What is tinnitus?

You know that ringing sound you keep hearing? Well, let’s just say it’s not your old high school fling calling you on the phone. On the contrary, it’s your body trying to tell you to get your hearing checked. This ringing in the ear, also known as tinnitus, has recently made headlines with singer-songwriter Eric Clapton. Already in his 70s, he revealed in a radio interview that he is experiencing hearing loss and tinnitus. It’s very common for musicians and people who’ve been exposed to loud noises to develop noise-induced hearing loss or ringing in the ear. What Eric and many others like him have in common is, they are doing something about their condition sooner than later.

An estimated 25 million Americans have already experienced noise or ringing in the ears, or Tinnitus, in the past years. Common triggers include acute hearing loss, excessive noise, impaired blood circulation, stress, or misalignment of the cervical spine or jaw joint.

Tinnitus can occur in one ear (left or right) or both. The noises originate in the head and ear canal rather than outside the body. There are about 200 health disorders that could cause tinnitus sounds. One of the most frequent reasons for ear ringing is hearing loss. The damage could be caused by age related factors, noise factors or both. Speaking with a hear.com expert can help you understand if you have hearing loss that may have gone unnoticed. 

The sounds experienced by people vary in volume, intensity and type. Some noises sound like high-pitched ringing while others sound like an airplane engine. Other types of noises are similar to the sounds of wind blowing, a rainstorm, or a tea kettle whistling. People experience intermittent or constant sounds. Whatever type of sound experienced, the noise disrupts a person’s life. A person may never have relief from constant ear noise.

About forty percent of the population will experience unpleasant ear ringing at some point in their lifetime. Ten to twenty percent will experience chronic tinnitus (a duration of over three months). Symptoms most commonly occur in people over the age of 40. However, people of all ages are susceptible to some form of disruptive and persistent ear ringing.

Carefully read the information below so that you can identify the symptoms, causes, and available treatments. Please call hear.com to speak with an expert about your questions. We will explain tinnitus in further depth, discuss your symptoms, and, if you like, set an appointment for you with a hearing specialist. Call us today!

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Definition of tinnitus

The main tinnitus symptom is hearing different noises when none are present in the external environment. These noises vary but many sound like leaves rustling in the wind, waves crashing, or plow trucks pushing snow over concrete. The noises may come and go or be present all the time, affecting one ear or both. Due to the constant noises, people may have sleep difficulties, poor concentration, headaches, and tension in the neck.

Ear noise sounds like:






If tinnitus is present for more than three days, one should go to an ear, nose and throat (ENT) doctor. To make a diagnosis the doctor usually begins by asking key questions to assess the patient’s condition and discover possible causes. The doctor will then examine the ear canal and the eardrum by means of an otoscope (basically a magnifying glass, mirror and a light) to check for damage to the ear. In many cases a hearing test is carried out to understand related and causal factors. The ENT doctor also conducts a series of other medical tests to provide a firm diagnosis.

Common examinations:

  • Examine the throat, nose and ears
  • Subjective hearing test 
  • Analyze the noise in the ear; test the noise emission of the inner ear (otoacoustic emissions) 
  • Test for any balance disorders 
  • Objective hearing test (auditory brainstem response)

Methods to diagnose tinnitus:

  • Blood analysis
  • MRT of the skull (magnetic resonance tomography)
  • CT of the skull (computer tomography) 
  • Examine the neck vertebrae and the jaw
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What is a subjective hearing test?

A subjective hearing test checks the patient’s perception of sound in the ears. While in a soundproof room, the patient listens to different sounds in a variety of frequencies via headphones. The patient indicates to the specialist the instant the sound becomes audible. This allows the ENT doctor to firstly establish any hearing loss and then to try to determine if the ear ringing is related to the hearing loss.

What are otoacoustic emissions?

Otoacoustic emissions (OAE) are active sound emissions, originating from the inner ear, which are often present, but not perceived. OAE occur due to movements of the exterior hair sensory cells. The OAE measurements are carried out using a small probe in the outer auditory canal. There are two types of otoacoustic emissions to distinguish. Objective audiometry measures the sound emissions, testing the functioning of the external hair sensory cells. Clinically relevant hearing disorders can be deduced from this.

Tinnitus and hearing aids

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Tinnitus and hearing difficulties

People with ear ringing often have hearing difficulties which reduce quality of life and health significantly. A hearing test used in a research study of ear noise therapy revealed 95% of tinnitus patients had damaged hearing. 89% of the patients had hearing impairment in both ears. Only 5% had no hearing impairment. However, one cannot conclude that hearing loss or difficulties result in ear ringing. Nonetheless, damaged hearing is considered to be a direct cause for ear ringing symptoms. Around 80% suffering hearing damage for a long period have chronic ear ringing. Hearing aids can be an appropriate means for treating hearing difficulties and at the same time prevent ear ringing. Please request a call with a hear.com expert to learn more about our hearing aids. 

The Tinnitus-Noiser

The use of hearing systems with so-called Tinnitus Noisers can effectively relieve Tinnitus and hearing loss. The Tinnitus Noiser counteracts the beeping and whistling by producing a signal that cancels out the distracting noises.

A Tinnitus Noiser produces a continuous noise that the patient perceives as pleasant. It is quieter than Tinnitus itself and has a calming effect on the auditory system and consequently the neural pathway to the brain relaying auditory sensations. This enables the brain to re-learn how to focus on noises in the external environment and minimizes or completely eradicates the fixation on the ear noise. The brain has filter systems that categorize sounds as important or not important. After a while, due to the constant signal produced by the Noiser, both the Noiser and the Tinnitus are categorized as not important. This therapy helps the brain become accustomed to sounds and after a certain time, fade them out. The result: Tinnitus is not sensed anymore.

Leading companies in the hearing aid sector have specialized in these devices due to the high number people experiencing ear ringing. Examples of hearing aid devices with built-in Tinnitus Noisers include the Widex Clear 440, featuring the Zen-Noise function. Hearing aids with Tinnitus Noisers are also offered for instance by the Signia Life and Signia Pure Carat models. The hearing aids from the model series Audéo Q by Phonak also include Tinnitus Noisers. The ReSound Alera TS is a device made to address Tinnitus exclusively. Moreover, Phonak offers a Smartphone Tinnitus Balance app, which allows access to a sound and music library, suitable for the treatment of Tinnitus.

Forms of treatment for tinnitus relief

The treatments and therapy varies according to what has actually caused the ear ringing. Therapies include acoustic stimulation, behavioral therapy approaches, medication, magnetic and electrical brain stimulation and physiotherapy. In acute cases, Vitamin E preparations, magnesium, glucocorticoids such as cortisone, local anesthetics administered intravenously such as procaine and active ingredients to improve blood circulation (e.g. pentoxifylline) are used. According to the cause and severity of the ear ringing, the treatment and therapy can be in tablet form or intravenous drip.

Forms of tinnitus

Acute and chronic tinnitus

Acute tinnitus occurs when an unpleasant ear noise suddenly appears and remains for up to three months. In the case of chronic ear ringing, the noises remain longer than the three months and may remain perceptible in the long term. Acute ear ringing is usually healed spontaneously or the patient recovers from the symptoms. The longer the ear noise remains, however, the higher the possibility of chronic illness.

Tinnitus after 3 month

Subjective tinnitus

Subjective tinnitus refers to an ear noise that can only be heard by that person. Most tinnitus cases are subjective. Subjective tinnitus is caused by a mistake in processing at the points of sound transmission and sound perception. There can be a dysfunction in the area of the middle ear right down to the cortex. For instance, ear noises occur through insufficient absorption of high sound pressure by the muscle in the middle ear. 

There are a number of possible causes of subjective ear ringing. Often ear noises become audible when a foreign substance enters or during a middle ear infection. A number of illnesses or stressors can trigger subjective tinnitus. Sudden deafness or hearing loss is generally accepted as a cause of ear ringing.

In summary: subjective tinnitus at a glance

  • Autoimmune disease of the inner ear
  • Ototoxic substances
  • A tumor on the hearing nerves (acoustic neurinoma)
  • Difficulty hearing (hypoacusis)
  • Stress
  • Problems with the neck vertebrae or in the teeth and jaw area trigger or increase the symptoms

Objective tinnitus

If an ear noise can be heard and measured by the person examining it is an objective tinnitus. By comparison with subjective tinnitus, objective tinnitus is rather rare.

In summary: objective tinnitus at a glance

  • Breathing noises
  • Current noises of arteries
  • Tension of the middle ear muscle
  • Movements in the opening of the ear trumpet or acute functional disorder of the Eustachian tube.
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Reasons for its emergence

The reasons for the emergence of tinnitus have only been partially explained. One of the possible causes is the effect of noise or certain medicaments on the auditory nerve. In healthy ears, the nerves spontaneously produce electrical impulses, so-called spontaneous activity. This changes when the noise meets the ear. Through this encrypted information is sent to the ear. If the auditory nerve is damaged it has the effect of spontaneous activity. This can reduce or change in time. It is assumed that a deviation of spontaneous activity results in subjective ear ringing. Tinnitus can also, however, take place in the brain.

In this case it is a so-called central tinnitus, a defective transmission of information, which occurs on the transmission path between the hair cells in the ear and the brain. One of the major causes of ear ringing continues to be diagnosed as stress. Stress induces a great number of physical reactions. The body excretes more of the hormone cortisol, which results in a constriction of the blood vessels reducing blood circulation. This reduction has a particular effect on the small blood vessels, the capillaries, and can lead to closure of the blood vessels in the inner ear. It is not yet known precisely how the reactions triggered by stress cause ear ringing.

Tinnitus in old age

Around 48 million people in the USA have hearing difficulties – brought about by various causes, such as specific diseases, strong medication or sudden deafness. Current figures estimate 10–15% of the population have tinnitus (for 2014). This illness cannot, however, be entirely placed into one age bracket. Children can also experience persistent ear ringing. Nonetheless, the majority of people with ear ringing are 50 or older. Furthermore, occurrences are diagnosed more frequently in women than men. 

Recent years have also seen an increasing frequency of ear ringing in youths and young adults. This increase in young tinnitus patients is caused, above all, by increasing contact with loud noise levels through music venues and the use of headphones and MP3 players. It is important that children and teens manage the volume levels of music and TVs to prevent hearing loss. It is also important to regularly check hearing, especially in children and teens. 

hear.com is here to advise and help you improve the health of your ears. Please contact us for more information about hearing aids with the tinnitus noiser.

Preventing tinnitus

The causes of tinnitus are many. But there is good news! The risk of occurrence can be reduced and there are preventative measures to take to avoid this illness. Fundamentally one must avoid the danger of damaging the ear through loud noises. Wear enough protection for your hearing against loud noises. Furthermore, one should reduce stress as much as possible. To this end, manage your time and allow for periods of relaxation and exercise. Recognize stress in your life, find healthy ways to cope with stress, have a support network, and eat balanced and healthy meals. These choices can lead to more energy and a more efficient everyday life. One should most certainly go to an ENT specialist with acute ear noise for a short-term therapy – usually through the use of medicaments – to avoid long-term problems. 

Good hearing with hear.com

hear.com is your expert in hearing aids. We have a nation-wide network of hearing aid providers, so we are certain to have a partner in your area! Your satisfaction is our greatest motivation. We can provide you with information on tinnitus as well as other diseases such as Meniere's disease and hypoacusis. We also introduce you to top hearing aid manufacturers and their products.