces tinnitus awareness)
- Tinnitus retraining therapy (TRT)
- Cognitive behavioural therapy (CBT) — most effective for distress
- Hearing aids (if hearing loss present — reduce tinnitus perception)
- Avoid silence — background sounds reduce tinnitus salience
FAQs
Can tinnitus go away?
Acute tinnitus (after loud noise) often resolves. Chronic tinnitus rarely disappears completely but management significantly reduces distress.
What is pulsatile tinnitus?
Tinnitus that beats with the pulse suggests a vascular cause — arteriovenous malformation, venous sinus stenosis, or rarely a glomus tumour. Requires urgent MRI/MRA.
Do any medications help tinnitus?
No medication is proven to cure tinnitus. Some antidepressants help with the distress and sleep disruption it causes.
Medical Disclaimer: New-onset pulsatile tinnitus, unilateral tinnitus with hearing loss, or tinnitus with neurological symptoms should be urgently investigated by an ENT specialist.