Tinnitus is the perception of sound when no external noise is present. It is commonly described as ringing in the ears, but can also be perceived as buzzing, hissing, whistling, or clicking. Tinnitus can be either temporary or chronic. It is caused by hearing loss, ear injuries, wax buildup, head or neck injuries, jaw problems, sinus issues, loud noises, certain medications, and various other medical conditions. Treatments aim to address the underlying cause of tinnitus and may include removing ear obstructions, treating infections, avoiding loud noises, reducing stress, using sound therapy, and in rare cases, medication.

1. TINNITUS
“RINGING SENSEATION IN EAR
WITHOUT EXTERNAL SOUND ‘’

2. OVERVIEW
Tinnitus is the medical term for a ringing or buzzing noise in the
ears. Most people refer to tinnitus as “ringing in the ears.” However,
you may hear more than just ringing.

3. Tinnitus is the perception of sound when
no actual external noise is present. While
it is commonly referred to as “ringing in
the ears,” tinnitus can manifest many
different perceptions of sound, including
buzzing, hissing, whistling, swooshing,
and clicking.
Tinnitus can be both an acute
(temporary) condition or a chronic
(ongoing) health condition.**

4. IF YOU HAVE TINNITUS, YOU MAY ALSO HEAR:
• ROARING
• BUZZING
• WHISTLING
• HISSING

5. TYPES
Subjective Tinnitus - Head or ear noises that are perceivable only to the
specific patient. Subjective tinnitus is usually traceable to auditory and
neurological reactions to hearing loss but can also be caused by an array of
other catalysts. More than 99% of all reported tinnitus cases are of the
subjective variety
Objective Tinnitus: Head or ear noises that are audible to other people, as
well as the patient. These sounds are usually produced by internal functions
in the body’s circulatory (blood flow) and somatic (musculoskeletal
movement) systems. Objective tinnitus is very rare, representing less than
1% of total tinnitus cases.

6. CAUSES
Tinnitus is a symptom associated with an
array of other health conditions.
Tinnitus is not a disease, but rather a
symptom of some other underlying health
condition. In most cases, tinnitus is a
sensorineural reaction in the brain to damage
in the auditory system. While tinnitus is often
associated with hearing loss, there are
roughly 200 different health disorders that
can generate tinnitus as a symptom. Below is
a list of some of the most commonly
reported catalysts for tinnitus.

7. Note: Tinnitus, by itself, does not necessarily indicate any one of the items listed
below. Patients experiencing tinnitus should see their physician or a hearing
health professional for a full examination to diagnose the underlying cause of
symptoms. In some cases, resolving the root cause will alleviate the perception of
tinnitus.

8. Hearing Loss
Sensorineural hearing loss is commonly accompanied by tinnitus. Some researchers believe
that subjective tinnitus cannot exist without some prior damage to the auditory system. The
underlying hearing loss can be the result of:
Age-related hearing loss (presbycusis) - Hearing often deteriorates as people get older,
typically starting around the age of 60. This form of hearing loss tends to be bilateral (in both
ears) and involves the sensory loss of high-frequency sounds. Age-related hearing loss explains,
in part, why tinnitus is so prevalent among elderly people.
Noise-induced hearing loss - Exposure to loud noise, either a single traumatic experience or
over time, can damage the auditory system and result in hearing loss and sometimes tinnitus as
well. Traumatic noise exposure can happen at work (e.g. loud machinery), at play (e.g. loud
sporting events, concerts, other recreational activities), and/or by accident (e.g. a backfiring
engine.) Noise-induced hearing loss is sometimes unilateral (one ear only) and typically causes
patients to lose hearing around the frequency of the triggering sound trauma.
It is important to note that existing hearing loss is sometimes not directly observable by the
patient, who may not perceive the inability to hear lost frequencies. But that does not mean
that hearing damage has not occurred. An audiologist or other hearing health professional can
perform audiometric tests to precisely measure the true extent of hearing loss.
The exact biological process by which hearing loss is associated with tinnitus is still being
investigated by researchers. However, we do know that the loss of certain sound frequencies
leads to specific changes in how the brain processes sound. In short, as the brain receives less
external stimuli around a specific frequency, it begins to adapt and change. Tinnitus may be the
brain’s way of filling in the missing sound frequencies it no longer receives from the auditory
system.

9. Obstructions in the Middle Ear
Blockages in the ear canal can cause pressure to build
up in the inner ear, affecting the operation of the
eardrum. Moreover, objects directly touching the
eardrum can irritate the organ and cause the
perception of tinnitus symptoms. Common
obstructions include:
Excessive earwax (ceruminosis)
Head congestion
Loose hair from the ear canal
Dirt or foreign objects
In many cases, the removal of the blockage will
alleviate tinnitus symptoms. However, in some
situations, the blockage may have caused permanent
damage that leads to chronic tinnitus.

10. Head and Neck Trauma
Injury to the head or neck can cause nerve, blood
flow, and muscle issues that result in the
perception of tinnitus. Patients who ascribe their
condition to head and neck trauma often report
higher tinnitus volume and perceived burden, as
well as greater variability in sound/s, frequency,
and location of their tinnitus.
Tinnitus related to head, neck, or dental issues is
sometimes referred to as somatic tinnitus.
(“Somatic” derives from the Greek somatikos,
meaning “of the body.”)

11. Temporomandibular Joint Disorder
Another example of somatic tinnitus is that caused by
temporomandibular joint disorder. The temporomandibular
joint (TMJ) is where the lower jaw connects to the skull,
which is located in front of the ears. Damage to the muscles,
ligaments, or cartilage in the TMJ can lead to tinnitus
symptoms. The TMJ is adjacent to the auditory system and
shares some ligaments and nerve connections with
structures in the middle ear.
Tinnitus patients with a TMJ disorder may experience pain in
the face and/or jaw, limited ability to move the jaw, and
regular popping sounds while chewing or talking. A dentist,
craniofacial surgeon, or other oral health professional can
appropriately diagnose and often fix TMJ issues. In many
scenarios, fixing the TMJ disorder will alleviate/reduce
tinnitus symptoms.

12. Sinus Pressure and Barometric Trauma
Nasal congestion from a severe cold, flu, or sinus
infection can create abnormal pressure in the
middle ear, impacting normal hearing and causing
tinnitus symptoms.
Acute barotrauma, caused by extreme or rapid
changes in air or water pressure, can also damage
the middle and inner ear. Potential sources of
barotrauma include:
Diving / Snorkeling / Scuba Diving
Flying (only during extreme, abnormal elevation
changes; normal commercial air travel is generally
safe)
Concussive explosive blasts

13. Traumatic Brain Injury (TBI)
Traumatic brain injury, caused by concussive
shock, can damage the brain’s auditory
processing areas and generate tinnitus
symptoms. TBI is one of the major catalysts
for tinnitus in military and veteran
populations. Nearly 60% of tinnitus cases
diagnosed by the U.S. Department of
Veterans Affairs are attributable to mild-to-
severe traumatic brain injuries.

14. Ototoxic Drugs
Tinnitus is a potential side effect of many prescription
medications. However, in most cases and for most drugs,
tinnitus is an acute, short-lived side effect, meaning if the
patient stops taking the medication, the tinnitus symptoms
typically subside. However, there are some ototoxic drugs
that cause permanent tinnitus symptoms. These include:
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Certain antibiotics
Certain cancer medications
Water pills and diuretics
Quinine-based medications
If you are worried about tinnitus as a side effect of your
medications, please consult your prescribing physician or
pharmacist. You should never stop taking a medication
without first consulting your healthcare provider. The risk of
stopping a medication may far exceed any potential benefit
in the reduction of the tinnitus sound.

15. Other Diseases & Medical Conditions
Tinnitus is a reported symptom of the following medical
conditions:
Metabolic Disorders: Hypothyroidism, Hyperthyroidism, Anemia
Autoimmune Disorders: Lyme Disease, Fibromyalgia
Blood Vessel Disorders: High Blood Pressure, Atherosclerosis
Psychiatric Disorders: Depression, Anxiety, Stress
Vestibular Disorders: Ménière's Disease,Thoracic Outlet
Syndrome, Otosclerosis
Tumor-Related Disorders (very rare): Acoustic Neuroma,
Vestibular Schwannoma, other tumorous growths
Again, a person experiencing tinnitus should not assume that
he/she has one of the medical conditions listed above. Only a
trained healthcare provider can appropriately diagnose the
underlying cause of tinnitus.

16. What are the treatment options
for tinnitus?
https://www.slideshare.net/AnuragP
andey270/tinnitus-healthcare-
providersppt

17. Thank you
For more info -
https://www.ata.org/about-
tinnitus/why-are-my-ears-ringing/#facts