Noise In Ears : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 30/09/2022

Noise in the ears (tinnitus) is a symptom in which a person hears extraneous sounds (crackling, ringing, hum) in the absence of their obvious source. There are several etiological factors of this condition: exposure to loud sounds, diseases and tumors of the hearing organ, hypertension and other vascular disorders. To determine the cause of tinnitus, audiometry with tuning fork tests, X-ray examination of the skull, angiography, otoscopy, and laboratory tests are performed. To stop the symptom, methods of psychotherapy, sedative phytopreparations are used.

general characteristics

Patients describe their subjective sound sensations in different ways: as a constant monotonous noise, a low hum, similar to the operation of an engine. Often patients say that they hear ringing or squeaking in their ears. Some people compare the auditory sensation to a rumble or crackle. Noise occurs suddenly, and it is not always possible to trace the connection between its appearance and the influence of external factors. It lasts from several minutes to several days and even weeks, which significantly reduces performance and causes negative emotions up to the development of depression.

Tinnitus can be either unilateral or bilateral. Sometimes the symptom is accompanied by severe pain in the ear and temples, hearing loss, dizziness and balance disorders. For some people, the noise is so strong that it completely drowns out the sounds of the outside world. Since subjectively unpleasant sound sensations can be caused by serious neurological or vascular disorders, it is urgent to visit a specialist to find out the cause of the symptom and select an adequate treatment regimen.


According to the sound characteristics, tinnitus is divided into tonal - continuous sounds of the same frequency (ringing, whistling, low-frequency hum) and non-tonal - periodic unpleasant auditory sensations in the form of clicks, crackling, roaring. According to the duration, the symptom is divided into acute (up to 3 months), subacute (from 3 to 12 months) and chronic (lasting more than 1 year). In clinical practice, tinnitus is classified according to the cause:

  • subjective noise . Often due to prolonged exposure to loud sounds on the auditory analyzer. Extraneous sounds are heard only by the patient, which prevents a person from concentrating on the actions performed, the conversation.
  • neurological noise . This type of tinnitus is caused by damage to specific nerve receptors in the inner ear, which occurs in Meniere's disease. Patients feel a strong hum, usually accompanied by dizziness.
  • somatic noise . It can be associated with damage to any organ, pathological impulses from which excite the auditory analyzer. Somatic tinnitus is sometimes triggered by movement and touch.
  • objective noise . The rarest type of disorder, which is caused by deformities of the vessels of the ear, pathology of the muscular system. Extraneous "pulsating" sounds can be heard by the doctor when using a stethoscope.

To assess discomfort, the Soldatov classification is used, which subdivides tinnitus according to severity. At degree 1, working capacity is preserved, the person is adapted to extraneous sounds. The appearance of intense noise at night indicates a transition to stage 2. A constant strong hum, which interferes with the performance of habitual duties, worries at stage 3, with a complete loss of working capacity, the 4th degree of the disease is diagnosed.

Causes of tinnitus

acoustic trauma

The appearance of noise is provoked both by a single sound exposure to prohibitive volume (shots from large-caliber weapons, fireworks, rock concerts), and by the constant influence of sounds, which is often found in people who listen to loud music through headphones, factory workers and sewing workshops. With an acute injury, a person temporarily loses his hearing, against which a monotonous ringing or squeaking appears in the ears. May be disturbed by severe throbbing pain in the temporal part of the head, dizziness.

With chronic exposure to sound stimuli, symptoms increase gradually. First, there are complaints of short-term noise (within 1-2 hours), which begins after staying in a room with loud sounds, using headphones. As the condition progresses, the buzzing in the ears becomes constant and is accompanied by hearing loss. The frequent occurrence of noise that disrupts performance, combined with headaches and hearing loss, is an indication for seeking medical help.

Age changes

Among people 55-65 years old, every fifth periodically notes the appearance of extraneous sounds, after 65 years the number of people suffering from hum and ringing in the ears increases to 40%. Complaints of two-way noise are characteristic, which at first feel very quiet and do not interfere with daily activities. Then the sounds seem more intense. Due to the worsening of the symptom at night, patients tend to suffer from insomnia. Tinnitus in the elderly is caused by degenerative changes in the inner ear and is combined with hearing loss, which requires a doctor's consultation.

Hypertonic disease

The appearance of tinnitus is typical for patients suffering from high blood pressure, and the intensity of auditory sensations depends on the parameters of blood pressure. Extraneous sounds are caused by the turbulent movement of blood through narrowed vessels with a thickened wall. Hypertensive patients periodically hear a slight hum, which usually occurs against the background of a headache and a deterioration in the general condition. Increased noise, accompanied by excruciating nausea, flickering "flies" before the eyes, is a symptom of an incipient hypertensive crisis.


Pathological processes in the ear

Tinnitus may indicate damage to the auditory analyzer, which is due to impaired perception and analysis of sounds, discoordination of the work of different parts of the hearing organ. These reasons often cause temporary sensations of hum or ringing, which cease to bother after the relief of the underlying pathology. With some lesions of the inner ear, which are difficult to treat, the noise becomes permanent. Tinnitus is caused by:

  • Inflammatory diseases : otitis externa and otitis media, eustachitis, labyrinthitis.
  • Blockage of the ear canal : sulfur plugs, foreign bodies, water ingress.
  • Diseases of the inner ear : Meniere's disease, otosclerosis.

Vascular disorders

Most often, the symptom occurs with atherosclerosis: the deposition of lipid plaques on the walls of the vessels of the inner ear disrupts the normal movement of blood, which is felt as a moderately intense "pulsating" noise. In most patients, the hum is more pronounced on the one hand, which is associated with the degree of damage to the vascular wall. Unilateral loud tinnitus is observed in patients suffering from temporal artery aneurysm. In this case, uncomfortable auditory sensations are combined with periodic headaches, dizziness.

Tumor causes

Noise in the ears is most characteristic of a benign formation - acoustic neuroma. With this neoplasia, unilateral tinnitus becomes the first symptom. A person notes the appearance of a weak constant hum in one ear, which does not disappear even at night. As the disease progresses, there is a gradual deterioration in hearing on the side of the lesion, sound sensations become more intense. Pulsating unilateral noise in combination with swallowing disorders, asymmetry of the palpebral fissure occurs with a glomus tumor of the ear.

Cervical osteochondrosis

In case of problems with the spine, the occurrence of ringing or hum in the ears is associated with sharp turns or tilts of the head, a long stay in an uncomfortable position. The causes of noise are the squeezing of individual vessels that go from the neck to the ear and brain. The symptom is observed periodically, the intensity of the sounds is low, so the performance in most patients does not suffer. With severe deformity of the cervical vertebrae, monotonous strong tinnitus is possible, combined with dizziness, fainting, and sharp pains in the neck.

Traumatic brain injury

Mild bruising of the head may be accompanied by a brief noise or ringing in the ears that does not cause much discomfort. With more significant damage, unusual auditory sensations are detected against the background of severe nausea and vomiting, intense headaches. Sometimes the symptom does not appear immediately after the injury, but after a few days. The noise that arose after hitting the head is the basis for an urgent visit to the doctor, since with a traumatic brain injury there is a risk of destruction of bone structures, intracranial hemorrhages.

Complications of pharmacotherapy

Ringing in the ears often develops 1-2 weeks after the start of etiotropic treatment of severe bacterial infections, due to the strong ototoxic effect of drugs. The symptom also occurs in patients with hypertension who are forced to take medications from several groups daily. Side effects from the auditory analyzer provoke such groups of medicines as:

  • Antibiotics : aminoglycosides, tetracyclines, macrolides.
  • Diuretic : furosemide, ethacrynic acid, hydrochlorothiazide.
  • NSAIDs in high doses : indomethacin, diclofenac, aspirin.
  • Tranquilizers : flurazepam, tranxen, phenazepam.

Rare Causes

  • Malformations of the auditory analyzer : Goldenhar syndrome, microotia, congenital sensorineural hearing loss.
  • Endocrine pathology : hypothyroidism, pituitary adenoma.
  • Diseases of internal organs : digestive system, kidneys.
  • Neurological causes : multiple sclerosis, age-related degenerative processes in the brain.
  • Damage to the temporomandibular joint .
  • Allergy .


When tinnitus appears, the patient is sent for examination to an otolaryngologist, who identifies the otogenic causes of the symptom. Diagnostic search is aimed at a detailed study of the functionality of the auditory analyzer and the structure of all parts of the ear. A comprehensive examination involves instrumental and laboratory methods, the most informative of which are:

  • Instrumental examination of the ear canal . Otoscopy is necessary to exclude inflammatory diseases of the outer and middle ear, ruptures of the tympanic membrane. To assess the degree of mobility of the tympanic membrane, a pneumatic Siegle funnel is used. The method is supplemented by the determination of the patency of the auditory tubes.
  • Audiometry . To detect hearing impairment, special devices are used that generate sounds of a given frequency. Speech audiometry is intended for express evaluation of the function of the auditory analyzer. With the help of tuning fork tests, the pathologies of the middle and inner ear are differentiated.
  • X-ray studies . Tinnitus is often caused by neurological causes, so patients usually do x-rays of the skull bones. In patients with symptoms of osteochondrosis, it is necessary to examine the spine. For a more detailed visualization of volumetric formations and structural disorders of the brain, CT and MRI of the head are prescribed.
  • Angiography. If an aneurysm or atherosclerotic lesion of the cerebral vessels is suspected, a contrast angiogram is recommended, which allows visualizing the structure of the vascular bed and establishing the exact localization of pathological changes. An even more modern method of examining blood vessels is MR angiography.

Laboratory methods are used as auxiliary, the examination plan includes general and biochemical blood tests, with a possible infectious cause of the disorder - serological reactions (ELISA, RIF, PCR). In inflammatory processes accompanied by discharge from the ear, bacteriological culture is performed. In difficult diagnostic cases, to establish the cause of tinnitus, consultations of other specialists (neurologist, oncologist) are required, some patients are shown a psychiatric examination.

Otoscopy - instrumental examination of the ear canal



Help before diagnosis

You can completely get rid of tinnitus only after treating the underlying disease that caused discomfort. Therefore, with the unreasonable appearance of extraneous sounds, a visit to the doctor should not be postponed. To reduce discomfort before identifying the cause of the disorder, mild herbal sedatives are recommended, soothing herbal teas. In some cases, self-massage of the auricles helps: rubbing movements, pressing with palms on the ears.

Conservative therapy

Since tinnitus is caused by various causes, treatment regimens are selected strictly individually, taking into account the underlying disease and concomitant pathology. A prerequisite for the effectiveness of therapy is the elimination of provoking factors (refusal of loud music in headphones, changing jobs, avoiding noisy parties and visiting nightclubs). Etiotropic therapy includes antibiotics, anti-inflammatory and antihistamines, angioprotectors, other groups of drugs, and their combinations. For symptomatic treatment of tinnitus use:

  • Sedatives . Herbal and synthetic drugs reduce the excitability of the brain and the speed of nerve impulses. Medicines also normalize the emotional state.
  • Antidepressants . Medicines are effective for constant noise, which is caused by chronic diseases, Meniere's disease. The drugs affect the centers in the brain, increase the concentration of serotonin.
  • Tranquilizers . Indicated for severe ringing or buzzing in the ears, leading to insomnia and reducing performance. The effectiveness of the funds is due to their sedative and hypnotic effect.

Experimental treatment

Tinnitus retraining therapy (TRT) is an innovative direction that is a type of cognitive behavioral therapy. The program involves individual sessions using psychotherapeutic methods, during which a person is taught ways to relax, techniques for switching attention. A component of the treatment is an individually selected sound therapy. The patient is offered to listen to a pleasant noise (the splash of waves, the rustle of leaves, the sound of rain). Over time, the brain learns to block these sounds, while the perception of pathological noise decreases.


If hum, ringing, tinnitus are associated with purulent inflammatory diseases, it is necessary to open and drain the tympanic cavity, which significantly speeds up the healing process. If tumors of the auditory analyzer are detected as the main cause of the disorder, they are removed with a mandatory cytomorphological study. Treatment of malignant neoplasms involves a combination of surgery with chemotherapy and radiation therapy. With aneurysms, the affected vessel is clipped.

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