Frequently asked questions

Tinnitus (pronounced tin-NIGHtis or TIN-uh-tis) is a ringing, humming, buzzing, or other sound in your head or ears that does not have an outside source. The sound comes from within your head. For most people, tinnitus is a constant sound. Tinnitus is not a disease – it is a symptom.

Sound vibrations in the air become coded signals that the brain interprets as
sound. With tinnitus, there are no sound wave vibrations causing nerve fibers
to fire. With most forms of tinnitus, some of the nerve fibers are firing on their
own. The brain interprets these signals as sound.

Tinnitus is not a disease, it is a symptom. Most patients develop tinnitus as a symptom of hearing loss, caused either by age, long-term hearing damage, or acute trauma to the auditory system. According to the general scientific consensus, hearing loss results in less external sound stimuli reaching the brain. In response, the brain undergoes neuroplastic changes in how it processes different sound frequencies. Tinnitus may result as a product of these maladaptive neuroplastic changes.

Tinnitus is typically caused by noise-induced hearing loss. Other common causes include:
• Age-related hearing loss
• Acoustic trauma
• Ototoxic drugs
• Head injury
• Temporomandibular joint disorder

While there is currently no cure for primary tinnitus, a wide range of therapies have been used and studied in attempts to provide symptomatic relief. It is often manageable, habituated to or ignored. In most cases it becomes less noticeable over time.

Less common underlying causes of tinnitus are relayed to an underlying medical condition and the tinnitus may go away once the condition is treated. These include:

• earwax or cerumen blocking the ear canal,
• middle ear diseases such as otosclerosis or eustachian tube dysfunction
• cochlear abnormalities such as Ménière’s disease
• auditory nerve pathology such as acoustic neuroma (vestibular schwannoma)

Nonauditory system disorders that can cause tinnitus include:

• vascular anomalies, myoclonus, and intracranial hypertension.

Source: Tunkel DE, Bauer CA, Sun GH, et al. Clinical Practice Guideline: Tinnitus Executive Summary. Otolaryngology–Head and Neck Surgery. 2014;151(4):533-541. doi:10.1177/0194599814547475

Generally it’s a good idea to see a physician or other healthcare professional if you have tinnitus that persists. In most cases, the tinnitus is a symptom of hearing loss. However, in some cases it is very important to see a physician. Although not medical advice, the information below can help you decide*.
1. If you experience any of the following:
• Injury to your body
• Weakness or paralysis of any muscles in your face
• Sudden unexplained hearing loss in one or both ears
> Go to Emergency Care or to an ENT (Ear, Nose,
Throat) clinic immediately.

 2. If you experience any of the following:
• Extreme anxiety or depression
• A current plan to end your life and a way to do it
Go to Emergency Care or to a Mental Health clinic
immediately.

3. If you experience any of the following:
• The tinnitus pulses with your heartbeat
• You have ear pain, drainage from your ear, or if there is a foul odor coming from your ear
• You have vertigo (the feeling that you are moving or the room is moving
when neither is moving)
Go to an ENT (Ear, Nose, Throat) clinic or to a physician as soon as
possible.

4. If you have tinnitus, and all of the following are true:
• The tinnitus is a constant sound that does NOT pulse with your heartbeat

• You have hearing loss and the tinnitus is heard in both ears.

• You do NOT have ear pain, drainage from your ear, or foul odor coming from
your ear
• You do NOT have vertigo
• You do NOT have weakness or paralysis of any muscles in your face
• You do NOT have sudden unexplained hearing loss
See an audiologist. (An audiologist is a non-physician hearing healthcare provider.)

*adapted from the Progressive Tinnitus Management workbook developed by the U.S. Veterans Administration’s National Center for Rehabilitative Audio Research