Tinnitus is a common disorder that can significantly affect daily life. It is characterized by the perception of sound or noise in the ear, and a thorough ENT examination with audiometric tests is necessary to identify the underlying cause.

We interviewed an otolaryngologist to provide insights into tinnitus.

What is tinnitus?

Tinnitus is the perception of a sound or noise in the ear, which can vary in tone. Patients may hear a buzzing, ringing, or whistling sound.

Tinnitus is a prevalent symptom, affecting 10-15% of adults. It may be constant or intermittent, weak or loud, leading to other symptoms such as headaches, anxiety, sleep disturbances, and concentration difficulties.

Tinnitus is commonly associated with hearing loss and can be split up into two types:

  • Subjective tinnitus: This is the most common type of tinnitus, where the brain produces a sound only the patient can hear.
  • Objective tinnitus: This type is less common, and an actual noise is produced by structures adjacent to the ear.

What are the causes of tinnitus?

Tinnitus can have multiple causes, including:

  • Earwax plug: Some patients report tinnitus with a sense of occlusion. Removal of the earwax plug can resolve this type of tinnitus.
  • Intense and frequent noises that damage the auditory system.
  • Inflammation of the ear, nose, or sinuses.
  • Head and neck trauma that causes reversible tinnitus.
  • Misalignments of the jaw-joint: This can affect the auditory system.
  • Thyroid disease or fibromyalgia.
  • Ménière’s syndrome (intermittent tinnitus): An accumulation of fluid in the ear can cause tinnitus that resolves as soon as the crisis ends.
  • Sudden deafness: It can be caused by an inner ear infarction or viral mononeuritis. Tinnitus associated with hearing loss in these cases may be a symptom that requires immediate treatment, including steroid therapy within 72 hours to try to remedy the hearing loss.

Diagnosis

The diagnosis of tinnitus involves:

  • Careful analysis of the patient’s medical and personal history.
  • Assessment of the characteristics of the tinnitus.
  • Objective examination of the external auditory canal and tympanic membrane by otoscopy and evaluation of the nasal passages, mouth, and temporomandibular joint.
  • MRI to clarify whether the tinnitus is idiopathic or related to some pathology.

Tinnitus: How to solve the problem?

Earwax removal may be enough to cure tinnitus caused by a plug of earwax. However, treatment of the underlying pathology may be attempted for cases associated with middle ear diseases, such as otosclerosis, although even surgery is not always curative.

For cases associated with hearing loss, modern hearing aids can provide excellent results. Unfortunately, there is no medical treatment available that effectively treats tinnitus.