Sounds perceived in the ear are medically defined as “tinnitus” and are often experienced as ringing, buzzing, humming, or a pulsating noise. This condition is generally a sign of disorders related to the auditory system and may be associated with various underlying conditions.
Inner ear disorders are among the most common causes of tinnitus. Conditions such as Ménière’s disease, tumors affecting the auditory nerve (acoustic neuroma), or sudden hearing loss can lead to these symptoms. As hearing loss progresses, the intensity of the ringing may also increase.
Circulatory system disorders, especially hypertension and atherosclerosis, can cause pulse-like sounds in the ear. These sounds are typically synchronized with the heartbeat and may indicate vascular (pulsatile) tinnitus, requiring cardiovascular evaluation.
Neck muscle tension, temporomandibular joint (TMJ) disorders, and stress-related muscle strain can also contribute to tinnitus. These conditions may affect the auditory system through mechanical or neurological pathways, leading to temporary or permanent symptoms.
What Do Sounds in the Ear Mean?
Sounds in the ear are most commonly associated with the medical term “tinnitus.” Tinnitus refers to the perception of sound without an external source. It is not considered a disease on its own but rather a symptom of an underlying condition. Individuals may describe these sounds in various ways, such as ringing, buzzing, humming, hissing, or a pulsating noise. The duration, intensity, and whether the sound is present in one or both ears can provide clues about its possible causes.
Problems Related to Earwax
Earwax buildup and hardening in the ear canal is one of the most common causes of tinnitus. Normally, earwax is a protective secretion that is naturally expelled from the ear. However, in some individuals, this process may not function effectively. Accumulated earwax can block the ear canal, leading to reduced hearing and a sensation of ringing. This condition is usually temporary, but ear cleaning should be performed by a professional.
Middle Ear Infections
Middle ear infections, although more common in children, can also cause tinnitus in adults. During an infection, fluid may accumulate in the middle ear. This fluid can restrict the movement of the eardrum, leading to sensations perceived as pressure, humming, or ringing. Symptoms such as pain, a feeling of fullness, and reduced hearing may accompany the condition. In such cases, evaluation and management are usually carried out by an ear, nose, and throat specialist.
Causes Related to the Inner Ear and Auditory Nerve
Sounds in the ear can sometimes originate from the inner ear structures or the auditory nerve. Age-related hearing loss is one of the leading causes. Over time, the delicate cells in the inner ear may lose their function, leading to changes in how sound is processed in the brain. This may be experienced as ringing or a continuous humming sound. Similarly, individuals with a history of exposure to loud noise may also develop tinnitus due to inner ear damage.
Conditions Related to the Circulatory System
Some individuals describe the sound in the ear as a heartbeat-like noise. This condition is known as “pulsatile tinnitus” and is often related to vascular structures. High blood pressure, narrowing of the neck vessels, or certain vascular anomalies can affect blood flow in areas close to the ear. This blood flow may be perceived as sound. When the sound is rhythmic and felt in one ear, circulatory system-related causes should be considered, and further evaluation may be necessary.
Temporomandibular Joint Problems
The jaw joint is anatomically very close to the ear. Therefore, temporomandibular joint disorders can also cause sounds in the ear. Clicking sounds from the joint during teeth clenching, grinding, or jaw movements may be mistaken for tinnitus. In such cases, the increase or decrease of the sound with jaw movement can be an important clue. Evaluation often requires a multidisciplinary approach.
Stress and Psychological Factors
Conditions such as intense stress, anxiety, and insomnia can increase awareness of tinnitus. In some individuals, tinnitus symptoms become more noticeable during periods of stress. This is thought to be related to the effects on the nervous system. Even if the sound itself is not new, increased focus on it and a higher level of discomfort may occur. Therefore, psychological factors are also considered as part of the evaluation process.
Medication Use and Side Effects
Some medications are known to have side effects that affect the ear. Certain painkillers, antibiotics, or diuretics, especially when used for long periods or at high doses, may contribute to tinnitus. In such cases, it is important to carefully review the patient’s medication history. Rather than discontinuing medication independently, medical evaluation is recommended.
When Is Specialist Evaluation Necessary?
Sounds in the ear may be short-term and temporary. However, if the sound becomes persistent, is concentrated in one ear, or is accompanied by hearing loss, dizziness, or balance problems, specialist evaluation becomes important. Additionally, if the sound is perceived as a heartbeat, investigating the underlying cause may be necessary. Since each individual’s condition is different, evaluation and management are planned on a case-by-case basis.
Prof. Dr. Özgür Kılıçkesmez is one of Türkiye’s leading interventional radiology and neuroradiology specialists, focusing on minimally invasive endovascular treatments. His primary areas of expertise include aneurysm and stroke treatments, embolization procedures, non-surgical treatments of thyroid and parathyroid diseases, interventional oncology, and peripheral vascular interventions. He currently serves as the Head of the Interventional Radiology and Neuroradiology Department at Istanbul Memorial Göztepe Hospital.
Graduating from Istanbul University Cerrahpaşa Faculty of Medicine in 1997, Prof. Dr. Kılıçkesmez received advanced training in interventional radiology and oncology as a Clinical Fellow at London Guy’s & St Thomas’ and King’s College Hospital between 2012 and 2013. He earned the title of Professor in 2020 and, in the same year, became the Founding Interventional Radiologist at SBÜ Çam and Sakura City Hospital. He also holds the EBIR (European Board of Interventional Radiology) certification.
Prof. Dr. Kılıçkesmez has 94 international and 40 national publications and over 2500 citations. He serves as a reviewer for prestigious journals such as the American Journal of Roentgenology (AJR) and Diagnostic & Interventional Radiology. With his clinical and academic expertise, he is a nationally and internationally recognized authority in stroke treatment, brain aneurysm, embolization, tumor ablation, and minimally invasive treatments of thyroid/parathyroid diseases.
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