Direct answer
Tinnitus is hearing a sound without an external source. It is often linked to hearing loss or noise exposure and is usually not dangerous. Arrange an ear examination and hearing test if it is persistent, one-sided, worsening or disruptive. Seek prompt care for pulse-synchronous tinnitus; seek emergency care when tinnitus follows head injury or occurs with sudden hearing loss, facial weakness or severe vertigo.
Symptoms
- Ringing, buzzing, roaring, hissing, humming, clicking or whooshing
- Sound perceived in one ear, both ears or within the head
- Soft or loud, high- or low-pitched sound
- Intermittent or continuous tinnitus
- Effects on sleep, concentration, mood or daily life
- Associated hearing loss, fullness, dizziness or imbalance
Possible causes
- Hearing loss related to age, noise or another cause
- Earwax, ear infection or middle-ear fluid
- Occupational, concert, headphone or blast noise
- Adverse effects of some medicines; do not stop prescribed medicine without advice
- Ménière’s disease or another inner-ear disorder
- Jaw-joint/clenching problems or head and neck injury
- Blood-vessel-related causes of pulsatile tinnitus
- Less commonly, an auditory-nerve disorder when unilateral tinnitus accompanies asymmetric hearing loss
How it is assessed
- Clarify onset, side, sound quality and whether it matches the heartbeat
- Review hearing loss, vertigo, pain/discharge, noise, injury, medicines and mental-health impact
- Examine the ear, eardrum, head and neck, with cranial-nerve assessment when indicated
- Offer appropriate audiological assessment for tinnitus, usually including pure-tone audiometry
- Consider tympanometry when middle-ear or Eustachian-tube dysfunction is suspected
- Use MRI, CT or vascular imaging according to clinical findings in pulsatile or selected unilateral/asymmetric tinnitus
- Assess sleep, anxiety, depression and any risk of self-harm
Treatment options
- Treat an identified cause such as wax, infection or a jaw-joint problem
- Offer an appropriate hearing aid when hearing loss affects communication; amplification may also make tinnitus less noticeable
- Use safe low-level background sound or sound enrichment rather than complete silence at night
- Use education, counselling and tinnitus-focused cognitive behavioural therapy for tinnitus-related distress
- Address sleep, stress and hazardous noise exposure
- No medicine is proven to cure tinnitus, and advertised vitamins or herbal supplements have not been shown to work
- Do not offer betahistine solely to treat tinnitus; a separate indication is a different clinical decision
When to seek emergency care
- New tinnitus after a head injury
- Sudden hearing loss or hearing that worsens rapidly over days
- Facial droop, limb weakness/numbness, slurred speech or another neurological symptom
- New severe vertigo, inability to walk or repeated vomiting
- Tinnitus synchronous with the heartbeat
- Persistent unilateral tinnitus with asymmetric hearing loss
- Severe distress, thoughts of self-harm or an immediate safety risk
Frequently asked questions
Does tinnitus mean a brain tumour?+
No. Most tinnitus is not caused by a serious tumour. Targeted assessment is important when persistent one-sided tinnitus accompanies asymmetric hearing loss, balance difficulty or facial symptoms.
Does tinnitus in one ear need a hearing test?+
Persistent unilateral tinnitus should be assessed with audiometry. It shows whether hearing loss is present, whether the ears differ and whether further evaluation is appropriate.
Why does pulse-synchronous tinnitus matter?+
A sound matching the heartbeat is pulsatile tinnitus. A blood-flow or vascular cause is sometimes present, so prompt clinical assessment and selected imaging may be needed.
Can a hearing aid help tinnitus?+
When hearing loss is present, a hearing aid can improve communication and may make tinnitus less noticeable. People with normal hearing do not all need amplification for tinnitus alone.
Can vitamins or supplements cure tinnitus?+
No vitamin, herbal extract or supplement has reliable evidence as a tinnitus cure. Treating a documented deficiency or another disease is a separate matter.
Related ENT services
Ear conditions and hearing careAssessment of ear infection, discharge, wax and hearing difficulty, with hearing tests, childhood speech-delay assessment and rehabilitation planning.→Hearing TestsAge- and symptom-appropriate tests help identify the type and degree of hearing loss.→Hearing AidsHearing-aid selection and follow-up based on reliable testing, individual needs, budget and listening environments.→This article is for patient education and does not replace individual diagnosis, audiometry or treatment. Do not wait for an appointment when emergency warning signs are present.