tinnitus
Meaning of tinnitus: Most tinnitus is generated inside the hearing pathways of the brain rather than by the ear, which is why quiet rooms make it louder.
Definition of tinnitus
Tinnitus is the perception of sound when no outside source is producing it. People describe ringing, buzzing, hissing, clicking or roaring, in one ear or both, steady or coming and going. It is a symptom rather than a disease in its own right, and it is most often accompanied by some degree of hearing loss, even when ordinary conversation still sounds normal.
What causes it?
Damage to the hair cells of the inner ear removes part of the signal the brain expects to receive. The auditory pathways appear to compensate by turning up their own gain, and that amplified background activity is heard as sound. This is why tinnitus so often travels with hearing loss, and why it stands out in a silent room where nothing else is competing for attention.
| Contributor | How it fits |
|---|---|
| Age-related hearing loss | The most common association, usually in both ears |
| Loud noise exposure | Damages hair cells; may follow a single blast or years of exposure |
| Earwax or middle ear fluid | Blocks outside sound, so internal noise becomes noticeable |
| Certain medications | Some antibiotics, chemotherapy agents, diuretics and high-dose aspirin are ototoxic |
| Meniere disease and acoustic neuroma | Ear and nerve conditions that typically affect one side |
How do the types differ?
Subjective tinnitus, by far the more common form, is audible only to the person experiencing it. Pulsatile tinnitus beats in time with the heart and reflects turbulent blood flow near the ear, so it is investigated as a circulation question rather than a hearing one. A rare third group, objective tinnitus, can be heard by an examiner and usually comes from muscle spasm in the middle ear or palate. Ringing that follows a new medication is treated as a possible drug effect and traced back to the timing of the change.
What happens at an assessment?
A hearing test maps which frequencies are affected, since the pitch of the tinnitus often matches the region of hearing loss. History covers noise exposure, ear surgery, head injury, drug list and whether the sound is one-sided or pulsing. Imaging is reserved for asymmetric or pulsatile patterns. There is often no cure for the underlying nerve change, so much of the care that follows targets the distress and sleep disruption rather than the sound itself, using hearing aids, sound enrichment and structured counseling approaches.
Used in a sentence
The patient described persistent ringing consistent with tinnitus in the left ear.
Good to know
Tinnitus in one ear only, or accompanied by hearing loss or dizziness on the same side, is evaluated more closely than tinnitus in both ears, since a one-sided pattern can point toward a more specific underlying cause.
Word origin
Where “tinnitus” comes from
From Latin tinnire, meaning to ring.