Ringing in ear has no easy solutions
by Eve Glazier, M.D., and
Elizabeth Ko, M.D.
Dear Doctors: I am a woman in my 80s and have been in pretty good health. However, I now have ringing in my ears that drives me crazy. I’ve tried drugstore pills and drops and a sound machine as well, but nothing works. I am hoping you can explain this ordeal and offer suggestions for relief.
Dear Reader: You have described something known as tinnitus. It is defined as a perceived sound that does not arise from an external source.
Tinnitus is not a condition in and of itself, but it is, instead, a symptom of some other underlying problem. The sound -- or sounds -- that someone with tinnitus hears occur because something taking place within the body has begun to affect the complex apparatus that allows us to hear.
Ongoing tinnitus affects an estimated 15% of the population in the United States. Many more people report having had temporary episodes, often due to exposure to a loud noise, or sometimes due to a blow to the head.
The most common sound associated with tinnitus is the ringing that you have described. People also report hissing, buzzing, whistling, chirping, whirring and roaring sounds. It’s not common, but some people say that they hear phantom music.
Potential physical causes of tinnitus include high blood pressure or a buildup of earwax. It can also be a side effect of certain medications. These include some types of antibiotics, antidepressants and cancer drugs, as well as large doses of aspirin.
But the major causes of tinnitus are exposure to loud or persistent noise and hearing loss. These can result in damage to the part of the inner ear, known as the cochlea, that translates the vibrations from sounds into nerve impulses. The information gathered by the cochlea is sent to specialized areas of the brain, known as auditory cortices, where the nerve impulses are interpreted as sound.
Tinnitus can affect one or both ears, and it can range in volume from a forgettable background noise to loud and persistent sounds that interfere with daily life. While some cases are temporary, for many individuals the sounds of tinnitus persist. Unfortunately, there is not a single treatment.
We recommend that you schedule an appointment with an ear specialist, known as an otolaryngologist. They can identify potential physical causes, such as earwax buildup, medication or a blood vessel condition, which are often treatable. They can also make sure that your blood pressure is under control.
A hearing specialist can also help you explore noise-suppression techniques, such as the use of a masking device that is worn in the ears. When hearing loss is a factor, the use of hearing aids can be helpful. These amplify external sounds, which often are louder than the inner sounds of tinnitus.
As you say, tinnitus can be maddening. And, unfortunately, there may not be an easy fix. But by working with a specialist, and through a process of trial and error, you may be able to arrive at a combination of techniques that will give you some relief.
(Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health.)
(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)