Question: I have worked in a factory where there has been considerable noise for more than 31 years, and I have tinnitus. I started wearing ear plugs — too late — but I know they will help prevent further damage so I wear them every day. The ringing is present, but it isn't debilitating. Is there any help that will reduce the ringing in my ears?

Dr. Hibberd's Answer:

Persistent tinnitus or ringing or buzzing in your ear(s) is important to have evaluated. Occupational noise exposure in the workplace may be one factor, yet other conditions should also be considered. Continue to wear ear protection, since the damage from noise exposure is often not reversible and the damage tends to be cumulative.

I recommend you have a standard workup for tinnitus. It would be routine to examine you for any evidence of underlying disease, especially external ear canal or middle or inner ear disease that may be compounding your problems. A hearing evaluation with air and bone conduction will help determine the route of investigation at a low cost.

Tinnitis may also be seen with acoustic neuroma (a tumor of the canal the auditory nerve travels in from the brainstem to the ear) as well as with numerous medical disorders, such as aneurysms, stenotic disease, and vascular disorders of the vessels in the neck. A skilled physician should be able to manage this work-up without immediately referring you to specialty care with an ENT or neurosurgeon until the diagnosis is confirmed.