Tinnitus Assessment and Treatment in Sydney

Tinnitus is the perception of noise in one or both ears when no external sound is present. Commonly described as ringing, buzzing, hissing, humming or clicking, tinnitus affects approximately 17 to 20 percent of Australians. While not a disease itself, tinnitus is a symptom that can indicate an underlying condition requiring investigation.

Symptoms

Tinnitus varies widely between individuals. Common descriptions include:

High-pitched ringing or whistling
Low-pitched buzzing or humming
Hissing, static or rushing sounds
Clicking or pulsing sounds
Sound in one ear, both ears, or perceived centrally in the head
Intermittent or continuous noise
Difficulty sleeping or concentrating
Anxiety or emotional distress related to the sound

Pulsatile tinnitus, a rhythmic sound that beats in time with your heartbeat, is a distinct subtype that can indicate a vascular abnormality and always warrants specialist investigation.

Causes

Tinnitus is most commonly associated with:

Hearing loss: the most common association, particularly age-related or noise-induced hearing loss
Noise exposure: prolonged or sudden exposure to loud sound
Ear infections: middle or inner ear infections
Earwax impaction: blocking the ear canal
Otosclerosis: abnormal bone growth in the middle ear
Meniere's disease: inner ear disorder with tinnitus, hearing loss and vertigo
Medications: certain antibiotics, anti-inflammatories and chemotherapy drugs
TMJ (jaw joint) disorders
Head or neck injuries
Stress and fatigue: can worsen existing tinnitus

Diagnosis

A thorough assessment at Central Sydney ENT includes:

ENT examination: Inspection of the ear canals and eardrums, assessment of the nose and throat, and cranial nerve examination.

Audiometry: A comprehensive hearing test to identify any hearing loss that may be associated with or contributing to the tinnitus.

Tinnitus assessment: Characterisation of the pitch, loudness and pattern of the tinnitus, and evaluation of its impact on daily functioning.

Imaging: MRI of the internal auditory canals may be recommended to exclude conditions such as acoustic neuroma (vestibular schwannoma), particularly when tinnitus is one-sided or associated with asymmetric hearing loss. CT angiography may be indicated for pulsatile tinnitus.

Our otologist Dr Philip Yeung has particular expertise in tinnitus investigation and management.

Treatment Options

Treating the Underlying Cause

When tinnitus has a specific treatable cause, such as earwax removal, treating an ear infection, correcting otosclerosis with surgery, or changing a medication, addressing that cause often reduces or eliminates the tinnitus.

Hearing Aids

For patients with both hearing loss and tinnitus, hearing aids amplify environmental sounds that can partially mask the tinnitus. Many modern hearing aids include built-in tinnitus masking programs that generate soothing background sounds.

Sound Therapy

Using external sounds, white noise, nature sounds, or specially designed tinnitus sound tracks, to reduce the contrast between the tinnitus and surrounding silence, particularly helpful at night.

Tinnitus Retraining Therapy (TRT)

A structured program combining sound therapy with counselling to help the brain habituate to tinnitus and reduce its perceived loudness and emotional impact over time.

Cognitive Behavioural Therapy (CBT)

CBT helps change the emotional and behavioural response to tinnitus, reducing distress, improving sleep and enhancing coping strategies. It is one of the most evidence-supported treatments for bothersome tinnitus.

When to See an ENT Specialist

Tinnitus in one ear only (unilateral tinnitus requires investigation)
Pulsatile tinnitus (beating or whooshing sound)
Tinnitus associated with hearing loss, dizziness or ear pain
Sudden onset tinnitus
Tinnitus significantly affecting your sleep, concentration or emotional wellbeing

Related Conditions

Hearing Loss: the most common association with tinnitus
Otosclerosis: can cause tinnitus alongside progressive hearing loss
Ear Infections: inflammation may trigger or worsen tinnitus
Cholesteatoma: middle ear disease that can present with tinnitus

Common Questions

Tinnitus FAQ

What causes tinnitus?+

Tinnitus has many possible causes. The most common is hearing loss, particularly age-related or noise-induced. Other causes include ear infections, earwax blockage, Meniere's disease, otosclerosis, head or neck injuries, certain medications, TMJ disorders, and stress. In rare cases, pulsatile tinnitus can indicate a vascular condition requiring investigation.

Is tinnitus a sign of something serious?+

In most cases tinnitus is not dangerous, but it should always be assessed by an ENT specialist to rule out treatable causes. Tinnitus that is one-sided, pulsatile (beating in time with your heartbeat), sudden onset, or associated with hearing loss, dizziness or facial weakness warrants prompt investigation.

Can tinnitus be cured?+

There is currently no universal cure for tinnitus, but effective management options exist. When tinnitus has a treatable underlying cause such as earwax, infection or otosclerosis, treating the cause often resolves the tinnitus. For chronic tinnitus, hearing aids, sound therapy, tinnitus retraining therapy and cognitive behavioural therapy can significantly reduce its impact.

Should I see an ENT specialist or audiologist for tinnitus?+

Both. An ENT specialist assesses and treats medical and surgical causes of tinnitus, while an audiologist provides hearing assessment, hearing aid fitting and tinnitus management strategies. At Central Sydney ENT, our ENT surgeons and audiologists work together to provide comprehensive tinnitus care.

Does tinnitus get worse over time?+

Not necessarily. Many people find their tinnitus stays stable or even improves with appropriate management. Factors that can worsen tinnitus include further hearing loss, stress, fatigue, caffeine, alcohol, and exposure to loud noise. Protecting your hearing and managing stress are important for tinnitus control.