Tinnitus

Tinnitus is the perception of sound — often described as ringing, buzzing, hissing, or whooshing — that occurs in the absence of any external source. It affects around 1 in 7 adults in the UK and can range from a minor nuisance to a severely distressing condition that interferes with sleep, concentration, and quality of life.

While there is no single cure, an accurate diagnosis and tailored management plan can significantly reduce its impact.

Tinnitus is a symptom, not a disease — and its causes can vary widely. It often arises from changes in the auditory system or brain’s interpretation of sound signals.

The sound may be:

• Constant or intermittent
• In one ear or both
• High- or low-pitched
• Pulsatile (in rhythm with the heartbeat)
• Associated with hearing loss, dizziness, or ear fullness

Pulsatile tinnitus is a distinct subtype in which patients hear a rhythmic sound that matches the heartbeat. This may indicate a vascular cause, such as:

• A prominent or dehiscent sigmoid sinus
• Turbulent blood flow in nearby vessels
• Arteriovenous malformations or glomus tumours

In these cases, tinnitus may be treatable. Mr Patel offers advanced diagnostic workup, including MRI/MRA and temporal bone imaging when needed, and for selected patients, surgical intervention such as sigmoid sinus resurfacing to reduce the sound transmission from the vessel to the inner ear.

Tinnitus may be linked to:

• Hearing loss (the most common cause)
• Noise exposure (e.g. loud music, industrial work)
• Ear wax impaction
• Middle ear conditions (e.g. glue ear, otosclerosis)
• Inner ear conditions (e.g. Ménière’s disease)
• Temporomandibular joint dysfunction (TMJ)
• Neck or jaw tension
• Stress or sleep disturbance
• Rarely, more serious causes such as vascular tumours or nerve disorders

Mr Patel offers a structured assessment to identify any underlying cause and tailor treatment accordingly. This includes:

• Microscopic ear examination
• Hearing tests (audiometry)
• Tympanometry to check for middle ear pressure problems
• Imaging tests. Such as MRI for single sided tinnitus or CT scan for pulsatile tinnitus
• Discussion of lifestyle and stress factors, which may worsen symptoms

Tinnitus is often most troubling when it occurs in silence, which is why understanding its context — both auditory and emotional — is key.

While there is no universal cure for tinnitus, the right approach can reduce its severity, improve coping, and often help patients stop noticing it altogether.

Mr Patel’s management may include:

• Treatment of reversible causes, such as ear wax, glue ear, or infection
• Hearing aids to improve sound input and reduce brain-driven “filling in”
• Sound therapy, including white noise or personalised masking devices
• Tinnitus retraining therapy (TRT) or cognitive behavioural therapy (CBT)
• Relaxation strategies for sleep and stress