Tinnitus is the perception of sound, like ringing, buzzing, or hissing, when no external sound is present. Vertigo is a specific type of dizziness characterized by a sensation of spinning or whirling, either of oneself or of the surroundings. While distinct, these two symptoms can sometimes arise from shared underlying health conditions.
Understanding Tinnitus
Tinnitus is the perception of sound in one or both ears or in the head, without an external source. It can manifest as ringing, buzzing, hissing, clicking, roaring, or humming. A common symptom, affecting approximately 15% to 20% of people, it is particularly prevalent in older adults. Tinnitus is considered a symptom, rather than a disease itself.
Common causes of tinnitus include exposure to loud noise, which can damage the delicate hair cells in the inner ear. Age-related hearing loss, known as presbycusis, also frequently leads to tinnitus as the number of functioning nerve fibers in the ears declines. Earwax blockage or ear infections can cause temporary tinnitus. Certain medications, such as some antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, and chemotherapy drugs, are known to cause or worsen tinnitus. Temporomandibular joint (TMJ) disorders, which affect the jaw, can also contribute to tinnitus due to their proximity to the ear.
Understanding Vertigo
Vertigo is a specific type of dizziness that creates a sensation of spinning or whirling, as if oneself or the surroundings are moving. This differs from general lightheadedness or faintness. It often leads to feelings of unsteadiness, nausea, and sometimes vomiting. As a symptom, it typically originates from issues within the vestibular system, which is responsible for balance.
The most common cause of vertigo is Benign Paroxysmal Positional Vertigo (BPPV), where tiny calcium crystals in the inner ear become dislodged and move into the semicircular canals. Labyrinthitis, an inflammation of the inner ear, or vestibular neuritis, an inflammation of the vestibular nerve, can also cause sudden vertigo, often following a viral infection. Head injuries can disrupt the vestibular system and lead to vertigo. Less common causes include certain medications, stroke, and brain diseases.
When Tinnitus and Vertigo Coincide
While tinnitus and vertigo are distinct symptoms, they can be related when they stem from a common underlying condition affecting the inner ear or brain pathways. These conditions often impact both the auditory and balance systems.
Ménière’s disease is a disorder of the inner ear characterized by episodes of severe vertigo, ringing in the ears (tinnitus), fluctuating hearing loss, and a feeling of fullness in the affected ear. This condition is thought to involve an abnormal buildup of fluid, called endolymph, within the inner ear, disrupting signals for both hearing and balance. Attacks can last from minutes to hours and can significantly impact daily life.
Vestibular migraine is a type of migraine that can cause episodes of vertigo and other vestibular symptoms, often accompanied by tinnitus, even without a headache. This condition involves disturbances in the brain’s processing of balance and auditory signals. Symptoms like aural fullness, sensitivity to light, and nausea can also occur during a vestibular migraine episode.
An acoustic neuroma, also known as a vestibular schwannoma, is a benign tumor that develops on the nerve leading from the inner ear to the brain. As this slow-growing tumor enlarges, it can press on the nerves responsible for hearing and balance, causing hearing loss, tinnitus, and balance issues, including vertigo. While true spinning vertigo is less common, imbalance and a sensation of unsteadiness are frequent.
Autoimmune Inner Ear Disease (AIED) is a rare condition where the body’s immune system mistakenly attacks the inner ear. This can lead to progressive sensorineural hearing loss, often bilateral, and is frequently accompanied by vestibular symptoms like vertigo, dizziness, and tinnitus. AIED can occur as an isolated condition or in conjunction with other systemic autoimmune diseases.
Investigating and Addressing Symptoms
When a person experiences both tinnitus and vertigo, a healthcare professional, such as an ENT specialist or neurologist, will conduct a thorough diagnostic process. This begins with a detailed medical history, including the nature, duration, and triggers of symptoms. Physical examinations focus on neurological function and ear health.
Specific tests are often ordered to pinpoint the underlying cause. Audiometry, or hearing tests, assesses hearing loss patterns which can provide clues about the inner ear’s function. Caloric testing and videonystagmography (VNG) evaluate the vestibular system’s responses and eye movements to help identify balance disorders. Imaging studies, such as an MRI of the brain, may be used to rule out structural issues like tumors or other neurological conditions.
For conditions like Ménière’s disease, medication may be prescribed to reduce fluid buildup or suppress vertigo episodes. Vestibular rehabilitation therapy (VRT), a specialized form of physical therapy, helps improve balance and reduce dizziness through specific exercises. Lifestyle modifications, such as dietary changes or stress management, can also be beneficial.
For tinnitus, sound therapy using white noise machines or masking devices can help make the perception of sound less bothersome. Counseling, including cognitive behavioral therapy (CBT), can also provide coping techniques.