That Ringing in Your Ears Is not Normal, Here is What It Means | Dr Sanjeev mohanty
- sanjeev mohanty
- Jun 23
- 6 min read
That Ringing in Your Ears Is not Normal, Here is What It Means By Prof. Dr. Sanjeev Mohanty | ENT, Head & Neck Surgeon | Chennai
Source & Appointment: www.drsanjeevmohanty.com
Introduction: The Sound No One Else Can Hear
Imagine a sound that never stops, a high pitched ringing, a low hum, a persistent buzzing or hissing, playing on loop inside your head. A sound that no one around you can hear. A sound that follows you into quiet rooms, keeps you awake at night, and makes it impossible to concentrate during the day. This is the daily reality for millions of people suffering from Tinnitus.
Tinnitus (pronounced TIN ih tus or ti NIGH tus) is one of the most common, and most misunderstood, ENT conditions in the world. In India, it is estimated that over 50 million people experience some form of tinnitus. Yet most patients dismiss the symptom, delay seeking help, or are incorrectly reassured that it is 'just stress.' In a significant proportion of cases, tinnitus is a symptom of an underlying medical condition that requires proper diagnosis and management.
In this blog, I want to give you a comprehensive medical understanding of tinnitus, what causes it, when to be concerned, what treatments are available, and how patients across Chennai and India can access the right ENT care.
What Exactly is Tinnitus?
Tinnitus is the perception of sound, ringing, buzzing, hissing, clicking, roaring, or pulsating, in the absence of an external acoustic source. It is not a disease in itself, but a symptom that can arise from a wide variety of underlying causes within the auditory system or beyond.
Tinnitus is broadly classified into two types:
• Subjective Tinnitus, The most common form (over 99% of cases). Only the patient can hear the sound. It originates from abnormal activity in the auditory nerve or brain pathways.
• Objective Tinnitus, Rare. An actual sound produced by anatomical structures near the ear (such as blood vessels or jaw joints) that can sometimes be heard by the examining physician using a stethoscope.
It can occur in one ear (unilateral) or both ears (bilateral), and can be constant or intermittent. Its character, pitch, volume, and pattern, varies significantly between patients and can change over time.
The Major Causes of Tinnitus
Understanding the cause of tinnitus is critical to determining the appropriate treatment. The most common causes I see in clinical practice in Chennai include:
• Noise induced hearing loss, The leading cause globally. Damage to hair cells in the cochlea from prolonged earphone use, occupational noise, or acoustic trauma disrupts normal neural signalling and produces phantom sounds.
• Age related hearing loss (Presbycusis), Natural degeneration of cochlear hair cells with aging, affecting those above 50 years significantly.
• Ear infections and wax blockage, Conductive hearing loss from ear canal blockage or middle ear infections can produce or worsen tinnitus.
• Ototoxic medications, Certain drugs including high dose aspirin, NSAIDs, aminoglycoside antibiotics, and some chemotherapy agents can cause or worsen tinnitus. Always inform your ENT specialist of all medications you take.
• Meniere's Disease, A disorder of the inner ear fluid system characterised by episodes of vertigo, hearing loss, ear fullness, and low frequency tinnitus.
• Vascular causes, Pulsatile tinnitus (a rhythmic sound synchronised with the heartbeat) may indicate high blood pressure, atherosclerosis, or vascular anomalies near the ear.
• Temporomandibular Joint (TMJ) Disorders, The jaw joint's proximity to the ear means TMJ dysfunction can frequently produce or aggravate tinnitus.
• Acoustic Neuroma, A benign tumour on the vestibulocochlear nerve, presenting with unilateral tinnitus, hearing loss, and balance disturbances. Though rare, it requires urgent exclusion in any patient with unilateral tinnitus.
• Stress and anxiety, While not a direct cause, psychological stress significantly amplifies the perception and distress associated with tinnitus.
Warning Signs: When Tinnitus Becomes an Emergency
Most tinnitus is benign and manageable. However, certain presentations require urgent medical attention. Please visit an ENT specialist immediately if you experience:
• Tinnitus in only one ear, This can indicate an acoustic neuroma or other serious pathology.
• Pulsatile tinnitus, Synchronised with your heartbeat; may indicate a vascular disorder.
• Sudden onset tinnitus with hearing loss, This constitutes a medical emergency (sudden sensorineural hearing loss) requiring treatment within 72 hours for best outcomes.
• Tinnitus accompanied by vertigo, dizziness, or balance problems.
• Tinnitus following head or neck trauma.
• Progressive worsening of tinnitus intensity over days or weeks.
How Tinnitus Is Diagnosed
At Dr. Mohanty's Speciality ENT Clinics in Manapakkam, Chennai, a systematic diagnostic approach is followed for every tinnitus patient. This includes:
• Detailed clinical history, Onset, character, associated symptoms, medication history, noise exposure history.
• Otoscopic examination, Inspection of the ear canal and eardrum.
• Pure tone audiometry, Comprehensive hearing assessment to identify any associated hearing loss.
• Tympanometry, Evaluation of middle ear function.
• Otoacoustic Emissions (OAE) test, Assessment of cochlear hair cell function.
• MRI or CT scans, Ordered when a retrocochlear cause (such as acoustic neuroma) or vascular lesion is suspected.
• Cardiovascular assessment, For pulsatile tinnitus cases.
The goal of this comprehensive evaluation is to identify a treatable underlying cause wherever possible, and to characterise the tinnitus thoroughly to guide appropriate management.
Treatment Options for Tinnitus
There is currently no single universal cure for tinnitus. However, a wide range of treatments can significantly reduce its severity and impact on quality of life:
1. Treating the Underlying Cause
Where an identifiable cause exists, ear wax impaction, infection, medication toxicity, or TMJ dysfunction, treating that cause often resolves or significantly improves tinnitus. This is why thorough diagnosis is paramount.
2. Sound Therapy
The use of external sounds to mask or blend with tinnitus perception. Options include white noise machines, tinnitus maskers built into hearing aids, and structured sound therapy programmes. Sound therapy helps the brain 'habituate' to tinnitus, reducing its perceived loudness and emotional impact over time.
3. Tinnitus Retraining Therapy (TRT)
TRT combines low level sound therapy with cognitive counselling to help the brain reclassify tinnitus from a 'threat' to a neutral, ignorable background signal. This neurological reprogramming can take 12 to 24 months but produces sustained relief in a significant proportion of patients.
4. Cognitive Behavioural Therapy (CBT)
CBT helps patients manage the psychological distress, anxiety, and sleep disruption associated with chronic tinnitus. While it does not reduce the loudness of tinnitus, it significantly improves quality of life and coping ability.
5. Hearing Aids
For patients with both tinnitus and hearing loss, which represents the majority, modern digital hearing aids amplify environmental sounds, reduce the contrast between external sounds and tinnitus, and provide significant relief.
6. Medical and Pharmacological Approaches
While no drug is specifically approved for tinnitus, certain medications may be helpful in specific circumstances, such as managing the anxiety component, treating Meniere's disease, or addressing vascular causes. These are always prescribed after thorough evaluation.
Living With Tinnitus: Lifestyle Guidance
Beyond medical treatment, several lifestyle modifications can help manage tinnitus effectively:
• Reduce caffeine and salt intake, Both can worsen tinnitus severity in susceptible individuals.
• Avoid silence, Paradoxically, very quiet environments make tinnitus louder. Use soft background music or white noise at home and during sleep.
• Manage stress actively, Yoga, mindfulness, and regular exercise have demonstrated benefits in reducing tinnitus severity.
• Protect your ears, Consistent use of hearing protection in noisy environments prevents further cochlear damage.
• Maintain good sleep hygiene, Tinnitus and sleep disruption reinforce each other. Addressing sleep quality is an integral part of management.
• Join a support group, Connecting with others experiencing tinnitus can reduce the sense of isolation and distress.
Conclusion: You Are Not Alone, And You Are Not Helpless
Tinnitus is one of the most emotionally challenging ENT conditions, not because of its physical severity, but because of its invisible, persistent, and intrusive nature. Many patients have been told, often by well meaning but uninformed practitioners, that 'nothing can be done.' This is not true.
With accurate diagnosis, individualised treatment, and appropriate counselling, the vast majority of tinnitus patients can achieve significant relief and return to a high quality of life. The key is to seek specialist care early, before the condition becomes entrenched.
If you or a family member is experiencing ringing, buzzing, or any persistent sound in the ears, please do not wait.
Book a consultation at Dr. Mohanty's Speciality ENT Clinics in Manapakkam, Chennai. Visit www.drsanjeevmohanty.com
or
call +91 97910 74677.
Source & Appointment: www.drsanjeevmohanty.com
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