Tinnitus is the perception of sound when no external sound is present, often described as ringing in the ears. It can also manifest as buzzing, hissing, roaring, or clicking in one or both ears. Tinnitus is not a disease but a symptom of an underlying condition, and its duration depends highly on the cause. The experience ranges from a fleeting moment to a permanent condition.
Acute Tinnitus: Causes and Expected Resolution Time
Temporary ringing is often linked to short-term, reversible events. Exposure to a sudden, very loud noise, such as a concert or machinery, can cause a brief episode of tinnitus. This temporary noise-induced ringing typically subsides within a few hours, though it can occasionally last for up to 48 hours as the auditory system recovers.
Minor physical issues can also cause acute tinnitus that resolves once the underlying problem is addressed. Excessive earwax buildup can block the ear canal, causing pressure changes that produce temporary ringing, which ceases immediately upon removal of the blockage. Similarly, fluid and pressure changes from a minor ear infection or barotrauma (such as from flying) can trigger temporary ringing that resolves as the condition clears, usually within a few days to a week. Certain medications, including high doses of aspirin and some nonsteroidal anti-inflammatory drugs (NSAIDs), can also induce temporary tinnitus that disappears once the drug is discontinued.
Underlying Conditions That Lead to Persistent Ringing
Ringing that persists beyond a few weeks is defined as chronic if it lasts for three to six months or more. The most frequent cause of persistent tinnitus is damage to the microscopic hair cells in the cochlea, the inner ear structure responsible for detecting sound. This damage can result from noise-induced hearing loss due to repeated exposure to loud sounds, or it can occur simply from the aging process, known as presbycusis.
When these hair cells are damaged, they fail to transmit proper signals to the brain, which attempts to compensate by generating the phantom sound. For these individuals, the ringing is often a lifelong symptom of permanent sensory damage, requiring long-term management. Head or neck trauma can also cause chronic tinnitus by damaging the auditory nerve or the brain areas that process sound.
Tinnitus may also be a symptom of Meniere’s disease, an inner ear disorder characterized by fluid pressure abnormalities. In this case, the ringing is often accompanied by episodes of vertigo and fluctuating hearing loss, and it is typically persistent because the underlying condition is slowly progressive. Vascular disorders can cause pulsatile tinnitus, a rhythmic sound synchronized with the heartbeat. This is caused by changes in blood flow near the ear, such as high blood pressure, and persists as long as the circulatory issue remains.
Certain medications, particularly some antibiotics and chemotherapy drugs, are ototoxic, meaning they cause lasting damage to the auditory system. The ringing caused by these ototoxic drugs can be permanent because it reflects structural damage to the inner ear. Tinnitus associated with these underlying conditions is unlikely to resolve on its own, requiring the person to develop strategies to cope with the persistent sound.
When Immediate Medical Evaluation is Necessary
While many cases of tinnitus are temporary, certain accompanying symptoms require prompt professional attention. You should seek a medical evaluation if the ringing has lasted for more than one week without a clear, temporary cause, suggesting a more complex underlying issue may be at work.
A sudden onset of tinnitus, especially when accompanied by sudden hearing loss, is considered a medical urgency, as immediate treatment may be necessary to preserve hearing. A medical evaluation is also warranted if the tinnitus is only present in one ear (unilateral tinnitus), as this can indicate a more serious condition like an acoustic neuroma. If the sound is pulsatile (beating in rhythm with your pulse), it should be evaluated to rule out a vascular cause. Any instance of tinnitus coupled with severe dizziness, vertigo, or a feeling of ear fullness should prompt an immediate visit to a healthcare provider.