The chances are very good that you or someone you know has experienced ringing in the ears at one point or another. It’s a common experience that generally doesn’t require urgent care. It is estimated that more than 30% of South Africans experience some form of ear ringing or buzzing, known as tinnitus, but do you know the facts about tinnitus?

For most people, tinnitus is temporary and disappears quickly. But some forms of tinnitus are long-lasting and can be associated with underlying disorders that require medical treatment. Here are five facts to understand the common causes of tinnitus and its associated symptoms better that you should know before seeking help.

1. There are two main types of tinnitus

Tinnitus is the noise generated in your head rather than the environment. It can derive from multiple places in the body, including the ear or brain itself and along the pathway between the ear and brain. The noise isn’t necessarily ringing or buzzing, it can also be a roaring, whistling, or hissing sound. Establishing the type of tinnitus you’re experiencing is the first step to uncover the cause and treat it efficiently.

There are two main types of tinnitus:

Non-pulsatile (subjective) tinnitus is caused by abnormal activity in the auditory cortex of the brain, which is responsible for processing sound. People with subjective tinnitus experience different noises, including sounds, tones, or static, that can change in pitch or quality. It’s often a result of the brain trying to fill in missing sensory information—similar to how someone with an amputated foot might claim they can still feel it because the brain is generating that sensation.

Pulsatile (objective) tinnitus is vascular in nature and usually involves noise from the blood vessels near the ear. People with pulsatile tinnitus hear their heartbeat or pulse in the ear. Pulsatile tinnitus is often caused by either abnormal blood vessels or abnormal vasculature issues such as tumours. It is much less common than non-pulsatile tinnitus.

2. Hearing loss and aging are common causes of tinnitus

The most common cause of non-pulsatile tinnitus is hearing loss, but it can also be brought on by ear-related disorders or from exposure to loud noises. People with sensorineural hearing loss—irreparable damage to cells in the inner ear—often experience tinnitus. The hearing nerve can only transmit sound information to the brain, so when there is an abnormality, the brain perceives it as noise rather than pain. In other cases of hearing loss that are less severe, it can be hard to determine where the sound is generated.

3. Some forms of tinnitus require medical attention

Most people will experience tinnitus at some point in their lives. Temporary tinnitus that is equal in both ears and dissipates after a few seconds is no cause for concern. If it persists or there are additional symptoms such as hearing loss, ear pain, dizziness, or headache, a hearing test, or audiogram, is recommended to determine whether there is hearing loss or other conditions that need to be addressed. Pulsatile tinnitus should be evaluated by an ear, nose and throat (ENT) doctor who can determine if imaging is necessary.

If you experience hearing loss only in one ear, it is another sign of tinnitus. Our owner audiologist should perform a hearing assessment on top of a physical examination to carefully evaluate the cause of the hearing loss. Sudden onset of tinnitus in one ear can also indicate sudden sensorineural hearing loss—moderate to severe hearing loss—that develops quickly and needs to be addressed urgently.

4. Tinnitus can be treated or suppressed

Tinnitus can get better or resolve, but it’s nearly impossible to predict if or when. When tinnitus occurs with hearing loss, hearing aids can mask and even suppress it by amplifying sound in the ear. For persisting tinnitus without hearing loss, masking devices that provide background sound are a common first line of treatment. Sound generators and noise machines, or even just a fan or the radio, can help distract the brain and provide more sound input to mask tinnitus. Hearing aids can also be used for people experiencing bothersome tinnitus if all appropriate medical evaluations have been done.

Another approach to treating tinnitus is removing a person’s emotional response to the sound through various therapies. There’s a direct route from sound and hearing to the part of the brain that gives emotional context to sensory information. The limbic system associate sensations with memories and emotional responses that can be good or bad, like the smell of fresh cookies causing you to think of your grandmother or a song that transports you to a place in time. With tinnitus, people can experience a fairly mild sound but have a severe emotional response that makes it unbearable. Removing the emotional response can help turn tinnitus into background noise and make it unnoticeable.

5. There are ways to lower the risk of tinnitus

The world is fundamentally noisy, and simply living in loud places like urban centres is a risk factor for tinnitus. But there are precautions that you can take to protect your hearing and reduce the risk. Always use hearing protection in loud settings or while using loud equipment like power tools or firearms, and limit the time you spend around loud noises. Another easy practice is setting headphones to lower volumes when listening to audio.

In most cases, tinnitus in both ears is not dangerous and can be managed. People with tinnitus commonly stop noticing the noise even though it’s still there. Knowing the different causes and warning signs of tinnitus can help you determine when to visit us.

About Strauss Audiology
Strauss Audiology is a professional audiology business in the northern suburbs of Cape Town, offering expert, effective hearing advice that is tailored to clients’ unique hearing needs. We conduct hearing evaluations, hearing tests and vertigo assessments, and provide a range of solutions to improve and protect clients’ hearing. This includes providing hearing aids to Cape Town clients. With 16 years of experience, and with the qualifications and certifications to deliver leading hearing care, you can trust us to take care of your hearing needs.

Want your hearing tested? Need a solution for hearing loss?