Tinnitus is the perception of abnormal ear or head noises without any external sound. Noises may be high pitched, ringing, clicking, or buzzing. Pulsatile tinnitus is caused by the flow of blood that accompanies each heartbeat.
Blood vessel disorders, such as an aneurysm, fistula, or hardening of the arteries are associated with pulsatile tinnitus
Fluid in the ear
Ruptured membrane in the ear
Injury to the head or neck
The sensations of tinnitus may have the following characteristics:
Ringing, roaring, buzzing, whistling, or hissing sounds
Intermittent, continuous, or pulsatile quality
Same or varying intensity
Single or multiple tones
More annoying symptoms at night or when there are fewer distractions
Sensation of normal internal events, such as blood pulsing or muscles contracting
Sometimes tinnitus is accompanied by hearing loss and
vertigo, a sensation of spinning while standing still.
When Should I Call My Doctor?
Call your doctor if you have tinnitus, especially if it:
Is associated with hearing loss, vertigo, change in personality, speech, or weakness in any body area
Starts after head or neck injury
Is associated with new medication
Is associated with pain in the ear, fever, nausea, or vomiting
Is interfering with your activities
The doctor will ask about your symptoms and medical history. A physical exam will be done. Special attention will be paid to your head, neck, and ears.
You will be asked questions about:
The sensations that you have
The factors that may increase or decrease the sensation
The medications that you take
History of trauma
The doctor will look at your ear canal and eardrum using an instrument with a light that is held at the external opening of the ear. A tuning fork can help evaluate hearing. You should receive a complete hearing test. Imaging tests, such as a
scan, may be ordered to rule out serious conditions.
In addition to hearing the test may include:
Auditory brain response
Electrocochleoraphy—to test for Meniere disease
Tinnitus treatment depends on what is causing the symptoms. This may mean:
Wearing a specially made splint to help manage
temporomandibular joint disorder
Taking antibiotics for a sinus or ear infection
Having the wax removed from your ear canal
Stopping or changing medications to see if tinnitus goes away
Therapy aims to eliminate or reduce bothersome sensations. Treatment may include:
No medication has been shown to be very effective in treating tinnitus. Your doctor may still try to use some medications to ease your symptoms. These may include antidepressants and sedatives.
If you have Meniere disease, your doctor may prescribe medication to treat that condition.
—sometimes relieves tinnitus and improves hearing in some people with hearing loss
Tinnitus masker—a device that emits a low level of white noise to help cover up the internal sensations and block out external noises
Lifestyle and Self-care Measures
Measures to discuss with your doctor if no cure or specific treatment is available include:
Last reviewed September 2018 by
EBSCO Medical Review Board
Marcie L. Sidman, MD
Last Updated: 9/14/2016
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