Tinnitus (ringing in the ears): causes, diagnosis and treatment
A ringing or buzzing in the ears can be extremely annoying and affect both physical and mental well-being. The sound can disrupt daily activities, make it difficult to be present in social situations and, in many cases, make it difficult to fall asleep. At Charlottenlund Private Hospital, we help you clarify the cause of your tinnitus, provide advice and guidance – and treat where there is a treatable cause.
Tinnitus is a sound in the ear or head without an external sound source – typically a hissing, ringing, whistling, buzzing or whistling tone that others cannot hear. Tinnitus is not a disease in itself, but most often a symptom of changes in the ear or auditory pathways. In the National Health Profile 2021, it was estimated that around 770,000 Danes – approximately one in six adults – have tinnitus, and according to the Weekly Journal for Doctors, the condition should initially be investigated by an ear, nose and throat doctor.
What symptoms does tinnitus cause?
Tinnitus is experienced very individually. Some describe the sound as a ringing or whistle in the ears, others as a hissing, buzzing, roaring or a pulsating sound. What is common is that the sound does not come from outside – it occurs in the ear or head. The sound can be in one ear or both, be constant or come and go, and it is often experienced most strongly in quiet surroundings, for example at bedtime. Fortunately, tinnitus is not always a permanent condition and can be experienced differently from day to day and week to week. Tinnitus can be accompanied by reduced hearing, sound hypersensitivity, sleep problems and difficulty concentrating.
What causes tinnitus?
Tinnitus is most often a symptom of changes in the ear, which can have several different causes – including loud noise exposure, age-related hearing loss or damage to the middle ear or inner ear. Tinnitus can also be triggered by a hole in the eardrum, eczema and inflammation of the ear canal, an earwax plug, calcification of the ear bones or diseases of the balance and auditory nerves, and certain medications can trigger or worsen tinnitus. Stress and muscle tension in the neck and jaw can intensify the experience of the sound. In many cases, there is no single explanation, and tinnitus can occur without any measurable hearing loss.
What is pulsatile tinnitus?
Pulsatile tinnitus is a rhythmic sound in the ear that follows the heartbeat – many describe it as being able to hear one's own pulse. In some cases, the sound can even be heard by others, for example by a doctor with a stethoscope; this is called objective tinnitus. In contrast to regular tinnitus, pulsatile (pulse-synchronous) tinnitus more often has a specific cause, typically in the blood vessels around the ear, and according to an article in Ugeskrift for Læger, pulse-synchronous tinnitus should always be investigated because the underlying cause can often be treated. Pulsatile tinnitus is benign in most cases, but precisely because a treatable cause can be hidden behind the symptom, you should always have it examined by an ear, nose and throat doctor.
What is pulsatile tinnitus?
Pulsatile tinnitus is a rhythmic sound in the ear that follows the heartbeat – many describe it as being able to hear one's own pulse. In some cases, the sound can even be heard by others, for example by a doctor with a stethoscope; this is called objective tinnitus. In contrast to regular tinnitus, pulsatile (pulse-synchronous) tinnitus more often has a specific cause, typically in the blood vessels around the ear, and according to an article in Ugeskrift for Læger, pulse-synchronous tinnitus should always be investigated because the underlying cause can often be treated. Pulsatile tinnitus is benign in most cases, but precisely because a treatable cause can be hidden behind the symptom, you should always have it examined by an ear, nose and throat doctor.
How is Tinnitus Investigated?
Any effective treatment for tinnitus begins with a comprehensive, systematic investigation to identify the type of tinnitus and its underlying causes.
At Charlottenlund Privathospital, every evaluation begins with an in-depth hearing test (audiometry) followed by a specialist medical examination. Your consultant will review your medical history and thoroughly examine your ear canal and eardrum using a high-definition otoscope or surgical microscope. This is paired with a middle ear pressure and function test (tympanometry).
- Pulsatile Tinnitus: If you experience tinnitus that pulses in time with your heartbeat, the doctor will use a stethoscope to listen for blood flow sounds around your ear, skull, and neck. If indicated, this is supplemented with a referral for diagnostic imaging, such as an MRI or ultrasound scan.
- Unilateral Tinnitus: If you have persistent tinnitus in only one ear, an MRI scan is often necessary. In rare cases, one-sided tinnitus can be the initial sign of a vestibular schwannoma (a benign, slow-growing tumor on the auditory nerve).
How is Tinnitus Treated?
Because tinnitus has many potential causes, treatment is highly individualized. There is no single "cure-all," and your management plan will be mapped out collaboratively between you and your ENT specialist.
- Treatable Medical Causes: If your tinnitus is caused by an underlying condition—such as a tight earwax plug, a perforated eardrum, or an infection of the ear canal—treating the primary issue will typically reduce or completely eliminate the ringing.
- Sound Amplification: For many patients with co-existing hearing loss, a modern hearing aid is the ideal solution. By amplifying natural environmental sounds, hearing aids draw your brain's attention away from the internal tinnitus.
- Therapeutic Approaches: According to clinical guidelines published in the Journal of the Danish Medical Association (Ugeskrift for Læger), key management strategies include specialized clinical counseling, sound therapy, and cognitive behavioral therapy (CBT).
For patients requiring ongoing support to manage chronic tinnitus, we have excellent success referring to public audiology and communication centers (kommunikationscentre), which provide specialized counseling and coping strategies. Ultimately, receiving clear, accurate information about what tinnitus is—and what it is not—is one of the most powerful steps in reducing the distress it causes.
Can Tinnitus Go Away?
Yes. Tinnitus can completely resolve if it is caused by a temporary or treatable condition—such as a buildup of earwax, an active ear infection, or acute noise exposure (e.g., after a loud concert), where the ringing typically fades within hours or a few days.
For chronic, long-term tinnitus, while there may not be a treatment that silences the sound entirely, the vast majority of people undergo habituation over time. This is a natural process where the brain learns to filter out the sound, making it far less noticeable. Professional treatment and counseling are designed to speed up this adaptation, helping many patients experience a significant reduction in discomfort.
When Should You Seek Medical Attention?
You should consult an ENT specialist if:
- Your tinnitus is new and does not resolve within a few weeks.
- The sound severely disrupts your sleep, concentration, or mood.
- The tinnitus is accompanied by sudden hearing loss or dizziness.
- Important: You should always have your ears evaluated if your tinnitus is pulsatile (beating like a heart) or strictly one-sided, as both require specialized diagnostic investigations.
- If tinnitus occurs suddenly alongside a significant drop in hearing, seek medical attention immediately.
Tinnitus Treatment at Charlottenlund Privathospital
Charlottenlund Privathospital has a long-standing tradition of excellence in diagnosing and supporting tinnitus patients. Founded in December 2019, our ENT department features 22 highly specialized consultants who manage approximately 10,000 patient visits annually.
- No Referral Needed: You do not need a referral from your GP to book a private consultation with us.
- Pricing: A preliminary examination with one of our ENT specialists ranges from DKK 2,400 to DKK 5,000 for self-paying patients, depending on the diagnostic testing required.
- Locations: Consultations and testing are available at our main facility in Charlottenlund or at our partner clinics nationwide.
Take control of your hearing health. Book an appointment online today or contact our clinic with any questions.
Sources:
- Danes' Health – The National Health Profile 2021. Danish National Board of Health, 2022. sst.dk
- Investigation and treatment of tinnitus. Weekly Journal for Doctors (2023). ugeskriftet.dk
- Fisker J et al. Arteriovenous fistula with objective tinnitus after birth. Ugeskrift for Læger 2011;173(4):284. ugeskriftet.dk
- DSOHH: Assessment and treatment of patients with tinnitus, clinical guidelines
Frequently Asked Questions
What is tinnitus?
Tinnitus is a sound in the ear or head without an external sound source – typically a hissing, ringing or whistling tone. Approximately one in six adult Danes has tinnitus.
Is pulsatile tinnitus dangerous?
Pulsatile tinnitus is benign in most cases, but it should always be investigated because more often than regular tinnitus, it has a specific cause that can be treated.
Can tinnitus go away on its own?
Yes, if the cause is temporary – for example, a loud noise or an earwax plug. Long-term tinnitus rarely disappears completely, but the discomfort can be significantly reduced.
What helps with tinnitus?
Counseling, sound therapy, and cognitive behavioral therapy are key treatments. In the case of concurrent hearing loss, a hearing aid can dampen the experience of sound.
Can earwax cause tinnitus?
Yes, a plug of earwax can cause tinnitus, which often disappears when the plug is removed by a doctor.
Is tinnitus caused by stress?
Stress is rarely the root cause, but stress and muscle tension can intensify the experience of tinnitus.
Is there any medicine for tinnitus?
There is no medicine that eliminates tinnitus, but medicine can in some cases treat the underlying cause.
Why can I hear my pulse in my ear?
A rhythmic sound that follows the heartbeat is called pulsatile tinnitus and is often caused by conditions in the blood vessels around the ear. It should always be examined by an ear, nose and throat doctor.
Do I need a referral to be examined?
No, not really – you can book an appointment directly. However, some health insurances require a referral or prior authorization.
How much does a tinnitus evaluation cost?
A preliminary examination by an ear, nose and throat specialist costs from DKK 2,400 to DKK 5,000 as a private payer, depending on the scope of the examination.
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