Tinnitus is a condition in which you hear sounds that are not occurring externally. In other words, you might hear a ringing, buzzing, hissing, whistling, or chirping noise, but there is no external source and no one else can hear the sound. Tinnitus is often called “ringing in the ears,” although the sound does not have to be ringing. Many people hear tones, and some have what’s called “pulsatile tinnitus,” which is when the sounds ebb and flow along with the person’s heartbeat. Tinnitus is fairly widespread, with about 30 to 50 million people in the United States alone suffering from the condition.

What Causes Tinnitus?

Tinnitus is usually a chronic condition (there are a few situations in which it’s temporary) caused by one or more of several factors. Hearing loss is often a part of tinnitus as well, especially noise-induced hearing loss.

When the cochlea is exposed to loud sounds, some of the components inside the cochlea, small hair cells that help transmit neurochemical frequency data to the brain, are damaged. Occasionally, when those hair cells are damaged and then die, the brain cells that would have interpreted the chemicals sent by the hair cells don’t die and instead misfire, making you think you’re hearing a sound when there’s nothing else causing it.

Because dead cochlear hair cells can’t be brought back to life, those who work or otherwise spend time in noisy situations have to be very careful about preserving their hearing. Construction workers, musicians, and even those who listen to headphones with music turned up are all susceptible to both noise-induced hearing loss and tinnitus.

For cases of temporary tinnitus, a virus or ear infection could be to blame. Sometimes a buildup of wax in the ear canal creates an irritating situation for the eardrum, leading to tinnitus as well. Other medical conditions that can lead to tinnitus include Ménière’s disease, which affects the portion of your inner ear that handles balance.

Medications can also cause temporary tinnitus; anti-inflammatories like aspirin are common culprits, but this type of tinnitus can often be reversed.

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How is Tinnitus Treated?

Treatments vary according to the cause. For example, excess wax can be removed; medications can be changed or stopped. If hearing loss is involved, the patient’s hearing aid could be programmed to help with the tinnitus. In more severe cases, a cochlear implant could be used to send more stable cochlear signals to the brain.

Masking devices and white noise machines can help cover the sound of the tinnitus for those who aren’t getting relief from hearing aids. Sound therapy is a customized treatment that is often more effective than using generic white noise machines.