Doctor's Answers (1)
Tinnitus refers to a ringing sound heard in the ear. It is quite common and most people would have experienced it at some point in their lives. The sound may have an actual source (objective tinnitus) or no actual source (subjective tinnitus - ie only the person suffering from it can hear it). Causes of tinnitus depends on whether it is subjective vs objective (are as follows):
Fortunately, over 95% of the tinnitus that I see in my clinical practice (and I believe for most other ENT Specialists or GPs too) are subjective tinnitus. In an otherwise healthy individual with no other ear, nose or throat symptoms, most subjective tinnitus are idiopathic (unknown cause) or related to hearing loss. We do not know exactly why such tinnitus exist but one of the hypothesis suggests that the sound originates from the hearing nerve, hearing organ or the hearing centre of the brain. These structures may have "misfired", resulting in sound generated in the head without an actual source (stimulus).
Assessment of a patient with tinnitus include a thorough clinical history and physical examination of the ear, as well as the head and neck region. A hearing test is also usually required to determine if there is any hearing loss associated with the tinnitus (which sometimes the patient may not be aware of).
Some of the red flags of tinnitus which require further assessment (e.g. CT scan or MRI) include:
Treatment of tinnitus depends on the underlying cause. For idiopathic subjective tinnitus, majority of the time, reassurance of the patient is all that is required. For patients who are bothered by the tinnitus, treatment options include:
If you have tinnitus that is persistent, troubling or has the red flags mentioned above, you should visit an ENT Specialist for an assessment.
Hope this helps and all the best!