Why Are My Ears Ringing?

Common Causes of Tinnitus and When to Seek Help 

Have you ever noticed ringing in your ears after attending a loud concert or using noisy equipment? Perhaps you hear buzzing, humming, hissing, or clicking even when the room is completely quiet.

These sounds are commonly referred to as tinnitus. For some people, tinnitus is brief and barely noticeable. For others, it can be persistent enough to interfere with sleep, concentration, conversations, and daily life.

Tinnitus is not a disease itself. It is a symptom that may have several possible causes. Although it is often not a sign of a serious medical problem, persistent or unusual ear ringing should not be ignored. 

What Does Tinnitus Sound Like?

Tinnitus is often described as ringing in the ears, but it can sound different from one person to another. You may hear:

• Ringing
• Buzzing
• Hissing
• Humming
• Roaring
• Clicking
• Whistling

The sound may occur in one or both ears. It can be constant or come and go, and its volume may range from a faint background noise to a sound that makes it difficult to concentrate or fall asleep.

According to the National Institute on Deafness and Other Communication Disorders, approximately 10% of American adults have experienced tinnitus lasting at least five minutes within the past year. 

What Causes Ringing in the Ears?

Tinnitus can have many possible causes. An examination and hearing evaluation can help determine whether an identifiable condition may be contributing to the symptoms. 

Hearing Loss

Tinnitus commonly occurs along with hearing loss. Changes in the sensory cells and nerve pathways involved in hearing can affect how the brain processes sound. In some cases, a person notices tinnitus before recognizing that their hearing has changed. 

Exposure to Loud Noise

Concerts, sporting events, power tools, lawn equipment, firearms, and loud workplace environments can damage hearing and lead to tinnitus.

Ringing after a loud event may fade, but repeated or extremely intense noise exposure can cause lasting damage. Wearing properly fitted hearing protection around hazardous noise can help protect your ears. 

Earwax Buildup

Earwax normally protects the ear canal, but excessive or impacted earwax can block sound and contribute to ear fullness, hearing changes, or tinnitus. If earwax is causing the problem, professional removal may help.

Avoid placing cotton swabs or other objects inside the ear. Doing so can push wax deeper, injure the ear canal, or damage the eardrum. 

Ear or Sinus Problems

Fluid behind the eardrum, an ear infection, or congestion affecting the Eustachian tube may sometimes be accompanied by ringing, pressure, or muffled hearing. Treating the underlying condition may improve these symptoms. 

Certain Medications

Some prescription and over-the-counter medications can cause or worsen tinnitus. These may include certain antibiotics, cancer treatments, diuretics, anti-inflammatory medicines, and other drugs, particularly at higher doses.

Do not stop taking a medication without speaking with the clinician who prescribed it. Instead, discuss your symptoms and ask whether tinnitus could be a side effect. 

Other Health Conditions

Less commonly, tinnitus may be associated with an injury or a condition affecting the ear, blood vessels, jaw, or nervous system. This is one reason an evaluation is important when tinnitus is persistent, worsening, or limited to one ear. 

Why Is the Ringing More Noticeable at Night?

Many people find that their tinnitus seems louder when they are trying to sleep. The sound may not actually be increasing. Instead, the quiet environment makes it more noticeable because fewer external sounds are competing for the brain’s attention.

A fan, quiet music, white-noise machine, or another gentle background sound may make nighttime tinnitus less noticeable. Limiting caffeine late in the day and establishing a consistent sleep routine may also help some people. 

When Should You See an ENT for Tinnitus?

Consider scheduling an evaluation  with an experienced ENT physician if the ringing:

• Persists or repeatedly returns
• Occurs primarily in one ear
• Is becoming louder or more disruptive
• Interferes with sleep, work, concentration, or quality of life
• Occurs with ear pain, drainage, pressure, or hearing changes
• Sounds rhythmic or seems to pulse with your heartbeat

Pulsatile tinnitus (the sensation of hearing a sound that follows your heartbeat) should be medically evaluated because it may have causes different from those of typical tinnitus. 

When Is Immediate Care Needed?

Seek prompt medical attention if tinnitus begins suddenly with hearing loss, especially if the hearing change affects one ear. Sudden hearing loss can be a medical emergency, and early treatment may improve the chance of recovering hearing.

Immediate evaluation is also appropriate when tinnitus follows a head injury or occurs with facial weakness, severe headache, neurological changes, or other concerning symptoms. 

What Happens During a Tinnitus Evaluation?

At Advanced ENT & Allergy, Dr. Timothy Queen and his team will ask when the tinnitus began, what it sounds like, whether it affects one or both ears, and what other symptoms you may be experiencing. Be prepared to discuss recent illnesses, noise exposure, medications, and changes in your hearing.

An ENT examination may identify concerns such as earwax buildup, infection, fluid, or another ear-related condition. A hearing test may also be recommended to determine whether hearing loss is present.

Depending on your symptoms and examination findings, additional testing or referral may be appropriate. 

Can Tinnitus Be Treated?

There is no single treatment that works for every person because tinnitus can have different causes. When an underlying problem such as impacted earwax, an infection, or a medication side effect is identified, addressing that issue may improve the symptoms.

When tinnitus is associated with hearing loss, hearing aids may make external sounds easier to hear and reduce the prominence of the ringing. Sound therapy, relaxation strategies, sleep support, counseling, and other approaches may also help make persistent tinnitus less disruptive.

Be cautious about supplements or products that claim to cure tinnitus. A proper evaluation is the best place to begin. 

Do Not Ignore Persistent Ringing in Your Ears

Occasional, brief ringing may not be cause for alarm. However, tinnitus that persists, affects only one ear, pulses with your heartbeat, or occurs with hearing loss deserves medical attention.

Advanced ENT & Allergy provides comprehensive evaluation for ear symptoms, hearing changes, and tinnitus. If ringing, buzzing, or another unexplained sound is affecting your comfort or quality of life, contact our office in Newport News, VA to request an appointment.

Dr. Timothy Queen has over 30 years of experience as a board-certified Otolaryngologist. He is also fellowship trained in Otolaryngic Allergy. Dr. Queen and his team provide comprehensive evaluation, testing, and treatment for tinnitus throughout Newport News, Hampton, York County, Williamsburg, Poquoson, and the greater Hampton Roads area.

References:

• National Institute on Deafness and Other Communication Disorders. “Tinnitus.” https://www.nidcd.nih.gov/health/tinnitus
• National Institute on Deafness and Other Communication Disorders. “Noise-Induced Hearing Loss.” https://www.nidcd.nih.gov/health/noise-induced-hearing-loss
• National Institute on Deafness and Other Communication Disorders. “Quick Statistics About Hearing, Balance, & Dizziness.” https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing