Do you hear ringing, roaring, clicking, buzzing, humming, or hissing sound in your ear or ears? If the answer to this question is yes, then you suffer from a condition called tinnitus. Tinnitus is a disorder in which one classically hears a “ringing” of the ears. As mentioned above, the ringing may also be described as roaring, clicking, buzzing, humming, or hissing. The noise level may be anywhere from very mild to fairly severe. The noise heard is not an external sound but rather in internal sound, not heard by others. Tinnitus affects between 10-20% of the population. It is generally described as a very annoying symptom to those who have had it. Tinnitus is more common in the elderly and can affect one ear or both ears. It can be constant or intermittent. It is more common in the elderly and usually occurs in the presence of another underlying condition such as hearing loss. Some of the underlying conditions that are known to cause tinnitus may include:
- Hearing loss – Usually caused by loud noises and due to broken hair cells in the inner ear. The hair cells usually move when sound waves are transmitted to the ear. Broken hair cells will interfere with the brain’s interpretation of the sound heard.
- Ear infections – Fluid build-up will increase the pressure in the ear which can cause tinnitus.
- Clogged ears – The pressure in the ear can increase from clogged ears due to a foreign body which is not uncommon in children, high altitudes, diving, Eustachian tube dysfunction, acoustic neuroma, or ear wax (i.e., cerumen).
- Acoustic neuroma – A noncancerous tumor that grows on the main nerve between the ear and the brain.
- Muscle spasms in the inner ear – The muscles in the inner ear can spasm for unknown reasons that may cause tinnitus.
- Otosclerosis – Hardening of the bones of the middle ear can lead to tinnitus.
- Sinus infections – Fluid build-up in the ears or increased pressure of the ears as a result of a sinus infection.
- Eustachian tube dysfunction – When the Eustachian tube becomes partially or fully blocked, one may develop an ear fullness sensation as well as popping or clicking of the ears. As a result, tinnitus may develop.
- Ménière’s disease – A build-up of fluid in the compartments of the inner ear, called the labyrinth, is thought to be the cause of this malady. Individuals develop tinnitus, vertigo/dizziness, and hearing loss.
- Allergies [i.e., allergic rhinitis (hay fever)] – Allergies cause tinnitus usually by causing fluid in the ear or by causing blockage of the Eustachian tubes. In addition, allergic individuals are more likely to have sinus disease.
- Temporomandibular joint (TMJ) conditions – The TMJ shares some ligaments and nerves with the middle ear. The chewing muscles are also near some of the muscles that insert into the middle ear. Together, these factors may affect hearing.
- Heart disease – Certain heart problems can increase the blood flow pressure and cause one to have tinnitus.
- Blood vessel disease – High blood pressure, atherosclerosis, and abnormalities of the blood vessels can cause a higher pressure in the blood vessels which can lead to tinnitus. Pulsatile tinnitus is a condition where one hears their own heartbeat.
- Thyroid dysfunction – Both overactive and underactive thyroid glands are known to cause tinnitus in some individuals.
- Medication side effects – Multiple medications are known to have the side effect of tinnitus including aspirin, nonsteroidal anti-inflammatory agents or NSAIDs (e.g., ibuprofen, naproxen), loop diuretics [e.g., furosemide (Lasix)], ACE inhibitors (e.g., lisinopril, enalpril), Accutane, anti-malarial drugs (e.g., chloroquine, hydroxychloroquine), and certain antibiotics (e.g., tobramycin, gentamicin)
- Hormonal changes – Abnormal estrogen levels have been associated with tinnitus. Premenstrual syndrome (PMS), perimenopause, menopause, and pregnancy have all triggered tinnitus. As mentioned above, abnormal thyroid levels may also cause tinnitus.
Despite the many causes of tinnitus, some underlying conditions cannot be treated very easily, while others, such as allergies, are easier to treat. Hay fever (i.e., allergic rhinitis) is quite common, as 25-30 million individuals in the U.S. suffer from it. Individuals with allergic rhinitis are more likely to be afflicted with tinnitus. In addition, people with allergic rhinitis are more likely to be bothered with sinus infections, ear infections, clogged ears, and Eustachian tube dysfunction, all of which are additional risk factors for tinnitus. The treatment of allergic rhinitis and/or its associated complications (i.e., sinus infections, ear infections, clogged ears, Eustachian tube dysfunction) can prevent, alleviate, or eliminate tinnitus in many individuals. Medications often used to treat allergic rhinitis may include antihistamines, decongestants, leukotriene antagonists, nasal corticosteroids, nasal antihistamines, and/or nasal anticholinergics. Allergy shots (i.e., allergy immunotherapy, allergy desensitization, allergy injections, allergy hyposensitization) are a very effective tool in the management of allergic rhinitis and asthma and are effective in 80-85% of the patients that take them.
The treatment of tinnitus due to non-allergic underlying conditions may also focus on treating the underlying condition. Examples may include stopping a medication if the tinnitus was caused by a side effect of the medication, hormone therapy in cases of hormonal changes causing tinnitus, or a dental consultation in cases where TMJ is the cause of the tinnitus. It should be noted that treating recalcitrant cases of tinnitus may entail the use of hearing aids, white noise machines and devices, and/or behavioral therapy.
The board certified allergists at Black & Kletz Allergy have been seeing patients with tinnitus for many years. Black &Kletz Allergy has 3 convenient locations in the Washington, DC, Northern Virginia, and Maryland metropolitan area. We have offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA which all offer on-site parking. The Washington, DC and McLean, VA locations are Metro accessible and there is a free shuttle that runs between the McLean, VA office and the Spring Hill metro station on the silver line. Please call us to make an appointment or you can click Request an Appointment and we will reply within 24 hours of the next business day. The allergists of Black & Kletz Allergy are eager to help you with your tinnitus or other allergy, asthma, or immunology needs. We are committed to providing excellent care and service to you as we have been doing in the Washington, DC metro area for more than 50 years.