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Understanding Tinnitus -- the Basics

What Is Tinnitus?

Tinnitus (pronounced ti-ni-tis), or ringing in the ears, is the sensation of hearing ringing, buzzing, hissing, chirping, whistling, or other sounds. The noise can be intermittent or continuous, and can vary in loudness. It is often worse when background noise is low, so you may be most aware of it at night when you're trying to fall asleep in a quiet room. In rare cases, the sound beats in sync with your heart (pulsatile tinnitus).

Tinnitus is very common, affecting an estimated 50 million adults in the U.S. For most people, the condition is merely an annoyance. In severe cases, however, tinnitus can cause people to have difficulty concentrating and sleeping. It may eventually interfere with work and personal relationships, resulting in psychological distress.

Although tinnitus is often associated with hearing loss, it does not cause the loss, nor does a hearing loss cause tinnitus. In fact, some people with tinnitus experience no difficulty hearing, and in a few cases they even become so acutely sensitive to sound (hyperacusis) that they must take steps to muffle or mask external noises.

Some instances of tinnitus are caused by infections or blockages in the ear, and the tinnitus can disappear once the underlying cause is treated. Frequently, however, tinnitus continues after the underlying condition is treated. In such a case, other therapies -- both conventional and alternative -- may bring significant relief by either decreasing or covering up the unwanted sound.

What Causes Tinnitus?

Prolonged exposure to loud sounds is the most common cause of tinnitus. Up to 90% of people with tinnitus have some level of noise-induced hearing loss. The noise causes permanent damage to the sound-sensitive cells of the cochlea, a spiral-shaped organ in the inner ear. Carpenters, pilots, rock musicians, street-repair workers, and landscapers are among those whose jobs put them at risk, as are people who work with chain saws, guns, or other loud devices or who repeatedly listen to loud music. A single exposure to a sudden extremely loud noise can also cause tinnitus.

A variety of other conditions and illnesses can lead to tinnitus, including:

  • Blockages of the ear due to a buildup of wax, an ear infection, or rarely, a benign tumor of the nerve that allows us to hear (auditory nerve)
  • Certain drugs -- most notably aspirin, several types of antibiotics, anti-inflammatories, sedatives, and antidepressants, as well as quinine medications; tinnitus is cited as a potential side effect for about 200 prescription and nonprescription drugs.
  • The natural aging process, which can cause deterioration of the cochlea or other parts of the ear
  • Meniere's disease, which affects the inner part of the ear
  • Otosclerosis, a disease that results in stiffening of the small bones in the middle ear
  • Other medical conditions such as high blood pressure, cardiovascular disease, circulatory problems, anemia, allergies, an underactive thyroid gland, and diabetes
  • Neck or jaw problems, such as temporomandibular joint (TMJ) syndrome
  • Injuries to the head and neck

Tinnitus can worsen in some people if they drink alcohol, smoke cigarettes, drink caffeinated beverages, or eat certain foods. For reasons not yet entirely clear to researchers, stress and fatigue seem to worsen tinnitus.

WebMD Medical Reference

Reviewed by Melinda Ratini, DO, MS on March 27, 2014

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