Dear Doctor: Sometimes I get a sudden hissing sound in my right ear that lasts for a few minutes and then slowly goes away. What is it, and is there anything I can do to make it stop?
Dear Reader: What you’re experiencing is known as tinnitus, which is the medical term for a perceived sound that doesn’t have an external source. Tinnitus is not a condition in and of itself, but is instead a symptom of some other underlying problem.
Exposure to noise is a major cause of tinnitus, as is hearing loss. Both can result in damage to the sensitive hair cells that line the cochlea. This is the portion of the inner ear that translates vibrations into nerve impulses, which are then sent to the brain to be interpreted as sound.
Blockage due to earwax buildup, as well as changes to the ear bones as we age, can contribute to tinnitus. Some medications, including certain antibiotics, cancer drugs, antidepressants and high doses of aspirin, are known to play a role in tinnitus.
Although the most common form of tinnitus involves a ringing in the ears, people with this condition may also hear the hissing you describe, as well as buzzing, clicking, humming, whistling or a roaring sound, like wind. In rare cases, patients with tinnitus have even reported hearing music.
Tinnitus can affect one or both ears. It ranges in volume from a low, background noise that is bearable and even forgettable, to sounds so loud and persistent that they interfere with daily life. In many cases, tinnitus is temporary. In severe cases, the phantom sounds never go away.
It is estimated that up to 45 million Americans — that’s 15 percent of the population — report having some form of tinnitus on a regular basis. Like you, the vast majority of them have subjective tinnitus, which is sound that only the patient can hear. In objective tinnitus, which affects just 1 percent of the population, the sounds a patient hears are audible to others as well. The causes of objective tinnitus are most often internal conditions related to blood flow in vessels near the ear.
Men are more prone to tinnitus than women, and it becomes increasingly common as we age. Individuals who work in loud environments, such as factories and construction sites, are at increased risk. Recent studies suggest that earbuds, which sit so close to the delicate structures of the inner ear, may also put users at higher risk.
At this time, there is no single treatment for tinnitus. An examination by an ear specialist, known as an otolaryngologist, can pinpoint whether tinnitus is due to earwax buildup, medication or, more rarely, a blood vessel condition. These are often treatable. If not, your doctor can help you explore noise suppression techniques such as using a white noise machine, or masking devices that are worn in the ears.
Meanwhile, you can take steps to lessen the impact of tinnitus. Make sure your blood pressure is under control, avoid loud noises, which can set off a tinnitus episode, and — this will improve your overall quality of life — be sure to get enough rest.
Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.