How is tinnitus diagnosed?

Doctor's Answers 2

High pitch ringing does sound typical of tinnitus. It’s common for tinnitus to be more noticeable when in quiet rooms, as you’ve described.

There are actually 2 kinds of tinnitus:

  • Subjective tinnitus is the most common, and is a type of tinnitus only you can hear. It’s usually caused by problems in your outer, middle or inner ear.
  • Objective tinnitus is uncommon, and is caused by noise generated by structures near your ear. Possible causes include a blood vessel problem or a middle ear bone condition.

You are right that loud noises from occupational hazards are one of the most common causes of tinnitus, however there can be other causes as well, eg:

Common causes:

  1. Medication side effects – Aspirin, some antibiotics, and certain anti-depressants are known culprits.
  2. Age-related hearing loss. There’s a known association between aging, and an increased incidence of tinnitus. It’s thought that this is due to a reduced number of nerve fibers in your ears.
  3. Earwax. Too much earwax can result in tinnitus.
  4. Ear bone changes. Otosclerosis is caused by abnormal bone growth. This tends to run in families.

Rare causes

  1. TMJ disorders. The temporomandibular joint is the joint in front of your ears.
  2. Acoustic neuroma. This benign tumor develops on the cranial nerve. It usually causes tinnitus in only one ear.
  3. Blood vessel problems. Eg. atherosclerosis and high blood pressure.

Many other people also never find a cause for their tinnitus. The good news however is that most tinnitus episodes do go away by themselves.

I’d suggest that you see a doctor to rule out any underlying and reversible causes for tinnitus.

He will clarify the story with you (how long have you had it for, any risk factors or contributing factors as above etc.) perform an ear examination, and may also order a hearing test and/or imagining to help exclude some of the above causes, as necessary.

In Singapore, you can start with a GP or polyclinic doctor. He will refer you on to see an ENT specialist, if necessary.

Cheers

What you described sounds like tinnitus. Usually, a high pitch ringing sound is a form of subjective tinnitus. Given your history of previous exposure to loud noises, your tinnitus may be due to hearing loss (which may be mild and not noticeable by you).

Fortunately, the majority of the time, tinnitus is not due to a dangerous condition. We do not fully understand why it happens, but there are theories that it may be due to the hearing nerve misfiring (e.g as result of damage from previous loud noise exposure) or it may be the brain generating the impulse that gives the perception of a sound.

It is best that you consult an ENT Specialist to have your clinical history taken, and to undergo a physical examination and hearing test.

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