Tinnitus

Tinnitus is the sensation of ringing, buzzing, whooshing, hissing, or clicking in the ears without an outside source. It's very common — about 1 in 10 adults experience it — and usually not dangerous, but it can be distressing and disrupt sleep and concentration. Most tinnitus is associated with hearing loss; treating that often helps.

Common causes

• Age-related hearing loss — the commonest.
• Noise-induced hearing loss — loud music, earphones at high volume, construction, firecrackers, industrial work.
• Ear problems — wax impaction, middle-ear infection, Eustachian tube blockage, otosclerosis.
• Ménière's disease — episodic vertigo + tinnitus + hearing loss (see its own page).
• Drug-induced — high-dose aspirin, some antibiotics (especially aminoglycosides, azithromycin class at high dose), chemotherapy (cisplatin, vincristine), loop diuretics.
• Vascular — pulsatile tinnitus (in sync with heartbeat) may indicate a vascular issue — needs review.
• Stress, anxiety, depression, insomnia — often worsen the perception.

When to see a doctor

• Tinnitus in one ear only, or with one-sided hearing loss.
• Pulsatile tinnitus (in time with heartbeat).
• Sudden hearing loss with tinnitus — urgent; steroid treatment within days can save hearing.
• With vertigo, balance problems, or facial weakness.
• Distressing to the point of affecting sleep, work, or mood.

Management

• Treat any reversible cause — remove ear wax, treat middle-ear infection, review medicines.
• Hearing aids — the single most effective treatment when tinnitus coexists with hearing loss. Often reduce tinnitus perception substantially.
• Sound therapy — low-level background sound (white noise, soft music, fan) helps the brain "tune out" the tinnitus.
• Cognitive behavioural therapy (CBT) — reduces distress and improves sleep; proven.
• Tinnitus retraining therapy (TRT) — combines counselling and sound therapy.
• Manage anxiety, depression, insomnia — treatment improves tinnitus tolerance.
• Avoid further loud-noise exposure; use ear plugs at noisy events and during firecracker/festival periods.

Avoid

• "Magic" tinnitus cures, online drops, and unregulated Ayurvedic pills — no evidence of benefit.
• Excessive caffeine, alcohol, and sleep deprivation (they often worsen tinnitus).