Tinnitus is the medical term for the perception of sound when no external source is present. This sensation is a symptom of an underlying issue within the auditory system, affecting millions of people. It is commonly described as a persistent ringing, though the sounds can vary widely and may cause significant distress, interfering with sleep and concentration. This guide will walk you through how to identify potential tinnitus symptoms and the diagnostic procedures used by specialists.
Understanding the Sounds of Tinnitus
The sounds associated with tinnitus are categorized into two main types based on who can hear them. Subjective tinnitus is the most common form, where the sound is perceived only by the patient and is often linked to changes in the auditory pathway, such as hearing loss. This phantom noise arises from abnormal neural activity in the brain.
The sounds of subjective tinnitus are frequently described as ringing, hissing, buzzing, roaring, or whistling. Less common is Objective Tinnitus, a rare form where the sound originates from a physical source within the body, such as muscle contractions or blood flow, and can sometimes be heard by a doctor during an examination. A specific type is pulsatile tinnitus, a rhythmic whooshing or throbbing sound that pulses in sync with the person’s heartbeat.
Initial Self-Screening for Tinnitus
Before consulting a specialist, you should track your symptoms to provide a detailed history. Note the characteristics of the sound, including its pitch, loudness, and whether it is constant or intermittent. Documenting the duration is helpful, especially whether it has been present for less than three months (acute) or more than six months (chronic).
You should also observe if the sound is present in one ear (unilateral) or both ears (bilateral), and if it changes when you move your neck or clench your jaw. Be aware of “red flag” symptoms that require prompt medical attention from an ear, nose, and throat (ENT) specialist. These include pulsatile tinnitus, the sudden onset of the sound, or any tinnitus accompanied by sudden hearing loss or severe vertigo.
Professional Diagnostic Procedures
A formal diagnosis begins with a consultation with an otolaryngologist (ENT) or an audiologist, who conducts a comprehensive evaluation. The cornerstone of the diagnostic process is the Comprehensive Hearing Test, or audiogram, which determines if the tinnitus is accompanied by hearing loss. This test involves sitting in a soundproof room and indicating when you hear specific tones and speech sounds.
Specialized Tinnitus Matching tests are often performed to quantify the patient’s subjective perception of the sound. The audiologist plays different tones and noises, adjusting the pitch and loudness until they match the sound the patient hears. Further audiological tests, such as Tympanometry, may be used to assess the function of the middle ear and rule out issues like fluid or ossicular chain problems.
If the tinnitus is unilateral, pulsatile, or accompanied by neurological symptoms, the specialist may order imaging tests like a Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scan. These scans rule out rare but serious underlying causes, such as a tumor near the auditory nerve or a vascular abnormality. While the diagnosis is often based on the patient’s symptom history, these tests help identify any treatable underlying conditions.
Next Steps Following a Tinnitus Diagnosis
Receiving a formal diagnosis shifts the focus from identification to management. This involves consulting with appropriate specialists, typically an audiologist for sound management and an ENT for medical clearance. Management plans are personalized, as treating the underlying cause—such as removing earwax or adjusting certain medications—can sometimes alleviate symptoms.
For most people, management focuses on reducing the awareness and distress caused by the sound, since a single cure is not currently available. Common approaches help the patient change their reaction to the sound and improve coping mechanisms:
- Sound therapy, which uses external sounds like white noise or nature sounds to mask or habituate the brain to the tinnitus.
- Tinnitus Retraining Therapy (TRT).
- Cognitive Behavioral Therapy (CBT).
- Hearing aids, which amplify external sounds, making the internal tinnitus less noticeable, especially when hearing loss is present.