From the Guidelines
Tinnitus is primarily caused by damage to the inner ear's hair cells, which can occur due to age-related hearing loss, exposure to loud noises, earwax blockage, ear bone changes, or certain medications, as supported by the most recent study 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
- Age-related hearing loss
- Exposure to loud noises
- Earwax blockage
- Ear bone changes
- Certain medications, such as gentamicin, some chemotherapy drugs, and high doses of aspirin
- Conditions like Meniere's disease, acoustic neuroma, or temporomandibular joint disorders
Triggers and Management
Common triggers include:
- Prolonged exposure to loud environments
- Head or neck injuries Stress and anxiety can worsen tinnitus symptoms. While there's no cure, management strategies include:
- Sound therapy
- Hearing aids
- Cognitive behavioral therapy
- Avoiding known triggers like caffeine, alcohol, and loud noises Protecting your hearing by using earplugs in noisy environments and keeping music at moderate volumes can help prevent tinnitus development or worsening, as recommended by 1. It is essential to note that 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, as stated in 1.
From the Research
Causes of Tinnitus
- Tinnitus is a symptom with a broad differential diagnosis, and its causes can be multifactorial 2
- Risk factors for tinnitus include age, hearing loss, noise exposure, inflammatory diseases or tumors of the ear, ototoxic drugs, head or cervical vertebra trauma, and psychological disorders such as anxiety and depression 3
- Tinnitus can be associated with sensorineural hearing loss, and a comprehensive audiologic evaluation should be performed for patients who experience unilateral tinnitus, tinnitus that has been present for six months or longer, or that is accompanied by hearing problems 4
- Other factors that can precipitate tinnitus include neurological injuries or disease, dental disorders, some medications, and certain infectious diseases 5
Types of Tinnitus
- Tinnitus can be classified as subjective or objective, and understanding the difference between the two is essential to the evaluation and management of patients with tinnitus 2
- Subjective tinnitus is the most common type and is perceived by the patient only, while objective tinnitus is a rare type that can be heard by the examiner 2
Prevalence of Tinnitus
- Tinnitus affects approximately 10% of the population 2
- An estimated 37% of adult Canadians had experienced tinnitus in the past year, and it was bothersome for 7% of the population 5
- Tinnitus is associated with poor self-reported mental health, mood disorder, a weak sense of community belonging, high daily stress, and poor quality sleep 5