Tinnitus is the perception of sound, such as ringing, buzzing, hissing, or roaring, when no external sound is present. It is not a disease itself but rather a symptom that can arise from various underlying causes. This phantom sound can occur in one ear, both ears, or even within the head.
Understanding Unilateral Tinnitus
Unilateral tinnitus refers to phantom sounds heard in only one ear, differing from bilateral tinnitus which affects both. While tinnitus is common, unilateral presentation is less frequent. Its one-sided nature often prompts a more focused investigation into its underlying cause.
Common Causes of Tinnitus in One Ear
Several conditions can lead to tinnitus in a single ear. Earwax blockage, for instance, can cause perceived noise by muffling external sounds or by pressing against the eardrum.
Middle ear issues, such as infections (otitis media) or fluid accumulation, can also trigger unilateral tinnitus. Otosclerosis, an abnormal bone growth that fuses middle ear bones, can impede sound transmission and lead to tinnitus, often starting in one ear.
Meniere’s disease, an inner ear disorder, is characterized by a combination of vertigo, hearing loss, and tinnitus, which can be unilateral. Acoustic neuroma, also known as vestibular schwannoma, is a benign tumor on the nerve connecting the inner ear to the brain. While rare, this tumor can cause unilateral tinnitus, often accompanied by hearing loss and dizziness.
Temporomandibular joint (TMJ) disorders, affecting the jaw joint near the ear, can refer sound to the ear due to pressure or nerve irritation. Vascular issues can also cause pulsatile tinnitus, a rhythmic whooshing or throbbing sound synchronized with the heartbeat, stemming from changes in blood flow due to narrowed blood vessels.
Sudden Sensorineural Hearing Loss (SSNHL), an abrupt decrease in hearing, is frequently accompanied by unilateral tinnitus. Head or neck injuries, including whiplash or concussions, can affect the inner ear, hearing nerves, or brain function related to hearing, resulting in unilateral tinnitus.
When Professional Medical Advice is Needed
Seeking medical evaluation for any new or persistent unilateral tinnitus is important. Unilateral tinnitus often indicates a specific underlying condition requiring diagnosis and treatment.
Certain “red flag” symptoms warrant prompt medical attention. These include sudden onset of tinnitus, especially when accompanied by sudden hearing loss. Dizziness or vertigo, facial weakness or numbness, and pulsatile tinnitus are also signs that necessitate immediate consultation. Severe pain or discharge from the ear alongside tinnitus should also prompt a visit to a healthcare professional. Consulting an Ear, Nose, and Throat (ENT) specialist or an audiologist is recommended for proper diagnosis.
Approaches to Managing Unilateral Tinnitus
Once an underlying cause for unilateral tinnitus has been diagnosed and addressed, various strategies can help manage the symptom itself. Sound therapy involves using external sounds to make the tinnitus less noticeable. This can include white noise, nature sounds, or masking devices, which help distract the brain or encourage it to habituate to the tinnitus sound.
Tinnitus Retraining Therapy (TRT) and Cognitive Behavioral Therapy (CBT) are approaches that help individuals change their reaction to tinnitus. TRT combines counseling and sound therapy to help the brain habituate to the tinnitus, making it less bothersome over time. CBT focuses on identifying unhelpful thoughts and beliefs about tinnitus and replacing them with more constructive alternatives, along with developing coping skills.
Lifestyle adjustments can also play a role in managing tinnitus. Stress reduction techniques, such as deep breathing or yoga, can be beneficial. Avoiding triggers like excessive caffeine, nicotine, and loud noise exposure is also advisable. Ensuring adequate sleep can help reduce the impact of tinnitus on daily life.
If unilateral hearing loss accompanies tinnitus, hearing aids can sometimes help. By amplifying external sounds, hearing aids provide more auditory input to the brain, which can reduce the perception of tinnitus. Many hearing aids also have built-in tinnitus masking features.