Hearing Health Guide
Definition
Tinnitus is the perception of sound without an external audio source. It manifests as ringing, buzzing, hissing, humming, or clicking. It is a symptom, not a disease, and almost always has an underlying cause. According to the American Tinnitus Association, approximately 15% of adults in the United States experience some form of tinnitus.
Subjective tinnitus is the most common form. The sound is heard only by the person experiencing it. It is typically caused by damage to the auditory system, most often the hair cells of the inner ear.
Objective tinnitus is rare. The sound can sometimes be heard by a clinician using a stethoscope. It is usually caused by a physical source such as a blood vessel problem, muscle contractions, or a middle ear condition, and is often treatable.
The most common cause of tinnitus is noise-induced hearing loss, which damages the hair cells of the cochlea from prolonged or sudden loud noise exposure. According to NIOSH, these hair cells do not regenerate once damaged.
Other common causes include age-related hearing loss (presbycusis), earwax blockage, certain medications (especially high doses of aspirin, NSAIDs, and some antibiotics), ear or sinus infections, and head or neck injuries.
In many cases, tinnitus coexists with measurable hearing loss. Not always, but often. A significant number of people with normal audiogram results still experience tinnitus, which suggests involvement beyond the cochlea.
The audiologists I worked with would see this regularly: patients coming in for hearing aid evaluations who mentioned tinnitus almost as an afterthought - something they had been living with for years. In most of those cases, the tinnitus frequency matched the region of greatest hearing loss almost exactly. That is not a coincidence. The brain overcompensates for the missing signal, and you hear the overcompensation.
Tinnitus and hearing loss frequently occur together. When hair cells in the cochlea are damaged, the auditory cortex may increase its sensitivity to compensate, amplifying neural noise that the brain interprets as sound. This is the leading hypothesis for why tinnitus often follows hearing loss.
If you experience tinnitus, it is worth having your hearing evaluated. A significant percentage of people who notice tinnitus for the first time have underlying hearing loss they were not aware of.
Tinnitus caused by temporary exposure (a concert, a loud environment, an ear infection) often resolves on its own within hours or days. Chronic tinnitus (lasting more than three months) is less likely to fully disappear.
There is currently no cure for most forms of chronic tinnitus, but management approaches including sound therapy, cognitive behavioral therapy (CBT), and hearing aids can significantly reduce its impact on daily life.
Common Questions