From the Guidelines
Tinnitus is primarily caused by damage to the inner ear's hair cells, which can occur from exposure to loud noises, aging, earwax blockage, ear infections, or certain medications, as stated in the most recent guidelines 1. This damage disrupts the normal transmission of sound signals to the brain, causing the perception of sound when no external sound is present.
Common Causes of Tinnitus
- Exposure to loud noises
- Aging
- Earwax blockage
- Ear infections
- Certain medications, such as ototoxic drugs, including some antibiotics, cancer medications, and high doses of aspirin 1 Other causes include:
- Head or neck injuries
- Blood vessel disorders like high blood pressure
- Meniere's disease
- Acoustic neuroma
- Temporomandibular joint (TMJ) disorders
Classification of Tinnitus
Tinnitus can be classified as pulsatile or nonpulsatile, primary (idiopathic) or secondary to another condition, and subjective or objective 1. The American Academy of Otolaryngology and Head and Neck Surgery Foundation (AAO-HNS) guidelines recommend targeted history and clinical examination as the initial evaluation and determination as to whether the tinnitus is bothersome or not, before any imaging 1. Stress and anxiety may not directly cause tinnitus but can worsen its perception 1. Treatment approaches vary based on the underlying cause and may include addressing the primary condition, sound therapy, hearing aids, cognitive behavioral therapy, or medications to reduce the impact of the symptoms 1.