Tinnitus

Ringing, buzzing, or hissing sounds perceived without external source

Overview

Tinnitus is the perception of sound, such as ringing, buzzing, hissing, or humming, without an external source. It is common, affecting about 10 to 15 percent of people, though only a small minority find it severely distressing. It is most often associated with hearing loss, and a leading explanation is that reduced input from the cochlea leads the auditory brain to increase its internal gain, producing activity that is perceived as sound. Other associations include noise exposure, earwax, ear infections, certain medications such as high dose aspirin and some antibiotics, head and neck injury, and stress. A subtype called somatic tinnitus changes with jaw or neck movement. Management approaches focus on reducing its impact rather than eliminating it, and include sound enrichment, hearing aids where hearing loss is present, and cognitive behavioural therapy, which has the strongest evidence base. Many people habituate over time. Pulsatile tinnitus, heard in time with the heartbeat, is a distinct form that is usually investigated for a vascular cause.