Overview
Tinnitus is the perception of ear noises without an external sound source – often described as whistling, hissing, humming or ringing. The sounds can occur on one or both sides, persist continuously or come in phases. Many people experience temporary ear noises, for example after a loud concert; these usually subside on their own. If the noises persist, medicine distinguishes between acute tinnitus (up to about three months) and chronic tinnitus (beyond that). This classification matters because it determines the next steps: in acute tinnitus, the focus is on promptly clarifying possible causes; in chronic tinnitus, primarily on managing the burden. In most cases ear noises are not dangerous, but they can significantly affect sleep, concentration and quality of life. In the video consultation, a structured initial medical assessment takes place: duration, character and accompanying symptoms are recorded, risk factors are discussed, and the next steps are agreed together – from self-help measures to a recommendation to see an ENT specialist.
Common causes
Ear noises have many possible triggers. Common ones include noise exposure (concerts, construction sites, headphones), an earwax plug, middle ear infections or impaired ventilation of the Eustachian tube during colds. Sudden hearing loss can also be accompanied by abruptly starting tinnitus and should be assessed promptly. Age-related hearing loss, temporomandibular joint dysfunction and tension in the neck and jaw muscles also play a role. Stress, psychological strain and lack of sleep usually do not cause tinnitus on their own, but they clearly intensify its perception and the burden it creates – many affected people report that the noises seem louder in quiet evening hours and under tension. Less commonly, high blood pressure, certain medications or inner ear disorders are the underlying cause. A pulse-synchronous, rhythmic ear noise can indicate a vascular cause and should be examined separately. In the consultation, these factors are systematically reviewed to narrow down the likely cause.
When to see a doctor
A medical assessment makes sense if ear noises persist for more than a few days, keep returning or affect your daily life. You should seek medical help promptly – ideally within 24 to 48 hours – in the case of sudden hearing impairment or hearing loss (suspected sudden sensorineural hearing loss), newly occurring one-sided tinnitus, a pulse-synchronous ear noise, or ear noises after an acoustic trauma or head injury. An examination is also advisable if you have accompanying dizziness, ear pain, fever or discharge from the ear. Call emergency services (112 in Germany) immediately if warning signs such as paralysis, numbness, speech or vision problems, severe spinning vertigo with vomiting, or a sudden, extremely severe headache occur together with the ear noises – these can indicate an emergency such as a stroke. For all other cases, the video consultation offers a fast initial assessment; based on the doctor's evaluation, you will receive a clear recommendation for the next steps.