Tinnitus (Ringing in Ears) — Causes, Symptoms & Treatment Options

Tinnitus — a ringing, buzzing, hissing, or whistling sound in the ears that no one else can hear — affects millions of people. While it cannot always be cured, it can almost always be managed effectively. Here is what you need to know.

What Is Tinnitus?

Tinnitus is the perception of sound in the ears or head when no external sound is present. It is not a disease itself — it is a symptom of an underlying condition. The sounds people describe include ringing, buzzing, hissing, whistling, humming, clicking, or roaring. It can affect one or both ears and can be constant or intermittent.

Tinnitus affects approximately 10–15% of the global population, and for about 1–2%, it significantly impacts quality of life, sleep, and concentration.

Common Causes of Tinnitus

• Noise-induced hearing loss — prolonged exposure to loud sounds (machinery, concerts, headphones at high volume)
• Age-related hearing loss (presbycusis) — the most common cause in adults over 50
• Earwax blockage — impacted wax pressing on the eardrum
• Ear infections — middle ear fluid or otitis media
• Ototoxic medications — certain antibiotics, NSAIDs, quinine, and chemotherapy drugs
• Eardrum perforation
• Meniere's disease — inner ear disorder affecting both hearing and balance
• TMJ disorders — jaw joint problems that affect the ear
• Stress and anxiety — can trigger or worsen tinnitus

Types of Tinnitus

Subjective tinnitus — Only the patient hears it. The most common type (95% of cases). Usually caused by hearing nerve or cochlear damage.

Objective tinnitus — The audiologist can also hear it with a stethoscope or sensitive microphone. Rare. Usually caused by a blood vessel abnormality or muscle spasm.

Pulsatile tinnitus — Sound pulses in rhythm with the heartbeat. Requires investigation to rule out vascular causes.

How Is Tinnitus Diagnosed?

At MMM Hearing Centre, Dr. Shehroz Majid will conduct:

• Full case history — onset, triggers, associated symptoms
• Pure-tone audiometry to assess hearing levels
• Tympanometry to check middle ear function
• Tinnitus pitch and loudness matching
• Medical referral if vascular or neurological causes are suspected

Treatment Options for Tinnitus

While there is currently no universal cure for tinnitus, the following approaches significantly reduce its impact:

Sound Therapy

Using background sounds (white noise, nature sounds) to reduce the contrast between the tinnitus sound and silence. This is the most evidence-supported management strategy. Hearing aids with tinnitus masking features are particularly effective.

Tinnitus Retraining Therapy (TRT)

A combination of sound therapy and counselling that helps the brain reclassify tinnitus as a neutral background noise rather than a threatening signal. Requires several months but produces lasting results.

Hearing Aids

If tinnitus is accompanied by hearing loss (which is very often the case), hearing aids restore ambient sounds that naturally mask the tinnitus — providing significant relief even without dedicated tinnitus programmes.

Counselling and Cognitive Behavioural Therapy (CBT)

Tinnitus distress is heavily influenced by anxiety and the way a person reacts to the sound. CBT helps modify these reactions and is one of the most effective tools for reducing tinnitus-related distress.

Lifestyle Adjustments

• Avoid prolonged silence — use background music or fans at night
• Reduce caffeine and alcohol consumption
• Manage stress with exercise and relaxation techniques
• Protect ears from loud noise