Should I Get an MRI for Tinnitus?

Tinnitus causes you to hear sounds in your ears that are not coming from an external source. This can be distressing. If you’re asking yourself, “should I get an MRI if I have tinnitus?”, the answer depends on your symptoms.

Here, we’ll explore when magnetic resonance imaging is recommended for tinnitus and what it can reveal, plus other diagnostic tests for tinnitus.

What is tinnitus?

Tinnitus occurs when you hear noise generated by your hearing system, which doesn’t exist in your environment. Sounds can include buzzing, grinding, hissing, humming, pulsing, ringing, singing, whistling and music.

These sounds can be distracting and cause stress, depression and anxiety. They can affect your perception and quality of life by disturbing your sleep and concentration.

Tinnitus is not the same as being excessively sensitive to external sounds (hyperacusis).

What causes tinnitus?

The exact cause of tinnitus is unclear, but it is linked to several conditions, including:

age-related hearing loss
earwax build-up
middle ear infections or bone growths (eg structural abnormalities of the temporal bone)
Ménière’s disease
damage to your inner ear by persistent exposure to loud noises or sudden exposure to a very loud noise

Brain tumours, head injuries and certain medications can also lead to tinnitus.

Types of tinnitus

Tinnitus can be categorised in several ways.

Unilateral tinnitus affects only one ear, while bilateral tinnitus affects both ears. Asymmetrical tinnitus is louder in one ear than the other. Pulsatile tinnitus causes sounds that are synchronised with your heartbeat.

The most common type is subjective tinnitus ie tinnitus that can only be heard by the person experiencing it.

When an MRI is recommended for tinnitus

If you experience tinnitus, your doctor may recommend an MRI scan if your tinnitus:

is pulsatile
occurs only in one ear (unilateral) or more in one ear (asymmetrical)
occurs alongside hearing loss
occurs alongside other symptoms eg balance problems, dizziness, migraines or headaches

This can help them uncover an underlying cause to determine the best management and treatment of your tinnitus.

How an MRI can help identify underlying issues

An MRI machine uses a strong magnetic field and radio waves to produce images of the inside of your body, including hard and soft tissues. It’s safe and painless.

An MRI scan of your internal auditory meatus can check the health of your brain tissue, nerves, bones and blood vessels to identify potential causes of your tinnitus, such as:

a tumour eg vestibular schwannoma
bone deformities in your middle ear
nerve damage
problems with the blood vessels supplying your ear

If blood vessel problems are suspected, your doctor may recommend a special type of MRI called magnetic resonance angiography.

Other diagnostic tests for tinnitus

There’s no single definitive way to get a diagnosis of tinnitus. Instead, your doctor will recommend several tests based on your symptoms. This may include:

physical examination of the inside of your ear
a hearing assessment
tympanometry to test the bones in your middle ear and eardrum
CT scan or ultrasound scan, depending on medical issues or structural disorders in the ear

Depending on these results, your doctor may recommend blood tests to check for conditions that can contribute to tinnitus eg anaemia, diabetes and thyroid problems.

They may also ask you to complete a tinnitus questionnaire to assess the impact on your life.