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Dr. Andrew Rynne

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What causes loud ringing sensation in the ears?

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Dr. Sumit Bhatti

ENT Specialist

Practicing since :1991

Answered : 2564 Questions

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Posted on Tue, 14 Mar 2017 in Ear, Nose and Throat Problems
Question: I have sudden loud ringing in one ear, with some hearing loss in that ear, this has happened once or twice before and it goes away. What are the probable causes and should I have it checked?
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Answered by Dr. Sumit Bhatti 2 hours later
Brief Answer:
Yes, you should get this checked.

Detailed Answer:
Hi,

Thank you for your query.

1. The first thing to do is to get the ears examined to rule out ear wax build-up.

2. If there is no ear-wax, get a PTA (Pure Tone Audiogram) to document any hearing loss. It is important to differentiate between Conductive Hearing Loss (CHL) and SensoriNeural Hearing Loss (SNHL).

3. Get a Tympanogram (Impedance Audiogram) done to check middle ear pressures and Eustachian Tube function.

4. An important cause to rule out is Endolymphatic Hydrops or Meniere's disease. Meniere's Disease is diagnosed on the following criteria:
a. Vertigo
b. Fluctuating hearing loss
c. Tinnitus
d. Fullness in the ear
There is usually nausea and vomiting, the hearing usually worsens during an attack and the tinnitus also worsens. Meniere's disease usually causes low frequency hearing loss initially (Audiogram sloping to left). Early Meniere's Disease may not have all these symptoms.

5. Autoimmune disorder work-up must be done. Autoimmune Inner Ear Disease (AIED) and Viral infections can also cause such symptoms. If this happens again, anti-virals and steroids can help.

6. An HRCT (High Resolution CT) Scan of the Temporal Bones should be done to rule out rarer causes. Vascular causes can be ruled out with an MR Angiogram.

7. If this happens after exposure to loud noise, it is known as a Temporary Threshold Shift (TTS).

8. Upload your examination and test results for further treatment advice.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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