Causes of Tinnitus Hard to Identify

Q:  Can you please explain tinnitus (ringing or buzzing sounds in the ears) that never lets up? What causes it, and is there any relief from it?

A:  Tinnitus is a nonspecific symptom that is poorly understood. In about half of the cases, no specific cause can be identified. Since tinnitus is a symptom and not a diagnosis, it is important to have a complete examination, including a thorough hearing test, to look for underlying disease. Temporary conditions which can cause a low-pitched ringing sensation are impacted earwax, ear infections, or perforation of the ear drum. Some medicines, even aspirin, can cause reversible tinnitus. Tinnitus is often associated with loss of hearing.

If the tinnitus is accompanied by dizziness and hearing loss, this could indicate Meniere's disease, a chronic problem. Meniere's disease is an abnormality of the inner ear causing a host of symptoms, including vertigo or severe dizziness, tinnitus or a roaring sound in the ears, fluctuating hearing loss, and the sensation of pressure or pain in the affected ear. Another rare but serious cause of ear ringing is acoustic neuroma, which is a tumor of the inner ear nerves. Tinnitus may also indicate disease of adjacent blood vessels.

No one knows what causes the actual buzzing or ringing sounds. If hearing loss is present, sometimes wearing a hearing aid helps decrease the tinnitus. A device is also available (a "tinnitus masker") which emits a sound to suppress the usual ringing.

Stimulants like caffeine, nicotine, and alcohol can worsen the tinnitus and should be avoided.

For more information see the HealthLink article Tinnitus: The Noise Inside Your Head or visit the website of the American Tinnitus Association.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.