Sussex ENT: Ear, Nose and Throat Surgery
Brighton and Sussex University Hospitals Trust
Worthing and Southlands Hospital



An Ear







Definition: When someone experiences the sensation of a noise in the ear which is not actually audible to other people. This is a very common sensation and many people experience it at some time. There are two main types.

Type 1: Pulsatile tinnitus is a noise which is pulsating in time with the heartbeat. It is caused by a person hearing blood flowing through their own head.

Type 2: A continuous ringing, hissing or humming noise.

In either case the noise may apparently come from one ear, from both ears, or not apparently from either ear. All tinnitus seems louder when the person experiencing it is in quiet surroundings. Pulsatile tinnitus may seem louder after exertion and is common in normal people. The continuous tinnitus is apparently made louder by exposure to loud noise and sometimes by stress, though it is heard most loudly when the patient is subsequently I quiet surrounds. It is usually regarded as the result of minor degenerative change in the ear or as the result of noise damage to the ear. It may be experienced by completely normal people. There are, however, certain specific conditions affecting the ear which may cause tinnitus. People experiencing tinnitus for the first time may think that it is a sign of serious ear disease, but this is extremely unlikely to be so. If the person has deafness, giddiness, pain or discharge from the ear, then it makes it more likely that there is some treatable problem in the ear and they should seek medical advice.


Management of tinnitus

People who experience tinnitus may fear that it is a symptom of a serious problem inside their head. Once they are reassured that this is not the case they may not require any other treatment. If they still find the noise troublesome then distraction from the tinnitus is probably the best initial treatment.
As all tinnitus seems louder in quiet surroundings, it is better to leave some background noise such as a radio playing in the room. This is well tolerated by day but may be more difficult at night when trying to get to sleep. In this circumstance a constant background noise is better, such as produced by a radio tuned off a station or by an electrical fan. If a radio is used as a noise source then the volume of the noise can be adjusted until it is only just louder than the tinnitus which the person is trying to “mask”. This technique of using distraction or masking noise to suppress the tinnitus is the principle behind the supply of tinnitus maskers. These are small noise generators which resemble hearing aids and which are worn behind the ear. They are, however, only appropriate for a small number of patients with tinnitus.

Many older people who experience tinnitus will also have some associated deafness. In these patients it may be helpful to provide them with a hearing aid. The hearing aid will help the deafness and also amplify ordinary everyday sounds of life and also this will provide a distraction from the tinnitus. This is an alternative to providing masking sound, but may also be combined with a tinnitus masker.

Drug treatment for patients with tinnitus is seldom necessary or helpful. It may, however, be helpful for a short time for patients to use a sleeping tablet if the tinnitus is causing great problems in getting to sleep. Occasional patients who find the tinnitus stressful or very depressing may require appropriate help to cope with these problems.

Tinnitus therapy can be organized within the department and involves a group meeting with a hearing therapist and other tinnitus sufferers to discuss different techniques to cope with it.

Other sites related to tinnitus can be found here