Musical Tinnitus
December 15, 2020
Musical Tinnitus

Musical tinnitus can also be called musical ear syndrome, musical hallucinations, or auditory imagery. Although it has many names, the condition is rare. While sometimes people hear music without an outside source due to mental illness, most patients get musical tinnitus after having had hearing loss for some time. Because the brain doesn’t get any signals from the ears, it invents sound to compensate. Some musical tinnitus patients have neither mental illness nor hearing loss but, for some reason, have become overly sensitive to all sound and start to hear music. 

What are the causes of musical tinnitus or musical ear syndrome?

While the mechanics behind MES are not very well understood, medical researchers have identified some causes. 

Hearing loss

Hearing music that isn't there is likely due to hearing loss. Although how it works isn’t known, experts think phantom sounds are caused by hypersensitivity in the brain's auditory center caused by sensory deprivation. Normally, the brain receives information from the senses to help you understand and interact with the world.  The brain doesn't understand why signals stop when hearing is damaged. It doesn't know how to ignore this sense and continues to seek input. When it can't find anything, the brain fills in information it knows from the world. You think you hear sounds when there is none because, in the case of MES or musical tinnitus, the brain chooses to fill in blanks with music. Why music rather than other sounds?  That hasn’t been explained.

Cochlear implant

Cochlear implantation or removal has been known to triggered MES. More studies are needed to discover why this can happen.

What do People Hear?

Since your brain fills in the blanks with what it knows, your own musical experience will likely dictate what you hear.  You could hear simple tones that create a melody or full orchestral compositions. Some people hear popular music or tunes they have heard on the radio. The perception of music or singing can be the same tune repeatedly or different music at different times.

How is musical tinnitus treated?

If you hear music without an outside source, consult your doctor for a diagnosis.  Treatment for musical ear syndrome should be designed on a case-by-case basis.

Hearing aids

Man wearing Audien Hearing Aids

Improving your hearing may ease symptoms. If a hearing aid helps you hear more, your brain may stop filling in the blanks with music. Sound therapy through hearing aids may also be helpful.

Cognitive-behavioral therapy

Cognitive-behavioral therapy (CBT) can help you deal with the music in your ears. You can train your brain to pay less attention.

Lifestyle changes

You can make small changes in your daily life to help reduce the effects of MES. If you can hear anything, with or without hearing aids, try adding other sounds. While it seems counterintuitive, listening to actual music sometimes discourages your brain from creating phantom music.

Other strategies that can help you deal with the stress of musical tinnitus:

  • Exercise- Anything you enjoy, including walking, stretching, aerobics, yoga, tai chi
  • Deep Breathing
  • Meditation and Mindfulness
  • Massage Therapy
  • Aroma Therapy

Sound Therapy

Infographic of benefits of sound therapy

As with other forms of tinnitus, musical ear syndrome is treated very effectively with sound therapy. By using advanced programs on your hearing aid or a tabletop sound machine, these programs will play sound s that can cause your musical hallucinations to fade into the background


Image of ototoxic Medications

If nothing else works, your doctor may try medications that may help. The following medications have been used to treat MES: Cholinergic and GABAergic agents, haloperidol, atypical antipsychotics, selective serotonin reuptake inhibitors (SSRI's), or serotonin-norepinephrine reuptake inhibitors (SNRI.s). Discuss medication side effects with your doctor

Musical tinnitus, also known as Musical Ear Syndrome, may be the auditory equivalent of Charles Bonnet syndrome. People who lose their sight and develop Charles Bonnet can have visual hallucinations because the brain stops getting visual cues and tries to fill in the blanks.  Musical tinnitus is rare. Some people don't mind the symptoms, but there are ways to combat them for those who do.

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Drew Sutton M.D.

Drew Sutton, MD is a board-certified otolaryngologist. He has extensive experience and training in sinus and respiratory diseases, ear and skull base surgery, and pulmonary disorders. He has served as a Clinical Instructor at Grady Hospital Emory University for more than 12 years.

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