Seek urgent medical care today if it started with:

• Sudden hearing loss, especially in one ear
• New facial weakness, numbness, severe vertigo, trouble walking, severe headache, or other neurologic symptoms
• A sound that matches your heartbeat, described as whooshing or pulsating
• Tinnitus after a head injury

What to do

• Arrange a primary-care or audiology assessment if it persists beyond a few weeks, is one-sided, accompanies reduced hearing, or is distressing.
• Avoid loud noise and use hearing protection for concerts, machinery, etc. Avoid total silence at bedtime: a fan, quiet music, or white-noise app may make it less noticeable.
• Check whether it followed a medication change, ear symptoms, or loud noise exposure. Do not stop prescribed medicines without speaking to the prescriber.
• If it is affecting sleep, mood, or concentration, cognitive behavioral therapy (CBT) has the best evidence for reducing tinnitus-related distress. Hearing aids may help when hearing loss is present. Current treatment guidance also supports counseling and sound-based strategies.

• Sudden or worsening hearing loss
• Ringing/whooshing exactly in time with your heartbeat
• Severe dizziness, facial weakness/numbness, new severe headache, or balance problems
• Ear discharge, severe pain, or symptoms after head injury

• whether it is sensorineural or conductive hearing loss
• whether both ears are similar or one ear is worse
• whether earwax, Eustachian-tube problems, noise exposure, medicines, or another cause needs treatment

1. Noise-related inner-ear damage
   Loud music/headphones, machinery, traffic, or past firecracker/concert exposure can affect high-frequency hearing and produce ringing.
2. Age-related hearing change
   Mild high-frequency sensorineural hearing loss can start gradually and cause tinnitus.
3. Wax, middle-ear pressure, or Eustachian-tube dysfunction
   These can cause a blocked-ear feeling and usually need examination or tympanometry to identify. No discharge does not completely rule them out.
4. Medication effects
   Some medicines can worsen tinnitus, including high doses of aspirin-type pain medicines, certain antibiotics, water tablets, and some chemotherapy drugs. The ENT should review the exact medicines you took.
5. Stress, anxiety, poor sleep, caffeine, nicotine, or jaw clenching/tooth grinding
   These often worsen tinnitus even when they are not the original cause.
6. Less commonly: Ménière disease, migraine-related ear symptoms, or a nerve-related condition. These are more relevant if there is vertigo, ear fullness, fluctuating hearing, or clear one-sided/asymmetric hearing loss.

• Inner-ear disorder, including Ménière-type disease, particularly if vertigo comes in distinct spinning attacks and you have ear fullness or fluctuating hearing. This combination can occur in Ménière disease, but it cannot be diagnosed from these symptoms alone. ENT Health describes the typical pattern.
• TMJ disorder: clicking often indicates TMJ dysfunction. Jaw clenching, tooth grinding, or bite problems can worsen tinnitus and cause ear fullness or discomfort. It can sometimes be associated with imbalance, but should not be assumed to be the only cause of true vertigo.
• Other vestibular causes, such as positional vertigo, vestibular migraine, or less commonly an ear or nerve-related condition.

• New weakness/numbness of face or body, trouble speaking, double vision, severe new headache, fainting, or inability to walk
• Sudden major hearing loss
• Continuous severe vertigo with repeated vomiting or rapidly worsening symptoms

• Do not self-start more medication.
• Avoid driving, heights, or machinery during vertigo.
• Avoid loud sound exposure.
• For jaw clicking: choose soft foods briefly, avoid gum, wide yawning, and clenching. A dentist or oral and maxillofacial/TMJ specialist can assess this after ENT review.