Tinnitus is a condition where you hear sounds coming from internal sources as well as the external environment. If you have tinnitus, you may hear noises even when there are no perceptible sounds around you.
It’s possible to experience tinnitus in one or both ears, depending on the causes. Here, we look at causes that can lead to tinnitus developing in one ear — also known as unilateral tinnitus. There are various causes of unilateral tinnitus, some are as common as a build-up of earwax, but others may be less obvious. Certain causes may require medical attention and management.1
Earwax protects the ear by trapping bacteria and dirt in the ear canal before they can reach the eardrum. However, too much earwax can block the ear canal, prevent normal hearing, disturb the eardrum, and cause unilateral tinnitus.
If you suspect you have unilateral hearing loss or tinnitus due to earwax, we recommend booking an appointment with an audiologist to confirm the cause. In selected stores, you can also take advantage of our earwax removal service without having to see a GP.
In Ménière’s disease, fluid pressure builds up in the inner ear, which can distort hair-cells, causing unilateral tinnitus that is usually low-pitched. Other symptoms of Ménière’s disease include dizziness and hearing loss.
Chronic middle ear infections (also known as chronic otitis media) can also cause unilateral tinnitus, especially among young children.
Common symptoms of otitis media may include:
- Ear pain
- Poor appetite or feeding
- Disturbed sleep
Rarer consequences that require medical assistance, other than tinnitus, include:
- Hearing loss
- Dysfunctions of balance
Cancer can have many symptoms, such as headaches, nausea and vomiting, and weight loss. If cancerous cells distort auditory nerves or the ear, it can result in unilateral tinnitus.
Cancer that occurs in the ear, the nose, the throat, or the brain can cause unilateral tinnitus. If you think you may be experiencing symptoms of unilateral tinnitus, it's best to visit your GP to check for any underlying causes. There are many treatments available, and your doctor will be able to advise you on the best one for you.
You may also notice symptoms of unilateral tinnitus if you’re currenty undergoing treatment for cancer or taking medication for cancer. If this is the case, it is advisable to speak to your consultant.
Injuries to the middle ear, either physical or acoustic, can lead to eardrum rupture.2 A ruptured eardrum can cause pain, hearing loss, fluid drainage, and unilateral tinnitus.
Infections can sometimes cause eardrum rupture, especially in children. Small eardrum perforation can usually heal on its own, but larger eardrum perforation may require surgery to repair it.
Multiple sclerosis (MS) is a neurological disorder where the immune system attacks the protective sheath (myelin) of nerve fibres, causing communication problems inside and outside of the brain.
Common neurological symptoms of MS include muscle weakness and numbness of the extremities, vision problems, coordination problems, and fatigue. Unilateral tinnitus can also occur in MS3. There are many treatments, such as anti-inflammatory steroids, that can slow down the progression of neurological symptoms of MS.
Cholesteatoma is a benign growth of skin cells behind the eardrum, often triggered by ear infections, which can cause hearing loss and tinnitus in the affected ear. If left untreated, the cholesteatoma can erode the middle ear bones, causing loss of hearing.
Cholesteatoma’s can be treated by Ear Nose and Throat doctors, who perform a procedure to remove the growth.
What should I do if I have tinnitus in one ear?
If you think tinnitus may be developing in one ear, you should speak to your GP in the first instance. When tinnitus is apparent in one ear only, further testing such as head imaging with MRI or CT scan may be required to identify the cause of unilateral tinnitus.
1. Wu V, Cooke B, Eitutis S, Simpson MTW, Beyea JA. Approach to tinnitus management. Can Fam Physician. 2018;64(7):491-495.
2. Adegbiji WA, Olajide GT, Olubi O, et al. Characteristics and Management of Childhood Tinnitus in a Developing Country. The International Tinnitus Journal. 2018;22(1):66-71.
3. Sagiv D, Migirov L, Glikson E, et al. Traumatic Perforation of the Tympanic Membrane: A Review of 80 Cases. J Emerg Med. 2018;54(2):186-190. doi:10.1016/j.jemermed.2017.09.018
4. Ralli M, Stadio AD, Visconti IC, et al. Otolaryngologic Symptoms in Multiple Sclerosis: A Review. The International Tinnitus Journal. 2018;22(2):160-169. doi:10.5935/0946-5448.20180027