All About Tinnitus, Part 1: Types & Causes

Tinnitus is known commonly as a ringing of the ears – though the sound may appear as a buzz, whistle, roar, crackling, whoosh of air, or in rare cases, music. Tinnitus is a condition in which a person hears a sound that is not caused by an external stimulus. Rather, it is a sound that comes from within. Tinnitus may last for a short period of time or it may be chronic.

Tinnitus may appear in one ear or both, and the sound may vary in pitch and volume between ears and over time. Tinnitus has been linked to increased stress and anxiety, and interferes with most aspects of daily life, from work to sleep. The incessant, frustrating sounds of tinnitus could stand in the way of productivity in the workplace, cause memory and communication problems, and prevent a good night’s sleep. If you are hearing phantom sounds, it’s important to visit us for a hearing test.

Generally speaking, tinnitus regularly affects 25 million people in the US, or approximately 10% of the adult population. Additionally, 60% of veterans returning from Iraq and Afghanistan have reported cases of tinnitus and hearing loss.

Tinnitus may affect anyone, at any time. In fact, most people have had short experiences with tinnitus. Approximately 50 million adult Americans report that they have experienced tinnitus at least once in their lives, whether consistently or for short periods of time. If you’ve ever stood too close to a speaker at a concert or listened to music at a high volume on your headphones – and then experienced a sort of ringing sensation in your ear after, you’ve experienced tinnitus. Many Americans have reported the experience of tinnitus for short bursts – as short as five minutes.

There is no singular, definitive cause for tinnitus, as it is generally considered a symptom of a related medical condition – most commonly, hearing loss. In a study from 2010, researchers found that tinnitus was more prevalent within populations of adult Americans who are older, were former smokers, and adults with hypertension, hearing impairment, or loud noise exposure. Smoking and hypertension increases the risk of tinnitus due to their effects on the vascular system, constricting blood vessels within the head and neck area.

Tinnitus is commonly linked to hearing loss; the exposure to loud noises, whether from one’s occupation or leisure activities (firearms, etc.) also increase the risk, due to damage to the hair cells of the inner ear. In some cases, changes within the ear (earwax blockage, ear bone changes) may cause tinnitus, as well as certain diseases related to the ear, such as Meniere’s disease (a condition in which excess fluid disturbs the balance within the inner ear). Head injuries and problems with the temporomandibular joint (TMJ), where the jaw and skull connect, may also cause tinnitus.

There are two types of tinnitus: subjective and objective.

Subjective tinnitus is experienced solely by the person suffering from tinnitus. This is the most common form of tinnitus, making up over 99% of cases. Subjective tinnitus is often linked to age-related or noise-induced hearing loss, in which exposure to loud sounds damage the hair cells of the inner ear. Researchers have suggested that damage these inner ear cells cause them to send signals to the brain to register sound, even when no stimulus is present. Subject tinnitus may also be the result of head and neck trauma, Meniere’s disease, or impacted earwax.

Objective tinnitus can be heard by both the person with tinnitus and someone in close proximity. Often times, objective tinnitus suggests issues with the cardiovascular system. There may be abnormalities in the blood vessels of the head and neck area surrounding the ear which cause the tinnitus. In the case of pulsatile tinnitus, the sound of tinnitus matches the rhythm of a heartbeat. Spasms of muscles near the ear may cause objective tinnitus, as well as increased blood flow to the ear area due to infection. Objective tinnitus is very rare, making up less than 1% of tinnitus cases.

Next time, in part 2, we’ll look at the relationship between hearing loss and tinnitus, and possible treatments for tinnitus. At Comprehensive Ear and Hearing, we offer comprehensive hearing and ear exams. Contact us to learn more.