Tinnitus and hearing loss often go hand in hand: between 15 and 20 percent of people experience tinnitus, and this happens especially often in older adults. Both symptoms share common causes, and some of the causes are treatable. Below — what the noise means, why hearing declines, and when it is dangerous to delay.
What tinnitus is
Tinnitus (from the Latin tinnīre — to ring) is a noise in the ears without an external source. A person hears ringing, humming, hissing, whistling, or clicking that no one else hears, and for the most part it is not a sign of anything dangerous.
The sound is in one ear, in both, or "in the head," is continuous or comes in waves. The loudness also varies — from a barely audible background to a level that makes it hard to make out speech.
A separate variety is pulsatile tinnitus, synchronous with the heartbeat. It is rare, most often points to problems with blood flow in the head or neck, and requires a prompt visit to a doctor.
Where the noise comes from
Most often tinnitus is associated with damage to the hair cells of the inner ear. The brain compensates for the loss of their sensitivity by amplifying the signals of neighboring cells, and the person hears a sound that isn't there — just as the ears still ring in a hall after a concert.
Some cases have removable causes: an ear infection, a buildup of earwax, a foreign object in the canal. The noise appears after a head or neck injury, with Ménière's disease, Eustachian tube dysfunction, otosclerosis, spasms of the middle ear muscles, or problems with the temporomandibular joint.
Blood vessels also play a role: atherosclerosis and high blood pressure increase blood flow and make the noise more audible. Doctors link tinnitus with diabetes, thyroid disease, anemia, migraine, autoimmune disorders, anxiety, and depression.
A separate category is medications: more than 200 drugs can cause or intensify the noise. The decision to review a prescription is made by the doctor, not the patient.
The noise can also appear after a viral infection: the virus damages the outer hair cells of the cochlea. After COVID-19, tinnitus was noted in 14.8 percent of those infected, and hearing loss in 7.6 percent.
Age, loudness, and the habit of asking people to repeat
Gradual hearing loss in both ears is most often associated with age or with years of loud noise. A person gets used to their own TV volume and doesn't notice that they ask others to repeat more often than others do.
Here are the signs noticed either by the person themselves or by their loved ones. Each of them is a reason to check your hearing.
- it is hard to make out speech, especially in a noisy place;
- you have to ask people to repeat what they said;
- music and the TV sound louder than others need;
- it is hard to talk on the phone;
- conversation is tiring because it requires effort.
Earwax plug
Excess earwax can block the canal. Then the ear feels plugged, it itches inside, hearing declines — more often on one side — and the noise is added.
The blockage can change the pressure in the ear and cause noise. The plug is removed by a doctor after an examination.
If hearing has not returned after the plug is removed, a conversation with the family doctor is not postponed.
Sudden hearing loss
Sudden hearing loss means a drop in hearing over hours or days, often together with a plugged feeling, ringing, or dizziness. The causes vary: perforation of the eardrum after an infection, a very loud sound, or a pressure change, labyrinthitis, Ménière's disease.
Such a condition does not wait for a convenient day, because it requires prompt treatment. With it, people see the family doctor the same day, and worsening over several days or weeks is also a reason for an urgent visit.
When to see a doctor immediately: tinnitus after a head injury; tinnitus together with sudden hearing loss, facial muscle weakness, or dizziness. Call 103 or 112 and do not drive yourself.
Who to see and how it is checked
At the appointment, the doctor examines the ears, looks for a removable cause — an infection or earwax — and checks hearing. Then refers to a specialist for further examinations.
Self-diagnosis does not work here, because different causes produce a similar picture.
This material is for reference and does not replace a doctor's consultation.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer