Ear, Nose & Throat

There’s help for that ringing in your ears


April 8, 2016

Tinnitus doesn’t have to rule your life. We’ve got answers.

Got a ringing or clicking in your ear? You’re not alone. About 15 percent of the U.S. population experiences some form of tinnitus, according to the U.S. Centers for Disease Control. That’s more than 50 million Americans.


What is tinnitus?

Tinnitus is often associated with a ringing in the ear, but it can also be a roaring, hissing, clicking, buzzing, whistling or chirping.

“Tinnitus is an auditory phantom sound that is heard when there is no actual external sound present,” explains Kenneth E. Watford, a doctor of nursing practice at the Vanderbilt Bill Wilkerson Center of Otolaryngology and Communication Sciences. “For some patients, the tone might intermittently change. It might also sound differently in one ear versus the other.”


What’s the difference between primary and secondary tinnitus?

Tinnitus might be related to another underlying medical condition. If your tinnitus is not related to another condition, it is considered primary, Watford says. However, if another medical condition is causing the tinnitus, it is considered secondary.

Conditions that could cause secondary tinnitus include: Meniere’s disease (a disorder of the inner ear that may cause episodes of vertigo), Eustachian tube dysfunction (the Eustachian tube is blocked or does not open properly), hearing loss, cerumen impaction (earwax buildup), otosclerosis (abnormal bone remodeling in the middle ear that causes hearing loss), nasal allergies, and anxiety or depression.

“Certain medications, such as aspirin, can also cause tinnitus,” Watford adds. “Poorly managed emotional stress is one of the leading causes of secondary tinnitus.”


What are the treatments for tinnitus?

Mindfulness and meditation techniques have proved helpful in cases of tinnitus. Prolonged emotional stress stimulates the sympathetic nervous system (fight or flight response), which then increases nerve activity in the brain, Watford says, and that might indirectly increase the severity of tinnitus.

“By learning to reduce stimulation of the sympathetic nervous system, and instead stimulate the parasympathetic nervous system (calming and well-being response),” Watford explains, “tinnitus tends to improve, and the patient experiences more peace of mind.”

Watford and his co-workers work closely with Vanderbilt’s Osher Center for integrative medicine to help patients with these calming techniques.

For patients with hearing loss, hearing aids can be helpful. Other methods include tinnitus retraining therapy and neuromonics tinnitus treatment.

Tinnitus retraining therapy (developed by Dr. Pawel Jastreboff while at the University of Maryland) uses external sound-generation devices in the ears. Neuromonics tinnitus treatment (developed by Australian Dr. Paul Davis) uses neuromonics sound processors to deliver acoustic stimuli that can retrain nerve pathways and thereby reduce the emotional response to tinnitus.


The Vanderbilt Bill Wilkerson Center specializes in ear, nose and throat diseases, and communication disorders such as hearing, speech, language and voice problems. Learn more here.