With SMH Otolaryngology Specialist Jack Wazen, MD
Tinnitus is the perception of sound in your ear, with no external source. A ringing or buzzing are two of the most common presentations, but tinnitus has been described in a variety of ways, including roaring, clicking, hissing or even a pure tone or multiple tones.
“But it is not speech or music,” says Dr. Wazen. “If you're hearing somebody talking to you or you're hearing musical elements, that is called auditory hallucination. And it is very different.”
Tinnitus is very common.
“We all are going to get tinnitus at some point because of degenerative changes in the ear,” says Dr. Wazen.
“But tinnitus is also a symptom, and should not be ignored.”
What Causes Tinnitus?
There are multiple causes of tinnitus, some as simple and unavoidable as aging, and others as simple and avoidable as exposure to loud noises. (Ear protection is recommended at all concerts, NASCAR events and Friday night fights over family dinner.)
“It could be wax in your ear canal or it could be fluid behind your eardrum,” says Dr. Wazen. “There are a lot of things that could cause tinnitus, and some of them are mild and reversible.”
But that ringing or buzzing could also be the sign of a serious disorder or disease, such as Meniere’s disease or a brain tumor.
“An acoustic neuroma—what we call a tumor on the nerve connecting the inner ear to the brain—can present itself as mild tinnitus,” says Dr. Wazen. “And people ignore it until, eventually, loss of hearing. Then one recognizes that there's a tumor growing there.”
Because of this, testing is recommended for all grades of tinnitus.
“Test it as soon as you recognize it,” says Dr. Wazen. “People try to ignore tinnitus as simply part of getting older, but the most important thing is finding a diagnosis.”
Testing For Tinnitus?
“Looking at the ear is going to give us a lot of information,” says Dr. Wazen. With a physical exam, the doctor can check for everything from wax impaction or
inflammation to infection or even damage to the eardrum.
“Loss of hearing comes in two flavors,” says Dr. Wazen. “There’s loss of volume, and there is loss of volume and speech discrimination, meaning that, even with more volume, you still don't understand what the words are or the sentence is.”
An audiogram tests both hearing and level of speech recognition, with the patient entering a booth or donning headphones and being presented with various sounds and tones and words.
- Auditory Brainstem Response Audiometry
Akin to an EKG or electrocardiogram for the ear, this test measures the electrical impulses from the ear as they travel through the hearing nerve into the brain. An additional test called electrical choreography checks those same electrical impulses within the cochlear, or inner ear.
“All of these tests combine to inform us on the status of the auditory system from the outer ear up into the brain,” says Dr. Wazen.
Can Tinnitus Be Treated?
Some causes of tinnitus are mild and reversible. Others are chronic.
But there are still effective ways to treat even chronic mild tinnitus.
- Masking confuses the brain or distracts it from the tinnitus by offering an alternative noise to focus on. This can be something like background music or a television show set to low volume, or just a spinning fan or the hum of the refrigerator. “Anything that points your attention away from the tinnitus is a good way to control your tinnitus,” says Dr. Wazen.
- Cognitive therapy can also be effective in helping someone live with tinnitus, and help enhance masking techniques.
For more severe tinnitus, however, there are medical interventions available.
Tinnitus caused by Meniere’s disease, for example, can potentially be treated with medicinal drops, relieving multiple symptoms.
“Unfortunately, tinnitus from aging still has no cure,” says Dr. Wazen. “But we're doing research on this and, hopefully, will find a cure someday.”
Where to Go for Relief?
If you’re living with tinnitus, talk to a doctor about diagnosis and treatment options.
Your primary care doctor can get you on the right track, or make an appointment with an Ear, Nose and Throat (ENT) specialist or an Otolaryngology specialist like those at the First Physicians Group Silverstein Institute.
Need help finding a specialist? Our HealthLine physician referral team can help: Click here or call 941-917-7777.
Learn More
To read more from Dr. Wazen about inner ear disorders and potential treatments, click here. 
Written by Sarasota Memorial copywriter Philip Lederer, MA, who crafts a variety of external communications for the healthcare system. SMH’s in-house wordsmith, Lederer earned his Master’s degree in Public Administration and Political Philosophy from Morehead State University, Ky, and only regrets it sometimes.