A person with tinnitus may hear sounds such as ringing, roaring, buzzing, or whistling. If the sounds are present in one ear only, doctors call it unilateral tinnitus. Unilateral tinnitus may be a cause for concern and could indicate a more serious condition.
If someone hears the noises in both ears, they have bilateral tinnitus. Doctors may treat unilateral tinnitus differently than bilateral tinnitus, as the two may have different underlying causes.
This article looks at the symptoms, causes, treatment, and home management of unilateral tinnitus.
It also looks at why the condition may be a cause for concern, other causes of ringing in one ear, and when to contact a doctor.
A person with unilateral tinnitus hears noises in one ear only. The noises may be constant, or they may come and go. The pitch, quality, and volume of the noises may fluctuate.
The National Organization for Rare Disorders notes that in some people with tinnitus, the noises are most evident in an otherwise quiet environment.
Other people with tinnitus experience the noises even in loud environments, and some people find that their symptoms become worse in noisy surroundings.
The types of noises people with tinnitus report hearing include:
In most cases of tinnitus, only the person with the condition can hear the noises.
Tinnitus may make it more difficult to hear in severe cases. It can also improve or worsen over time.
However, unilateral tinnitus sometimes has more serious causes. It may indicate the presence of other, more severe conditions, which may lead to permanent hearing loss.
Causes of unilateral tinnitus include:
- cerumen impaction
- acoustic trauma, such as an explosion or very loud noise close to the ear
- chronic noise exposure, such as frequent exposure to loud machinery or construction noise at work
- cholesteatoma, an abnormal skin growth in the middle ear
- otosclerosis, a disease that affects the bones in the middle ear
- chronic otitis media, in which fluid persistently remains or returns in the ear
- tympanic membrane perforation, which is a ruptured ear drum
- Meniere disease, a disease that can cause progressive hearing loss
- semicircular canal dehiscence, which is caused by a small hole that develops in the canals of the ear
The causes of unilateral tinnitus may be more complex if a person experiences them alongside neurologic symptoms, such as vertigo and hearing loss. These causes
The treatment for unilateral tinnitus may differ among individuals.
A doctor may be able to greatly reduce or improve the symptoms by addressing their cause. This may involve treatments such as earwax removal for cerumen impaction or antibiotics for chronic otitis media.
A doctor may also treat hearing loss.
There is no cure for tinnitus, but treatment to help manage the symptoms
- Counseling and cognitive therapy: This may help a person understand their tinnitus and address any issues the condition may contribute to, such as stress, anxiety, and depression.
- Masking: A person can listen to relaxing sounds or white noise to mask the sound of tinnitus. This can reduce the symptoms and their psychological impact.
- Hearing aids: A hearing aid may help improve hearing loss and may also feature a built-in masking noise.
- Medication: Medications such as antidepressants may help improve psychological symptoms, and benzodiazepines such as alprazolam may help treat stress, which can trigger symptoms of tinnitus.
To help manage tinnitus at home, a person may benefit from:
- using relaxation techniques, such as deep breathing or yoga
- improving sleep hygiene to contribute to better quality sleep
- avoiding silence by listening to soft music or sounds to mask the tinnitus
- joining a support group
- avoiding things that may trigger or exacerbate tinnitus, such as loud noises and stress
- engaging in hobbies and activities as a distraction
There are several other potential causes of ringing in one or both ears. These include:
- a neck or head injury
- problems in the jaw
- high blood pressure
- chronic conditions such as diabetes, anemia, thyroid disorders, and lupus
- tumors in the head, neck, or brain
- Lyme disease, a disease that a person can contract after a bite from a black-legged tick
- meningitis, a condition that causes the membranes around the spinal cord and brain, called the meninges, to swell
- measles, a highly contagious disease that can cause severe complications
- rubella, a condition that may cause mild symptoms but can harm an unborn fetus if it occurs during pregnancy
- sickle cell anemia, a condition that causes red blood cells to malfunction
- hypercholesterolemia, a genetic difference that causes high cholesterol
- cytomegalovirus, a herpes virus that may cause flu-like symptoms and complications
- neurosyphilis, an advanced stage of syphilis that affects the central nervous system
A person should contact a doctor if they:
- experience new or sudden tinnitus
- experience tinnitus along with other symptoms
- develop depression, anxiety, or other conditions as a result of tinnitus
- have difficulty sleeping or have tinnitus that affects their quality of life in other ways
- have a buildup of earwax or an object in the ear that a doctor can remove
- hear sounds that are rhythmic or pulsing, which could indicate a cardiovascular problem
- discover that the noise is not subjective and others can hear it
- experience neurological symptoms, such as vertigo and hearing loss
The outlook for those with unilateral tinnitus is highly dependent on its cause.
If the cause is temporary and mild, such as a buildup of earwax, a doctor can remove the blockage, and the tinnitus may improve quickly and disappear.
If a person has chronic tinnitus, in which doctors do not know the cause, or the tinnitus does not respond to treatment of the underlying cause, it
Treatment such as cognitive therapy, relaxation techniques, masking, and hearing aids may relieve the symptoms and reduce their impact on a person’s mental health and day-to-day living.
In some cases, unilateral tinnitus may indicate a more serious underlying cause than bilateral tinnitus.
There are various potential causes of unilateral tinnitus, such as impacted earwax, exposure to loud or constant noise, and several medical conditions.
These include ear infection, ruptured ear drum, Meniere disease, and neurological conditions such as MS and stroke.
Treatment typically involves addressing the underlying cause, masking, wearing a hearing aid, and receiving counseling to cope with the tinnitus symptoms.