Tinnitus is the perception of sound, often described as ringing, buzzing, or hissing, when no external source is present. While frequently associated with damage to the auditory nerve or age-related hearing loss, some cases are caused by a simple, treatable physical obstruction in the ear canal. This mechanical blockage, typically from earwax, is one of the few causes of tinnitus that can potentially be resolved completely with a straightforward procedure.
How Blocked Ear Canals Cause Tinnitus
The inner workings of the ear are highly sensitive to pressure and sound transmission. When excessive earwax (cerumen) builds up and fully impacts the ear canal, it causes conductive hearing loss. This blockage prevents sound waves from reaching the eardrum efficiently, changing how the brain processes auditory information. The central auditory system may compensate for the reduced external input by generating its own noise, which is perceived as tinnitus.
Impacted cerumen can also cause tinnitus through direct physical irritation. The mass of wax may press against the delicate eardrum (tympanic membrane), sending abnormal signals to the inner ear structures. This mechanical stimulation can trigger the perception of phantom noise.
This type of tinnitus is often temporary and linked directly to the physical obstruction. For many people, the symptom resolves immediately or soon after the impacted wax is successfully removed. This direct link makes cerumen impaction one of the most reversible causes of tinnitus.
Professional and Home Removal Methods
When earwax is suspected of causing tinnitus, professional removal is the safest and most effective approach. The three clinical methods are microsuction, manual removal, and irrigation.
Clinical Removal Methods
Microsuction is the most precise technique, using a low-pressure vacuum and a microscope for direct visualization to gently suction the wax out of the ear canal. Manual removal involves using specialized instruments like curettes or forceps to physically extract the wax, often preferred for hard or large plugs. Irrigation uses a controlled, low-pressure stream of warm water to flush the wax out. This method is safe only if the eardrum is intact.
Home Care and Safety
For home care, the only recommended intervention is the use of cerumenolytic agents, or wax-softening drops. Common over-the-counter options include:
- Hydrogen peroxide
- Carbamide peroxide
- Mineral oil
- Olive oil
These drops soften the wax mass, making it easier for the ear’s natural cleaning mechanism to work or preparing it for professional removal.
Never insert objects into the ear canal, as this can worsen the condition and cause injury. Using cotton swabs often pushes the wax deeper, leading to a more severe impaction that can increase tinnitus symptoms. Ear candling is not supported by scientific evidence and carries severe risks, including burns, puncturing the eardrum, or blocking the canal with candle wax.
Other Common Causes of Tinnitus
If earwax removal does not alleviate the ringing, the tinnitus is likely a symptom of a more complex underlying condition. The most frequent cause is noise-induced hearing loss, resulting from damage to the tiny hair cells in the inner ear after exposure to loud sounds. Age-related hearing loss (presbycusis) is another common factor, as the number of functioning nerve fibers naturally declines over time.
Tinnitus can also be triggered by ototoxic medications. These include high doses of nonsteroidal anti-inflammatory drugs (NSAIDs), some antibiotics, and certain chemotherapy drugs. Other medical conditions that may cause the symptom include Meniere’s disease, which involves fluid pressure issues in the inner ear, or temporomandibular joint (TMJ) disorders.
Seek a medical evaluation if the tinnitus is only in one ear, is pulsatile (sounds like a rhythmic whooshing or heartbeat), or is accompanied by dizziness or sudden hearing loss. These symptoms suggest a cause beyond simple earwax and require professional diagnosis and treatment.