Formula Medical Group
Apple Valley, CA

James Krider, MD

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Ringing in the ears - tinnitus

Ringing in the ears is described as hearing a high-pitched sound that has no external or internal sound source. In addition to ringing, the sound may seem like a buzzing, roaring, whistling, or hissing noise. The sound may vary at different times.

Tinnitus, the medical term for ringing in the ears, is a common problem. Sometimes it has a temporary, trivial cause. Persistent tinnitus, however, is often caused by an ear disorder or other diseases. If it becomes a permanent problem, it usually causes some loss of hearing.

Causes of ringing in the ears

Anemia is a blood disorder characterized by either a decrease in the number of red blood cells or an abnormality of the hemoglobin, the pigment in red cells that carries oxygen. Since a lack of oxygen can result in tinnitus, anemia is a possible cause of ringing in the ears.

Brain injuries or disorders
A head injury or disease affecting the brain may also damage the auditory nerve and other structures involved in hearing, resulting in ringing in the ears. Possibilities include head trauma, infection, brain inflammation, hemorrhage, and certain brain tumors.

Cardiovascular disease
If the ringing in the ears has a pulsing sound, it may be due to a cardiovascular disorder. Possibilities include high blood pressure, hardening of the arteries, or an aneurysm.

Colds and flu
A cold or bout of the flu often causes head congestion, which may lead to temporary ringing in the ears.

Drug toxicity
Chronic overuse of certain drugs can cause ringing in the ears. The most common culprits are aspirin and other nonsteroidal anti­inflammatory medications. Other drugs that produce this side effect include quinine and its synthetic analogs, aminoglycoside antibiotics, and certain diuretics. Lead poisoning and alcohol toxicity also cause tinnitus.

The thyroid gland, located in the

Hearing normally occurs when sound waves vibrate the tympanic membrance and are transmitted into nerve impulses that are relayed to the brain by the auditory nerve.

Hearing normally occurs when sound waves vibrate the tympanic membrane and are transmitted into nerve impulses that are relayed to the brain by the auditory nerve.


Ringing in the ears should be reported to a doctor promptly if: it persists for more than a few hours after exposure to a loud noise, it is associated with an ear infection and does not disappear when the infection clears, or it arises due to an unknown cause.

neck, produces a hormone called thyroxine. A lack of thyroxine causes body tissues to become puffy. When this puffiness affects the ears, it can cause hearing loss and tinnitus.

Infections of the outer or middle ear often cause tinnitus. The infection may occur alone or in conjunction with a cold or flu or it may originate in the ear itself. If the ear is permanently damaged by the illness, the ear ringing may become chronic.

Meniere's disease
Meniere's disease is believed to be caused by an increase of fluid in the labyrinth of the inner ear. It can affect both balance and hearing, and may also cause severe vertigo and consequent nausea. Attacks of Meniere's are usually intermittent.

Noise and sensorineural hearing loss
This is the type of hearing loss that arises from problems in the inner ear or the nerve from the inner ear to the brain, or from the brain itself. One of the most com­mon causes is excessive noise, either chronic exposure to loud noise over a long period, or acoustic trauma such as sudden, severe noise produced by an explosion. Tinnitus caused by such acute noise exposure is often temporary, but it signals

underlying damage that can worsen and become permanent with further exposure to noise.

Glands in the outer ear produce wax to protect the external auditory canal. Some people produce so much wax that it obstructs the canal and causes tinnitus. This is easily removed by a physician.

This involves degeneration of the ear bone, which can immobilize mechanisms important in hearing in the middle ear. Surgery is usually required to prevent deafness or restore hearing.

Vertigo is a type of dizziness in which the person feels that the room is spinning. It also may be accompanied by other ear or neurologic problems and persistent ringing in the ears.

Advice about ringing in the ears

Mild to moderate ringing in the ears usually is not heard during the course of daily activities. To mask the sound while reading, doing other quiet work, or going to sleep, try one of the following:

  • Keep a radio on tuned to a soft music station.
  • Turn on an air conditioner or a fan.
  • Purchase a "white sound" machine.
  • Play a record or tape of soothing environmental sound, such as a rainfall or ocean waves.
  • For more severe cases, ask your doctor about a tinnitus masker, which is worn like a hearing aid and provides a more pleasant and less diverting sound.
This article was last reviewed November 13, 2005 by Dr. James Krider.
Reproduced in part with permission of Home Health Handbook.
Artery hardening
Brain abscess
Brain cancer
Common cold
Ear bone degeneration
Earwax buildup
Fractured skull
Head injuries
Hearing loss, neural
Hearing loss, sensory
High blood pressure
Infections, children
Infections, ear
Infections, inner-ear
Infections, middle-ear
Med's, antibiotics
Med's, arthritis
Med's, diuretics
Med's, painkillers
Meniere's disease
Thyroid, deficiency

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