Tinnitus and Ringing Ears

What are Tinnitus and Hyperacusis?

Tinnitus is the name given to the sensation of sound when there is no external sound present. Tinnitus is not the same for everyone. Sometimes the sound is heard in the head and not in the ears. Hyperacusis is the name given to the hypersensitivity to sounds in the environment.

What causes Tinnitus/Hyperacusis?

Many things can cause tinnitus or hyperacusis (eg hearing loss, head injury, muscle tension, some drugs). The actual mechanism is not known, but a lot of research is being undertaken to determine the site of dysfunction. Because most people with hearing loss or hyperacusis having a hearing loss, testing is always recommended.

What is the effect of Tinnitus?

It has been said that the majority of the population will have tinnitus (albeit briefly) at some stage in their life. 17% of the population are estimated to have problem tinnitus. 1% have tinnitus severe enough to cause annoyance and about 0.5% have tinnitus that results in an ability to lead a normal life. For most people, tinnitus is only a nuisance, however for a few people it can be a chronic condition resulting in a loss of concentration, sleep problems and even depression.

What is the effect of Hyperacusis?

Over sensitivity to sound can be very debilitating because it will often prevent people from going into any background noise. Many people start to wear ear plugs to reduce the amount of sound going into the ear. Unfortunately when ear plugs are worn in the absence of very loud sound, hyperacusis can be aggravated.

What makes tinnitus worse?

The aggravators of tinnitus doe change from person to person. Common aggravators are:

  • Stress
  • Loud sounds
  • Caffeine
  • Nicotine
  • Aspirin & some medications
  • Alcohol & drugs
  • Some foods


What should a person with tinnitus do?

The person with tinnitus should consult a qualified audiologist. An examination by an otologist may be recommended. The purpose of this is to determine if the tinnitus is the result of a condition, which can be treated medically. If not medial treatment is appropriate, non-medical treatment can be beneficial.

For most patients with bothersome tinnitus and hearing loss, a trial with hearing aids is recommended. This is to increase the general sounds in the environment so that the brain is less focused on hearing the body's internal sounds. In time, the brain's "volume control" can be adjusted so that the tinnitus is less obtrusive.

For people who are bothered by the tinnitus than a hearing problem, devices which produce a masking noise can be used to help desensitise the auditory system. The noise generators work in the same way as an aid, retraining the brain to ignore its own internal noise.

Is there a magic cure for tinnitus?

There is no magic pill that immediately eliminates tinnitus. All treatments take time (about six months) and aim to reduce the annoyance and intrusiveness of the tinnitus. With both tinnitus and hyperacusis treatment counselling is also needed so that people are aware that often some form of behavioural modification is needed was well as the use of devices.

What should a person with Hyperacusis do?

If a person experiences tolerance problems to everyday sounds, they must not be encouraged to use ear protection unless they are in a situation where the noise levels are so high that hearing loss is likely to develop (greater than 80 dBA). If ear protection is used inappropriately, hyperacusis will be aggravated.

In most instances clients are encouraged to increase the amount of sound in their environment to help retrain the auditory pathways. Because of this when a hearing loss is also present, aids may be helpful as long as they are programmed to squelch down damaging levels of sound.

Can we prevent Tinnitus/Hyperacusis?

Because many things can cause tinnitus and hyperacusis it is difficult to say how to prevent it. One of the more common causes of tinnitus and hyperacusis is hearing loss. Any programmes designed to reduce the incidence of hearing loss (eg ear protection) will reduce the incidence of tinnitus and hyperacusis.

Murali Mahadevan

Specialist ENT Surgeon

For all enquiries and appointments call (09) 925 4050

Gillies Hospital & Clinic
160 Gillies Avenue
Epsom, Auckland 1005

Facsimile: (09) 925 4051

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Fellow of Royal Australasian College of Surgeons