Tinnitus
Tinnitus is the perception of sound — ringing, buzzing, hissing, or clicking — in one or both ears without an external source. It affects up to 15% of adults and can significantly disrupt sleep, concentration, and emotional wellbeing. While there is no single cure, a range of effective management strategies can substantially reduce its impact on daily life.
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This page provides general health information only. Sudden tinnitus in one ear, pulsatile tinnitus, or tinnitus with hearing loss should be assessed urgently.
What is tinnitus?
Tinnitus is a symptom — not a disease in itself — that arises from abnormal activity in the auditory system. The sounds perceived (ringing, buzzing, hissing, whooshing, clicking) are generated within the brain or auditory pathway rather than from an external source. Tinnitus may be in one ear, both ears, or felt centrally in the head.
Most people with tinnitus habituate to it over time — the brain learns to filter it as background noise, much as you stop noticing the hum of a refrigerator. For some, however, tinnitus remains intrusive and affects sleep, concentration, and emotional health. The psychological impact of tinnitus — anxiety, depression, and hypervigilance to the sound — often perpetuates distress more than the tinnitus itself.
Causes
- Noise-induced hearing loss — the most common cause; damage to cochlear hair cells from loud music or occupational noise
- Age-related hearing loss (presbycusis)
- Earwax build-up — a common and easily treated cause
- Middle ear infections or Eustachian tube dysfunction
- Ménière's disease — episodic tinnitus with vertigo and fluctuating hearing loss
- Acoustic neuroma — a benign tumour on the hearing nerve; causes unilateral tinnitus with hearing loss
- Ototoxic medications — high-dose aspirin, certain antibiotics, and chemotherapy agents
- Cardiovascular conditions — pulsatile tinnitus (synchronised with heartbeat) requires vascular assessment
- Jaw and neck problems — TMJ disorder and cervical spine dysfunction can cause or worsen tinnitus
Pulsatile tinnitus — a rhythmic whooshing or beating in the ear synchronised with your heartbeat — requires urgent assessment to rule out vascular causes including arteriovenous malformation or carotid artery stenosis.
When to see a doctor
See a doctor for any new tinnitus — particularly if it is in one ear only, is accompanied by hearing loss or dizziness, is pulsatile, or began suddenly. A thorough assessment identifies treatable causes and provides the foundation for an appropriate management plan.
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Management strategies
- Treating underlying causes — earwax removal, ear infection treatment, medication review
- Sound therapy — using background noise (white noise, nature sounds, music) to reduce the contrast of tinnitus against silence; particularly effective at night
- Hearing aids — for those with associated hearing loss; amplifying environmental sound reduces tinnitus perception significantly
- Tinnitus retraining therapy (TRT) — combines sound therapy and counselling to accelerate habituation
- CBT for tinnitus — the most evidence-based psychological approach; reduces emotional distress and improves quality of life
- Mindfulness and relaxation — reduce the anxiety and hypervigilance that amplifies tinnitus distress
- Avoiding loud noise — and always using hearing protection in loud environments
- Reducing caffeine, alcohol, and stress — all can temporarily worsen tinnitus
How eMedClinic can help
Our ENT specialists provide thorough tinnitus assessments, arrange audiological testing and imaging where appropriate, treat identifiable causes, and provide a personalised management plan. We also support people whose tinnitus is causing significant psychological distress with referrals to appropriate therapies.
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