Having an ear ringing: this is an experience that we have all done at least once. Ringing in the ears is indeed a fairly common disorder, which can occur transiently continuously. Usually benign, they can have multiple causes.
Whistling ear, how to recognize it
What is it?
It is a stray noise that the person hears when there is usually no real hearing source. This whistling sound can be heard in one or both ears, occasionally, intermittently, or continuously.
To qualify these extraneous noises that can take different forms besides whistling – buzzing, hammering, clicking … – we use the generic term tinnitus. A distinction is made between objective tinnitus, which is very rare, and linked to real and measurable noise, and subjective tinnitus, which is much more frequent.
Some people with ringing in the ear also suffer from hyperacusis, which is an intolerance to loud noises, or have a strong perception of sounds normally perceived as weak.
Some people are more prone to developing ringing ears:
- the elderly, due to the physiological deterioration of hearing mechanisms with age;
- men, more affected than women by this type of symptom;
- people exposed to noise by their profession in particular.
Stress is not a risk factor, but it can increase the perception of this whistling sound and therefore aggravate its impact on quality of life.
Causes of ringing ears
There are multiple causes that can cause these temporary or continuous ringing ears.
Exposure to a very loud sound source
After exposure to loud noise (concert, night in a disco, etc.), it happens to perceive ringing in the ears. Exposure to too loud noise (2 hours in a sound environment reaching 91 dB or 15 minutes at 100 dB) leads to auditory fatigue resulting in a slight decrease in hearing, a feeling of a blocked ear, whistling or buzzing. All of them will usually be transient, while the ear cells recover.
Following a violent sound or shock
Exposure to a violent sound or shock can lead to irreversible damage to the inner ear, with or without perforation of the eardrum. Bleeding from the ear may then occur, accompanied by wheezing and sometimes dizziness. This type of hearing trauma is an emergency and requires consulting a specialist without delay.
An earwax plug
Sometimes earwax accumulates in the ear canal and creates a plug that can cause whistling, ringing in the ears, the feeling of a blocked ear, transient hearing loss, itching, or even pain in the ear.
The formation of an earwax plug is favored by inappropriate and repeated cleaning of the ears with cotton swabs, swimming, frequent use of earplugs, and wearing hearing aids, but also certain anatomical features (high production of earwax, strong hair in the external ear canal that prevents earwax from evacuating properly, small diameter ear canal).
High blood pressure
High blood pressure is characterized by abnormally high blood pressure (greater than or equal to 140/90) on the wall of the arteries, even at rest or in the absence of stress.
Ringing and ringing in the ears are symptoms of high blood pressure, along with headaches, dizziness, palpitations, nosebleeds, numbness, or tingling in the hands or feet. The high blood pressure makes the blood flow more audible, hence this so-called pulsatil tinnitus. Other pathologies affecting the blood vessels can also be at the origin of this pulsatile tinnitus: atherosclerosis, abnormality of the capillaries, carotid, or jugular.
Age-related hearing loss
Wheezing and other tinnitus can be the precursor of hearing loss, especially in the elderly. We are talking about presbycusis.
An abnormality of the inner ear
A vascular malformation, abnormal muscle contractions, a lesion of the cochlea (part of the inner ear where the organ receiving hearing, the organ of Corti) is located) can be the cause of whistling sounds that will be objective, that is to say, real and measurable.
Taking certain medications
Some long-term medications are ototoxic: they are potentially toxic to the ears. They can damage the cells of the inner ear and cause, among other inconveniences, wheezing.
Some are definitively proven ototoxicants: they are mainly antibiotics, diuretics, salicylates (aspirin and related drugs), drugs ordered against malaria, and anticancer drugs. Others are potentially ototoxic especially after prolonged use or at high doses; this is the case of Ibuprofen (Advil, Nurofen), quinine, and some anti-depressants such as imipramine (Tofranil).
This disease, whose cause remains unknown to date, manifests itself in the form of attacks combining different symptoms: whistling or ringing in the ears, intense and sudden vertigo, partial hearing loss, dizziness, loss of balance, and rapid eye movements.
Many other causes can cause ear ringing: otitis media, otosclerosis, head trauma, torticollis, obstruction of the ear canal, etc.
Sometimes no cause is found.
Risks and complications of whistling ear
Complications associated with the cause of ringing in the ear
A plug of earwax can cause a transient decrease in hearing.
Hypertension is an important risk factor for cardiovascular diseases, kidney failure, and retinal damage.
If it is a problem with the inner ear, the complication to fear is hearing loss. Ditto following a shock or exposure to a very violent sound, which can permanently alter hearing.
Impaired quality of life
Tinnitus in itself is not dangerous, but when intense and continuous, it can become very disabling on a daily basis and have a real impact on quality of life. In addition to causing insomnia, irritability, and trouble concentrating, they are sometimes associated with depression.
Treatment and prevention of ringing ear
Treatment for the ringing ear will be that of the underlying disease or problem if identified.
The earwax plug can be removed by the ENT doctor in the office. To prevent it, it is advisable to avoid using cotton swabs. A simple cleaning of the external duct, with water or with a cotton pad, is enough.
To prevent ringing from too much noise, it is advisable to wear earplugs and stay away from speakers during concerts. After exposure to an intense sound source, it is recommended to rest in silence to let your ears recover.
Following an auditory trauma, an emergency consultation is required (within 48 hours maximum). Oral or intravenous drug therapy should be initiated promptly to give the best chance of hearing recovery and limit tinnitus.
Hypertension will be treated with hypertensives.
Some inner ear abnormalities can be treated surgically.
In case of the persistent ringing of the ears whose cause remains unknown or impossible to treat, different techniques exist:
- the white sound generator: this device diffuses, in the affected ear, a white sound at low volume, to hide the whistling;
- wearing a hearing aid;
- Cognitive behavioral therapy does not completely remove tinnitus, but it does improve the way the patient perceives and copes with it, with significant improvement in depression scores and quality of life, according to a meta-analysis.
- Acoustic Habituation Therapy (TAH) or Tinnitus Retraining Therapy (TRT) consists in reprogramming your brain so that it selectively filters sounds, using different tools such as relaxation and attention diversion techniques, etc.
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