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Severe, persistent tinnitus and other related symptoms
Last reviewed: 04.07.2025
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In medical practice, we often encounter complaints of ringing in the ears. If we turn to medical terms, this diagnosis will sound like tinnitus. This disease does not exist on its own, it is a sign of some disease. Therefore, it is necessary to immediately diagnose the disease that causes such sensations.
This may be a disease or the impact of external factors. Sometimes after an injury, when a foreign body gets in, due to the abuse of psychotropic substances. Also during the period of age-related or functional changes.
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Causes tinnitus
Read about the causes of tinnitus in this article.
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Risk factors
The risk group includes people who are often exposed to loud sounds and noises. This could be loud music, industrial noises and vibrations. People whose professional activities are associated with various sound and vibration oscillations, tests at ultra-high or ultra-low frequencies are significantly at risk. Tinnitus often appears in professional pilots, testers, tankers, military personnel, employees of production shops and enterprises, miners.
Young people who lead an overly active lifestyle, constantly visit clubs, noisy parties, concerts, car audio shows are at risk. People who listen to music on headphones are also at risk.
Epidemiology
Tinnitus only indicates the development of diseases of the hearing organs in 15% of cases. In the remaining 85% of cases, it is a sign of other diseases of the internal organs. In 32% of cases, noise occurs as a result of cerebrovascular accidents. In 27% of cases, it occurs as a result of injuries or overload of the ear with loud sounds, excessive vibrations. In 19% of cases, it occurs as a result of nervous stress, mental overstrain. In 90% of adults, noise is considered a normal variant, 30% periodically feel noise in the ears, which passes quite quickly.
Of these, 20% consider the noise to be excessively pronounced and uncomfortable. In elderly people, noises occur in 80% of cases. The frequency of this pathology in children is 6%, in adolescents - 5%, in adults - 9%. More than 65% of people feel noise in one ear, the remaining 35% - in both ears. In men, the frequency of this pathology is approximately 2.2 times higher than in women, since men are more susceptible to the effects of industrial factors.
Symptoms
Symptoms include the occurrence of various discomforting sensations in the ear, such as ringing, noise, buzzing, hum. It can cause various reactions in a person. Many people experience anxiety, fear, worry, panic in connection with the occurrence of ringing. Rarely do such phenomena cause positive emotions and pleasant sensations. Ringing is often accompanied by hearing loss. Usually, noise and ringing appear suddenly, or their development occurs in a relatively short time.
Noise can arise as a result of disorders of any of the ear parts, and is often accompanied by pain in this part. Moreover, dizziness, headache, weakness, nausea can develop. In rare situations, it is accompanied by vocal hallucinations, musical composition. Sometimes the ringing can increase gradually, increasing in intensity.
The first signs are sound sensations in the inner ear, which occur at different times and with varying intensity.
- Constant ringing in the ears
If there is a constant ringing in the ears, almost without stopping, one can suspect the presence of diseases, pathologies of normal blood circulation, hypertension (arterial pressure constantly increases). Similar symptoms can also be a sign of a neoplasm on the auditory nerve.
- Noise and ringing in the ears
Serves as a sure sign of sensorineural hearing loss. This is one of the stages, occurs mainly in elderly people. Occurs against the background of atherosclerotic vascular lesions, with other diseases.
The development of such symptoms can be facilitated by damage to small vessels that supply blood, as well as a sharp decrease in oxygen supply to the body. It is worth fearing antibiotics that have an ototoxic effect. The main drugs that impair hearing and cause various noises are kanamycin, gentamicin, neomycin.
They also appear in pathologies of the circulatory system. Especially if microcirculation in small vessels is disrupted. This leads to death, improper functioning of the hearing organ. Sounds are perceived incorrectly, they are processed and interpreted incorrectly. This can also be associated with blood sugar levels. Noises often occur in patients with diabetes.
When the vertebral artery is compressed, there may also be a disruption of blood circulation, blood transport, and excess carbon dioxide. There is a constant noise. These sensations may increase/decrease as the head position changes.
- Pain and ringing in the ear
The suspicion falls on a malignant or benign neoplasm, a neuroma of the auditory nerve. It is a benign neoplasm, the causes of which are not fully understood. It is known that the neuroma comes out of the inner ear. The pathology grows and develops slowly.
The ringing occurs because the nerve is constantly irritated and transmits excitation to the corresponding areas. Only the irritation is not carried out by sound waves, but by a tumor. Diagnosed using a computer tomogram.
Treatment tactics depend on the degree and severity of the disease. At first, they limit themselves to observation tactics: they only monitor the condition of the tumor. This can only be done if it is benign. If the tumor is cancerous, it must be removed as quickly as possible. Surgical removal of the tumor is performed by craniotomy.
- Ringing in the right ear
The right ear is ringing as a result of otitis of the right ear. Fluid accumulates, which disrupts the transmission of impulses to the nerve and areas responsible for processing auditory information.
Inflammation is accompanied by the development of a bacterial infection. Edema and hyperemia also develop, limiting the mobility of the auditory ossicles. Otitis is often accompanied by painful sensations.
In chronic pathology, the normal functioning of the auditory nerve is disrupted. It stops receiving and processing the necessary information, or its accuracy changes significantly. Over time, the nerves stop distinguishing sounds of different frequencies, and constant pain and constant ringing appear.
- Ringing in the left ear
Often the cause of ringing is otitis of the left ear. It can be a consequence of a cold, bacterial or viral infection, allergic edema or direct trauma to the ear. It can occur after taking ototoxic drugs.
When early signs appear, the ear cavity is first examined, then the doctor determines the cause of the pathology and selects the appropriate treatment. Conservative therapy is not always effective; surgical intervention may be required.
- Severe ringing in the ears
A loud ringing occurs mainly after an injury, due to some external intervention. It can occur due to salt deposits, the formation of a sulfur plug, deterioration of blood supply and age-related changes in the auditory analyzer.
Often, a strong ringing is caused by some factor sending a false signal to the brain. The sensations that arise in this case are subjective, always audible only to the patient.
It can also occur with both benign and malignant tumors. Ringing should always alert the patient and become a reason for examination.
- Ringing in the ears and dizziness
Dual pathology is caused by the accumulation of a large number of nerve impulses. This can occur due to various injuries, inflammatory processes. With atherosclerosis, which is accompanied by the formation of blood clots.
They also occur with increased sensitivity to certain sounds, which is most often observed during stress and neuropsychic overstrain. In this case, dizziness is often accompanied by a feeling of fear. Nausea and increased sweating may appear. Panic also develops, which leads to injury and loss of consciousness.
All this often occurs against the background of osteochondrosis, chronic stress, overexertion. Often caused by allergies, kidney and liver diseases.
- Ringing in the ear and congestion
Often, ear congestion occurs when a sulfur plug appears. It is a buildup of earwax in the external auditory canal. In order to remove the plug, you need to see an otolaryngologist. The plug is removed quite easily and quickly.
- Weakness and ringing in the ear
Weakness may occur due to overfatigue, decreased overall resistance of the body. This is accompanied by a decrease in blood pressure, atony, and disruption of normal blood circulation. As a result, ringing in the ears occurs.
- Ringing in the ears and nausea
If nausea and ringing in the ears occur simultaneously, Meniere's disease may be suspected. Severe cases may be accompanied by vomiting. In this case, the auditory nerve is affected.
First, they try to treat the disease with conservative methods using medications and a special diet. Symptomatic therapy is carried out, aimed at eliminating the symptoms: dizziness, nausea. If these symptoms do not respond to treatment, but only worsen, surgical intervention is carried out.
Operations are performed in various ways, but most of them end with the person becoming deaf in one ear. Therefore, expectant therapy is first performed, in which the operation is not performed, but the condition is constantly monitored. At the slightest sign of deterioration, the operation is performed immediately. After the operation, a hearing aid is inserted.
Sometimes a stapedectomy is performed. This is an operation in which one of the auditory ossicles is not removed but replaced with a prosthesis.
- Tinnitus and headache
Headaches often occur as a result of cerebrovascular accidents, brain diseases, including tumors. They can also occur with inflammation of the middle ear, with nervous and mental overstrain.
- Ringing in the ears and clogged ears
Ear congestion may occur during takeoff and landing of an airplane, with a sharp change in pressure, high in the mountains, when diving to depth. This is a normal phenomenon. But today 50% of people suffer from such sensations in everyday life. This is due to a change in pressure inside the body. A sharp drop in blood pressure, intracranial pressure is possible. Also as a result of dysfunction of the temporomandibular joint.
When darkening in the eyes is accompanied by ringing, it can be assumed that he has atherosclerosis, vascular damage by a thrombus, arterial/venous stenosis.
- Ringing in the ears in the morning, after sleep
It usually occurs with low blood pressure, as well as with edema, congestion. With heart failure, circulatory and respiratory disorders, tinnitus also develops. There may be muscle weakness, atony, dizziness.
- Ringing in the ears in the evening, before going to bed
Usually, in the evening, tinnitus occurs due to overwork, nervous, mental and physical overstrain, stress. Lack of nutrients, metabolic disorders, high blood pressure can contribute to increased pressure in the evening.
- Ringing in the ears at night
Typically, this phenomenon occurs with pressure drops, neuroses, cerebrovascular accidents, and heart and vascular diseases. It may indicate the presence of neuropsychiatric diseases and disorders, as well as overwork and chronic stress.
- Ringing in the ear and hearing loss
It is a sign of oterosclerosis. This disease is a chronic disease of the hearing organs, the cause of which has not yet been fully clarified. With this disease, the structure and function of the bones in the middle ear are disrupted. At first, the disease develops in one ear, then gradually progresses and is transmitted to the second ear.
- Heart palpitations and ringing in the ears
If you experience ringing in the ears and a pulsating noise that resembles a heartbeat and corresponds to the heart rhythm, you can assume an arteriovenous malformation, in which abnormal communications develop between the arteries and veins. Also, pulsation and ringing can indicate the development of a tumor that contains a large number of its own arteries. Often, this is a malignant tumor. Noise in the ear can be heard with a stethoscope, so this category of noises and ringing is classified as objective noises that can be heard by others.
- Intermittent ringing in the ears
Periodic short-term ringing in the ears can occur due to overwork, stress, as well as increased pressure, spasms, and various short-term changes in the body. Even if the ringing does not cause much discomfort, it is necessary to be examined by a doctor, since it can be a symptom of a serious disease that can be most effectively treated only at an early stage of development.
- Temperature and ringing in the ears
This is usually observed during the development of an acute inflammatory or infectious process in the ear. Often the temperature rises with otitis, as well as with inflammation of the auditory nerve.
- Pulsating ringing in the ears
Ringing in the ears that resembles a pulse or heartbeat indicates serious disorders of the cardiovascular system. These may be myocarditis, heart defects, as well as abnormal structure of arteries and veins. Pulsating pain may also occur with the development of tumors.
- Ringing and echo in the ear
Echo can be a sign of an abnormal internal environment in the ear. It occurs when the inner ear is filled with pathological fluid, or when the auditory ossicles are tightly fused together.
- Neck pain and ringing in the ears
This may be a sign of cervical osteochondrosis, impaired nerve conduction, inflammation of the auditory nerve and myelin sheaths of the part of the brain that is responsible for processing signals received from the auditory analyzer.
- Ringing in the ears when talking
Many elderly people experience ringing in the ears during conversation. It occurs due to age-related changes in the inner ear, with the depletion of the eardrum. Vibration of hair cells can also occur, which irritate the nerve and transmit a signal to the corresponding area of the brain.
- Heaviness in the head, ringing in the ears
Heaviness may occur with an intense inflammatory and infectious process, with a chronic infection. A feeling of heaviness and pressure accompanies a person in the presence of pathological fluid and pus in the cavity of the inner ear, as well as with severe swelling.
- Metallic ringing in the ears
It is a consequence of damage to the eardrum and other structures of the inner ear. Most often, such ringing occurs when the eardrum is damaged by a loud sound, various vibrations. Such a sensation can occur after a concert, after visiting events with loud sounds.
- Ringing in the ears
The ringing of a bell indicates damage to the hair cells that transmit a signal to the auditory nerve. In some pathologies, these cells may constantly vibrate, and the nerve is constantly irritated and transmits a signal to the auditory center of the brain. This is how a ringing occurs that is heard only by the person himself, and those around him do not feel it.
- Nosebleeds and ringing in the ears
With increased pressure, decreased tone and fragility of blood vessels, nosebleeds may occur. This phenomenon may be accompanied by ringing in the ears, since the tone of the vessels increases, the blood filling of the vessels increases, including the ear vessels. Hairy cells are better innervated, which leads to them becoming more sensitive and vibrating, irritating the nerve with the slightest vibration, even if it occurs as a result of vascular pulsation.
- Nausea, chills and ringing in the ears
Nausea occurs with Meniere's disease, as well as with increased arterial and intracranial pressure. Nausea can also be observed with a sharp jump in pressure
Tinnitus in a child
It bothers children quite often. Often the main reason is incorrect treatment of the throat and nasopharynx, which leads to complications in the ear. Even a mild cold can develop a disease of the inner ear. This is due to the peculiarities of the anatomical structure: the Eustachian tube connecting the nasopharynx with the ear is too short, so the infection from the nasal cavity penetrates into the ear and causes inflammation there. As a result, ringing and noise in the ears occur.
An infection in the ear can occur even if you blow your nose incorrectly. Frequent rhinitis, chronic sinusitis, adenoiditis can be the cause of ear infection. Viral load and decreased immunity increase the likelihood of pathology. Getting liquid or a foreign body into the ear can cause hissing and ringing. In a child, ringing can also develop due to the immaturity of the structures of the nose, throat, ear, and also because the microflora is not yet sufficiently formed.
Tinnitus in a teenager
A teenager often experiences tinnitus. This is due to age-related characteristics of the body when it adapts to new living conditions. Hormonal changes occur, nervous activity is activated. Growth increases rapidly, and often outpaces the development of blood vessels. The blood vessels of the brain are particularly affected, since they are the thinnest. They can become atonic, or, conversely, acquire excessive tone. This condition is called vegetative-vascular dystonia. The blood vessels of the inner ear are also subject to similar changes.
Against the background of hormonal changes, nervousness develops, nervous regulation becomes unstable. Excessive excitability and increased sensitization appear. The nerve fibers of the inner ear are also subject to excessive irritation, react to signals incorrectly.
Teenagers often have a weakened immune system, so they are most at risk of developing infectious and inflammatory processes. Inflammatory processes often affect the inner ear, which leads to ringing and noise. Most often, the cause of ringing is otitis, in which the middle ear becomes inflamed.
If you experience ringing, noise, or other similar sensations in the ear, you should see a doctor. In this case, you may need to consult an adolescent therapist or otolaryngologist. Doctors will conduct an examination, prescribe the necessary tests and instrumental studies. This will make it possible to make the correct diagnosis, select the necessary treatment that will help get rid of unpleasant symptoms.
Tinnitus During Pregnancy
It is considered a normal variant, since there is a sharp increase in the volume of circulating blood in the body. This is very pronounced during physical exertion and climbing stairs.
Who to contact?
Diagnostics tinnitus
To find the cause of tinnitus, you need to conduct diagnostics. To do this, you need to contact an ENT specialist and a neurologist. The ENT specialist will examine the condition of the ear, exclude possible ear pathologies. If necessary, prescribe treatment. If no structural or functional ear disorders are detected, then you need to look for the cause of the pathology in another system.
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Tests
Usually, laboratory tests are not performed. But in some cases, a clinical or biochemical blood test, urine test may be needed. They will provide an opportunity to determine the overall picture of what is happening in the body, as well as to assess the course and direction of the main processes. The results may indicate the presence of pathologies in any areas. Indicators may be found that indicate the development of an inflammatory, infectious or allergic process.
If an allergy is suspected, a detailed immunogram, an analysis for immunoglobulin E, which is a marker of a delayed-type allergic reaction, and allergy tests may be required.
If a bacterial or viral infection is suspected, a bacteriological culture or virological studies are performed. It is advisable to conduct an analysis for latent infections.
Instrumental research
The main method of instrumental examination is measuring arterial pressure. For this, a tonometer is used, systolic and diastolic pressure is measured.
If there is a suspicion of a malignant tumor that has caused the ringing in the ears, an MRI or CT scan is performed. These methods make it possible to identify the tumor. Then a biopsy is performed, during which a piece of tumor tissue is taken for further histological examination. Sowing is done, and the nature of the tumor is determined by the nature of growth.
If osteochondrosis is suspected, an X-ray examination is performed.
If heart and vascular diseases are suspected, angiography and electrocardiogram are performed.
Differential diagnosis
Differential diagnostics is based on the need to differentiate diseases that have similar symptoms. First of all, otoscopy is performed, during which pathology of the hearing organs is confirmed or excluded. To do this, you need to get a consultation with an ENT specialist, who will study the condition of the ear using special instruments.
The ENT specialist also conducts auscultation, or listening. A stethoscope is used for this. With its help, the doctor listens to noises behind the ear. If they coincide with the patient's heart rhythm, this indicates the presence of cardiovascular pathology, as well as the presence of muscle and vascular spasms.
At the second stage, differential diagnostics is performed by a neurologist. First, he talks to the patient. To do this, the doctor collects all the necessary information about the patient: personal data, life history. Then he listens to the patient's subjective complaints and feelings.
During the conversation, the doctor learns in detail what is bothering the patient, how long it has been there, receives information about the nature of the ringing, strength, duration. This allows making initial conclusions about the nature of the pathology. If a disease of any organ system is suspected, the patient is sent for consultation to the appropriate specialist, who conducts further research and draws conclusions.
Treatment tinnitus
Read about treating tinnitus in this article.
Complications and consequences
Tinnitus is not an independent disease, but only one of the symptoms of some other disease or injury. Therefore, if you do not treat tinnitus, you can miss a serious pathology. It can be absolutely any disease: inflammatory, allergic, infectious, and even a tumor. The disease can be associated with the organ of hearing, or it can relate to a completely different organ system.
Often ringing indicates mental disorders and disorders of the nervous system, excessive exposure to stress, overwork. Ringing can also occur as a result of prolonged exposure to anxiety.
What to do if the ringing in the ear does not go away?
If the ringing in the ear does not go away for a long time, you need to see a doctor. It is necessary to conduct an examination, identify the cause of the ringing and choose the appropriate treatment. The noise can be a symptom of a serious disease.
Prevention
To prevent tinnitus, you need to undergo preventive examinations. If any diseases are detected, you need to undergo treatment. It is also important to promptly and correctly treat diseases of the nasopharynx, pharynx, eliminate foci of infection, since from the nasopharynx the infection can easily penetrate into the ear and cause an inflammatory process there, which often becomes the cause of tinnitus.
It is important to maintain hearing hygiene, avoid injuries and damage. It is necessary to avoid exposure to loud and sharp sounds, loud music. It is important to exclude exposure to noise, vibrations, ultra-low and ultra-high frequencies. When working with harmful noise factors, it is necessary to observe safety precautions, undergo timely medical examinations. This is especially true for those who work with transport, airplanes, and carry out construction work. Shots, loud fireworks also have a negative impact on health.
It is important to observe hygiene rules when diving and swimming. Water can get stuck in the inner ear, causing tinnitus. For prevention, it is necessary to avoid stress, excessive mental stress, emotional swings. A spa vacation, massage, meditation, and acupuncture will help with this. Sports and creative activities are also useful.
Forecast
If you see a doctor in a timely manner, you can conduct a diagnosis and identify the cause of tinnitus. If this cause is eliminated, the pathology disappears on its own. The prognosis may be unfavorable if degenerative, oncological and other irreversible processes occur in the ear. In this case, the symptom can almost never be eliminated. You will have to put up with it and live with it your whole life.