Tinnitus refers to the perception of sound in one or both ears when no external sound is present. This phenomenon can manifest as ringing, buzzing, hissing, clicking, roaring, or whistling. When these perceived sounds are localized to a single ear, it is known as one-sided, or unilateral, tinnitus. This localization distinguishes it from more common bilateral tinnitus, which affects both ears simultaneously.
Causes of One-Sided Tinnitus
One-sided tinnitus can stem from various underlying issues. Unlike tinnitus affecting both ears, unilateral tinnitus sometimes signals a specific problem within or near the affected ear.
Common causes involve blockages or infections within the ear canal. An accumulation of earwax, known as cerumen impaction, can create pressure on the eardrum, leading to one-sided tinnitus. Middle ear infections, or chronic otitis media, cause inflammation and fluid buildup behind the eardrum, which can trigger tinnitus in the affected ear. Additionally, a ruptured eardrum, resulting from infections, physical injury, or exposure to loud noise, can cause tinnitus along with pain and hearing loss.
Other causes relate to structural or functional issues around the ear. Temporomandibular joint (TMJ) disorders, affecting the jaw joint, can lead to one-sided tinnitus due to pressure or nerve irritation from jaw misalignment or muscle tension. Otosclerosis, a condition involving abnormal bone growth in the middle ear, can also result in unilateral tinnitus.
More significant conditions can also manifest as one-sided tinnitus, sometimes accompanied by other neurological symptoms. Meniere’s disease, an inner ear disorder characterized by fluid buildup, can cause episodes of vertigo, pressure, and tinnitus in one ear. Sudden sensorineural hearing loss (SSHL), an unexplained rapid decrease in hearing in one ear, often presents with unilateral tinnitus.
An acoustic neuroma, also called a vestibular schwannoma, is a benign (non-cancerous) tumor that grows on the vestibulocochlear nerve, which connects the ear to the brain. This slow-growing tumor can cause one-sided tinnitus, hearing loss, and dizziness. Vascular anomalies, such as aneurysms or issues with blood vessels near the ear, can lead to pulsatile tinnitus, a rhythmic whooshing or pulsing sound synchronized with the heartbeat, which may be heard in one ear.
When to Seek Medical Attention
One-sided tinnitus warrants medical evaluation. If the ringing or other sounds persist for more than a week, or if they are disruptive to daily life or affect hearing, it is advisable to consult a healthcare professional.
Certain accompanying symptoms should prompt immediate medical attention. These include sudden hearing loss, dizziness, or vertigo, as these may signal conditions like Meniere’s disease or sudden sensorineural hearing loss that require urgent treatment. Facial numbness or weakness, severe headaches, and changes in vision, when present alongside one-sided tinnitus, could indicate more serious neurological issues, such as a brain tumor or stroke, necessitating prompt assessment.
Diagnosis and Management Approaches
Diagnosing the cause of one-sided tinnitus begins with a comprehensive medical history, where a doctor will inquire about the nature of the tinnitus, its onset, and any accompanying symptoms. A thorough physical examination, particularly of the ear and neurological system, helps identify clues.
Audiometric testing, including audiometry and tympanometry, is performed to assess hearing levels and the function of the middle ear. These tests determine if hearing loss is present and its type. If unilateral tinnitus or asymmetric hearing loss is detected, imaging scans like an MRI of the brain and inner ear may be recommended to rule out conditions such as acoustic neuroma or other structural problems.
Management approaches for one-sided tinnitus are dependent on the identified underlying cause. If earwax blockage is the culprit, professional earwax removal can resolve the tinnitus. Middle ear infections may be treated with antibiotics or ear drops. For conditions like Meniere’s disease, medications to manage vertigo and fluid balance may be prescribed.
In cases of acoustic neuroma or otosclerosis, surgical intervention might be considered to address the underlying structural issue. When a specific cause cannot be found or after the underlying condition is addressed, management focuses on alleviating the tinnitus symptoms. Sound therapy, using external sounds like white noise to mask the tinnitus, and counseling, such as cognitive behavioral therapy, can help individuals cope with the persistent sounds and reduce their impact on quality of life.