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Diseases » Tinnitus » Causes

Causes of Tinnitus



Contents

List of causes of Tinnitus

Following is a list of causes or underlying conditions (see also Misdiagnosis of underlying causes of Tinnitus) that could possibly cause Tinnitus includes:

More causes: see full list of causes for Tinnitus

Causes of Tinnitus (Diseases Database):

The follow list shows some of the possible medical causes of Tinnitus that are listed by the Diseases Database:

Source: Diseases Database

Causes of Tinnitus: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review the full text of medical books online, free, without registration, for more information about the causes of Tinnitus.

Tinnitus: Differential Diagnosis
(In a Page: Signs and Symptoms)

  • Acute or chronic otitis media
  • Impacted cerumen
    • Eustachian tube dysfunction
      –“Ocean roar” that may wax and wane with respiration
    • Dysfunctional hearing aid
    • Presbycusis (high pitch)
    • Idiopathic (low pitch)
    • Noise-induced hearing loss (high pitch)
    • Meniere's disease
      –Triad of tinnitus, hearing loss, and vertigo
    • Ototoxicity secondary to drugs
      –High pitch
      –May persist after medication (e.g., aminoglycosides)
      –May be dose-related (e.g., aspirin)
    • Trauma
      –Commonly associated with airbag, whiplash, barotrauma
      –May have ruptured tympanic membrane
    • TMJ syndrome
      –Nonpulsatile tinnitus (Costen's syndrome)
      –Associated jaw symptoms (e.g., pain, clicking)
    • Migraine headache
    • Vascular disease (e.g., atherosclerosis, diabetic vasculopathy, arteriovenous malformation, small vessel disease, hypertension)
    • Stroke
      • Otosclerosis
        –Associated with chronic otitis media or tympanic membrane trauma
      • Pseudotumor cerebri
      • Tumor
        –Glomus tympanicum or jugulare: Pulsatile tinnitus with hearing loss
        –Acoustic neuroma: Unilateral hearing loss and tinnitus, headache
      • Infections (e.g., meningitis, Lyme disease, rubella)
      • Less common etiologies (“zebras”) include thyroid disease, Paget's disease, myoclonus of palatal muscles, fetal insults (infections, toxins), sickle cell disease, osteogenesis imperfecta, neurosyphilis, symptomatic Chiari malformation, late onset congenital hearing loss, dissecting aneurysm, carotid cancer, and multiple sclerosis

READ FULL BOOK TEXT ONLINE »

Tinnitus: Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)

  • Impacted cerumen
    • Eustachian tube dysfunction
      –“Ocean roar” that may wax and wane with respiration
  • Acute otitis media
    –Red TM with poor movement, ±fluid
  • Chronic otitis media
    –Persistent otitis with poor TM movement
  • Noise-induced hearing loss
    –High pitch
  • Trauma
    –Airbag, whiplash, barotrauma, etc.
  • Temporal-mandibular joint disorder
    –Nonpulsatile tinnitus
  • Migraine
    • Ototoxicity
      –High pitch
      –Many drugs, including salicylates and aminoglycosides
  • Otosclerosis
  • Pseudotumor cerebri
  • Infections (meningitis, Lyme disease, rubella)
  • Acquired AVM, arterial bruit, venous hum (positional change of tinnitus)
    • Tumor
      –Glomus tympanicum or jugulare (pulsatile tinnitus with hearing loss)
      –Acoustic neuroma
  • Thyroid disease
  • Autoimmune inner ear disease
  • Idiopathic
    –Low pitch
  • Fetal insults
    –Infections, toxins, etc.
  • Sickle cell disease, anemia
  • Osteogenesis imperfecta
  • Symptomatic Chiari malformation
  • Late-onset congenital hearing loss
  • Less common causes are
    –Hypertension
    –Myoclonus of palatal muscles
    –Multiple sclerosis
    –Small vessel disease
    –Presbycusis (high pitch)

READ FULL BOOK TEXT ONLINE »

Tinnitus: Medical causes
(Handbook of Signs & Symptoms (Third Edition))

Acoustic neuroma

An early symptom of acoustic neuroma — an eighth cranial nerve tumor — unilateral tinnitus precedes unilateral sensorineural hearing loss and vertigo. Facial paralysis, headache, nausea, vomiting, and papilledema may also occur.

Atherosclerosis of the carotid artery

With atherosclerosis of the carotid artery, the patient has constant tinnitus that can be stopped by applying pressure over the carotid artery. Auscultation over the upper part of the neck, on the auricle, or near the ear on the affected side may detect a bruit. Palpation may reveal a weak carotid pulse.

Cervical spondylosis

With degenerative cervical spondylosis, osteophytic growths may compress the vertebral arteries, resulting in tinnitus. Typically, a stiff neck and pain aggravated by activity accompany tinnitus. Other features include brief vertigo, nystagmus, hearing loss, paresthesia, weakness, and pain that radiates down the arms.

Eustachian tube patency

Normally, the eustachian tube remains closed, except during swallowing. However, persistent patency of this tube can cause tinnitus, audible breath sounds, loud and distorted voice sounds, and a sense of fullness in the ear. Examination with a pneumatic otoscope reveals movement of the tympanic membrane with respirations. At times, breath sounds can be heard with a stethoscope placed over the auricle.

Glomus jugulare (tympanicum tumor)

A pulsating sound is usually the first symptom of this tumor. Other early features include a reddish blue mass behind the tympanic membrane and progressive conductive hearing loss. Later, total unilateral deafness is accompanied by ear pain and dizziness. Otorrhagia may also occur if the tumor breaks through the tympanic membrane.

Hypertension

Bilateral, high-pitched tinnitus may occur with severe hypertension. Diastolic blood pressure exceeding 120 mm Hg may also cause severe, throbbing headache, restlessness, nausea, vomiting, blurred vision, seizures, and decreased level of consciousness.

Labyrinthitis (suppurative)

With labyrinthitis, tinnitus may accompany sudden, severe attacks of vertigo, unilateral or bilateral sensorineural hearing loss, nystagmus, dizziness, nausea, and vomiting.

Ménière’s disease

Most common in adults — especially in men between ages 30 and 60 —  Ménière’s disease is a labyrinthine disease that’s characterized by attacks of tinnitus, vertigo, a feeling of fullness or blockage in the ear, and fluctuating sensorineural hearing loss. These attacks last from 10 minutes to several hours; they occur over a few days or weeks and are followed by a remission. Severe nausea, vomiting, diaphoresis, and nystagmus may also occur during attacks.

Ossicle dislocation

Acoustic trauma, such as a slap on the ear, may dislocate the ossicle, resulting in tinnitus and sensorineural hearing loss. Bleeding from the middle ear may also occur.

Otitis externa (acute)

Although not a major complaint with otitis externa, tinnitus may result if debris in the external ear canal impinges on the tympanic membrane. More typical findings include pruritus, foul-smelling purulent discharge, and severe ear pain that’s aggravated by manipulation of the tragus or auricle, teeth clenching, mouth opening, and chewing. The external ear canal typically appears red and edematous and may be occluded by debris, causing partial hearing loss.

Otitis media

Otitis media may cause tinnitus and conductive hearing loss. However, its more typical features include ear pain, a red and bulging tympanic membrane, high fever, chills, and dizziness.

Otosclerosis

With otosclerosis, the patient may describe ringing, roaring, or whistling tinnitus or a combination of these sounds. He may also report progressive hearing loss, which may lead to bilateral deafness, and vertigo.

Presbycusis

Presbycusis is an otologic effect of aging that produces tinnitus and a progressive, symmetrical, bilateral sensorineural hearing loss, usually of high-frequency tones.

Tympanic membrane perforation

With tympanic membrane perforation, tinnitus and hearing loss go hand-in-hand. Tinnitus is usually the chief complaint in a small perforation; hearing loss is usually the chief complaint in a larger perforation. These symptoms typically develop suddenly and may be accompanied by pain, vertigo, and a feeling of fullness in the ear.

Other causes

Drugs and alcohol

An overdose of salicylates commonly causes reversible tinnitus. Quinine, alcohol, and indomethacin may also cause reversible tinnitus. Common drugs that may cause irreversible tinnitus include the aminoglycoside antibiotics (especially kanamycin, streptomycin, and gentamicin) and vancomycin.

Noise

Chronic exposure to noise, especially high-pitched sounds, can damage the ear’s hair cells, causing tinnitus and a bilateral hearing loss. These symptoms may be temporary or permanent.

READ FULL BOOK TEXT ONLINE »

Tinnitus: Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))

Acoustic neuroma

An early symptom of this eighth cranial nerve tumor, unilateral tinnitus precedes unilateral sensorineural hearing loss and vertigo. Facial paralysis, headache, nausea, vomiting, and papilledema may also occur.

Anemia

Severe anemia may produce mild, reversible tinnitus. Other common effects include pallor, weakness, fatigue, exertional dyspnea, tachycardia, bounding pulse, atrial gallop, and a systolic bruit over the carotid arteries.

Atherosclerosis of the carotid artery

In this disorder, the patient has constant tinnitus that can be stopped by applying pressure over the carotid artery. Auscultation over the upper part of the neck, on the auricle, or near the ear on the affected side may detect a bruit. Palpation may reveal a weak carotid pulse.

Cervical spondylosis

In this degenerative disorder, osteophytic growths may compress the vertebral arteries, resulting in tinnitus. Typically, a stiff neck and pain aggravated by activity accompany tinnitus. Other features include brief vertigo, nystagmus, hearing loss, paresthesia, weakness, and pain that radiates down the arms.

Ear canal obstruction

When cerumen or a foreign body blocks the ear canal, the patient may experience tinnitus, conductive hearing loss, itching, and a feeling of fullness or pain in the ear.

Eustachian tube patency

Normally, the eustachian tube remains closed, except during swallowing. However, persistent patency of this tube can cause tinnitus, audible breath sounds, loud and distorted voice sounds, and a sense of fullness in the ear. Examination with a pneumatic otoscope reveals movement of the tympanic membrane with respirations. At times, breath sounds can be heard with a stethoscope placed over the auricle.

Glomus jugulare or glomus tympanicum tumor

A pulsating sound is usually the first symptom of these tumors. Other early features include a reddish blue mass behind the tympanic membrane and progressive conductive hearing loss. Later, total unilateral deafness is accompanied by ear pain and dizziness. Otorrhagia may also occur if the tumor breaks through the tympanic membrane.

Hypertension

Severe hypertension (diastolic blood pressure exceeding 120 mm Hg) may cause bilateral high-pitched tinnitus, a severe throbbing headache, restlessness, nausea, vomiting, blurred vision, seizures, and decreased level of consciousness.

Intracranial arteriovenous malformation

A large malformation may cause pulsating tinnitus accompanied by a bruit over the mastoid process.

Labyrinthitis (suppurative)

In this disorder, tinnitus may accompany sudden, severe attacks of vertigo, unilateral or bilateral sensorineural hearing loss, nystagmus, dizziness, nausea, and vomiting.

Ménière’s disease

Most common in adults—especially in men between ages 30 and 60—this labyrinthine disease is characterized by attacks of tinnitus, vertigo, a feeling of fullness or blockage in the ear, and fluctuating sensorineural hearing loss. These attacks last from 10 minutes to several hours; they occur over a few days or weeks and are followed by a remission. Severe nausea, vomiting, diaphoresis, and nystagmus may also occur during attacks.

Ossicle dislocation

Acoustic trauma, such as a slap on the ear, may dislocate the ossicle, resulting in tinnitus and sensorineural hearing loss. Bleeding from the middle ear may also occur.

Otitis externa (acute)

Although not a major complaint in this disorder, tinnitus may result if debris in the external ear canal impinges on the tympanic membrane. More typical findings include pruritus, a foul-smelling purulent discharge, and severe ear pain that’s aggravated by manipulation of the tragus or auricle, teeth clenching, mouth opening, and chewing. The external ear canal typically appears red and edematous and may be occluded by debris, causing partial hearing loss.

Otitis media

This infection may cause tinnitus and conductive hearing loss. However, its more typical features include ear pain, a red and bulging tympanic membrane, high fever, chills, and dizziness.

Otosclerosis

In this disorder, the patient may describe ringing, roaring, or whistling tinnitus or a combination of these sounds. He may also report progressive hearing loss, which may lead to bilateral deafness, and vertigo.

Palatal myoclonus

In this disorder, muscles of the palate contract rhythmically, either intermittently or continuously, causing a clicking sound in the ear and vibratory tinnitus. The contractions are visible with a nasopharyngeal mirror.

Presbycusis

This otologic effect of aging produces tinnitus and progressive, symmetrical, bilateral sensorineural hearing loss, usually of high-frequency tones.

Tympanic membrane perforation

Tinnitus and hearing loss go hand-in-hand in this disorder. Tinnitus is usually the chief complaint in a small perforation; hearing loss, in a larger perforation. These symptoms typically develop suddenly and may be accompanied by pain, vertigo, and a feeling of fullness in the ear.

Other causes

Drugs and alcohol

An overdose of salicylates commonly causes reversible tinnitus. Quinine, alcohol, and indomethacin may also cause reversible tinnitus. Common drugs that may cause irreversible tinnitus include the aminoglycoside antibiotics (especially kanamycin, streptomycin, and gentamicin) and vancomycin.

Noise

Chronic exposure to noise, especially high-pitched sounds, can damage the ear’s hair cells, causing tinnitus and bilateral hearing loss. These symptoms may be temporary or permanent.

READ FULL BOOK TEXT ONLINE »

Tinnitus: Differential Overview
(Field Guide to Bedside Diagnosis)

❑ Impacted cerumen

❑ Otitis media

❑ Eustachian dysfunction

❑ Presbyacusis

❑ Hypertension

❑ Drugs

❑ Ménière

❑ Arterial bruit

❑ Acoustic neuroma

❑ Vascular aneurysm

❑ Arteriovenous malformation

❑ Functional

❑ Glomus tumor

READ FULL BOOK TEXT ONLINE »

Tinnitus: Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

Acoustic neuroma

Acoustic neuroma, a tumor of the eighth cranial nerve, causes unilateral tinnitus that precedes early symptoms of unilateral sensorineural hearing loss and vertigo. Facial paralysis, headache, nausea, vomiting, and papilledema may also occur.

Anemia

Severe anemia may produce mild, reversible tinnitus. Other common effects include pallor, weakness, fatigue, exertional dyspnea, tachycardia, bounding pulse, atrial gallop, and a systolic bruit over the carotid arteries.

Atherosclerosis of the carotid artery

With atherosclerosis of the carotid artery, the patient has constant tinnitus that can be stopped by applying pressure over the carotid artery. Auscultation over the upper part of the neck, on the auricle, or near the ear on the affected side may detect a bruit. Palpation may reveal a weak carotid pulse.

Cervical spondylosis

With cervical spondylosis, a degenerative disorder, osteophytic growths may compress the vertebral arteries, resulting in tinnitus. Typically, a stiff neck and pain aggravated by activity accompany tinnitus. Other features include brief vertigo, nystagmus, hearing loss, paresthesia, weakness, and pain that radiates down the arms.

Ear canal obstruction

When cerumen or a foreign body blocks the ear canal, tinnitus may occur with conductive hearing loss, itching, blockage, and a feeling of fullness or pain in the ear.

Eustachian tube patency

Normally, the eustachian tube remains closed, except during swallowing. However, persistent patency of this tube can cause tinnitus, audible breath sounds, loud and distorted voice sounds, and a sense of fullness in the ear. Examination with a pneumatic otoscope reveals movement of the tympanic membrane with respirations. At times, breath sounds can be heard with a stethoscope placed over the auricle.

Hypertension

Bilateral, high-pitched tinnitus may occur with severe hypertension. Diastolic blood pressure exceeding 120 mm Hg may also cause severe, throbbing headache; restlessness; nausea; vomiting; blurred vision; seizures; and decreased level of consciousness.

Intracranial arteriovenous malformation

A large intracranial arteriovenous malformation may cause pulsating tinnitus accompanied by a bruit over the mastoid process. Other manifestations include severe headache, seizures, and progressive neurologic deficits.

Labyrinthitis (suppurative)

With suppurative labyrinthitis, tinnitus may accompany sudden, severe attacks of vertigo, unilateral or bilateral sensorineural hearing loss, nystagmus, dizziness, nausea, and vomiting.

Ménière’s disease

Ménière’s disease, a labyrinthine disease, is characterized by attacks of tinnitus, vertigo, a feeling of fullness or blockage in the ear, and fluctuating sensorineural hearing loss. These attacks last from 10 minutes to several hours; they occur over a few days or weeks and are followed by a remission. Severe nausea, vomiting, diaphoresis, and nystagmus may also occur during attacks.

Ossicle dislocation

Acoustic trauma, such as a slap on the ear, may dislocate the ossicle, resulting in tinnitus and sensorineural hearing loss. Bleeding from the middle ear may also occur.

Otitis externa (acute)

Although not a major complaint with otitis externa, tinnitus may result if debris in the external ear canal impinges on the tympanic membrane. More typical findings include pruritus, foul-smelling purulent discharge, and severe ear pain that’s aggravated by manipulation of the tragus or auricle, teeth clenching, mouth opening, and chewing. The external ear canal typically appears red and edematous and may be occluded by debris, causing partial hearing loss.

Otitis media

Otitis media may cause tinnitus and conductive hearing loss. However, its more typical features include ear pain, a red and bulging tympanic membrane, high fever, chills, and dizziness.

Otosclerosis

With otosclerosis, the patient may describe ringing, roaring, or whistling tinnitus or a combination of these sounds. He may also report progressive hearing loss, which may lead to bilateral deafness, and vertigo.

Presbycusis

Presbycusis, an otologic effect of aging, produces tinnitus and a progressive, symmetrical, bilateral sensorineural hearing loss, usually of high-frequency tones.

Tympanic membrane perforation

With tympanic membrane perforation, tinnitus and hearing loss go hand-in-hand. Tinnitus is usually the chief complaint in a small perforation; hearing loss, in a larger perforation. These symptoms typically develop suddenly and may be accompanied by pain, vertigo, and a feeling of fullness in the ear.

Other causes

Drugs and alcohol

An overdose of salicylates commonly causes reversible tinnitus. Quinine, alcohol, and indomethacin may also cause reversible tinnitus. Common drugs that may cause irreversible tinnitus include the aminoglycoside antibiotics (especially kanamycin, streptomycin, and gentamicin) and vancomycin.

Noise

Chronic exposure to noise, especially high-pitched sounds, can damage the ear’s hair cells, causing tinnitus and a bilateral hearing loss. These symptoms may be temporary or permanent.

READ FULL BOOK TEXT ONLINE »

Tinnitus: Medical causes
(Nursing: Interpreting Signs and Symptoms)

Acoustic neuroma.An early symptom of acoustic neuroma, unilateral tinnitus precedes unilateral sensorineural hearing loss and vertigo. Facial paralysis, headache, nausea, vomiting, and papilledema may also occur.

Atherosclerosis of the carotid artery.With atherosclerosis of the carotid artery, the patient has constant tinnitus that can be stopped by applying pressure over the carotid artery. Auscultation over the upper part of the neck, on the auricle, or near the ear on the affected side may detect a bruit. Palpation may reveal a weak carotid pulse.

Cervical spondylosis.With degenerative cervical spondylosis, osteophytic growths may compress the vertebral arteries, resulting in tinnitus. Typically, a stiff neck and pain aggravated by activity accompany tinnitus. Other features include brief vertigo, nystagmus, hearing loss, paresthesia, weakness, and pain that radiates down the arms.

Eustachian tube patency.Normally, the eustachian tube remains closed, except during swallowing. However, persistent patency of this tube can cause tinnitus, audible breath sounds, loud and distorted voice sounds, and a sense of fullness in the ear. Examination with a pneumatic otoscope reveals movement of the tympanic membrane with respirations. At times, breath sounds can be heard with a stethoscope placed over the auricle.

Glomus jugulare (tympanicum tumor).A pulsating sound is usually the first symptom of this tumor. Other early features include a reddish blue mass behind the tympanic membrane and progressive conductive hearing loss. Later, total unilateral deafness is accompanied by ear pain and dizziness. Otorrhagia may also occur if the tumor breaks through the tympanic membrane.

Hypertension.Bilateral, high-pitched tinnitus may occur with severe hypertension. Diastolic blood pressure exceeding 120 mm Hg may also cause a severe, throbbing headache, restlessness, nausea, vomiting, blurred vision, seizures, and decreased level of consciousness.

Labyrinthitis (suppurative).With labyrinthitis, tinnitus may accompany sudden, severe attacks of vertigo, unilateral or bilateral sensorineural hearing loss, nystagmus, dizziness, nausea, and vomiting.

Ménière's disease.Ménière's disease is characterized by attacks of tinnitus, vertigo, a feeling of fullness or blockage in the ear, and fluctuating sensorineural hearing loss. These attacks last from 10 minutes to several hours; they occur over a few days or weeks and are followed by a remission. Severe nausea, vomiting, diaphoresis, and nystagmus may also occur during attacks.

Ossicle dislocation.Acoustic trauma, such as a slap on the ear, may dislocate the ossicle, resulting in tinnitus and sensorineural hearing loss. Bleeding from the middle ear may also occur.

Otitis externa (acute).Although not a major complaint with otitis externa, tinnitus may result if debris in the external ear canal impinges on the tympanic membrane. More typical findings include pruritus, foul-smelling purulent discharge, and severe ear pain that's aggravated by manipulation of the tragus or auricle, teeth clenching, mouth opening, and chewing. The external ear canal typically appears red and edematous and may be occluded by debris, causing partial hearing loss.

Otitis media.Otitis media may cause tinnitus and conductive hearing loss. However, its more typical features include ear pain, a red and bulging tympanic membrane, high fever, chills, and dizziness.

Otosclerosis.With otosclerosis, the patient may describe ringing, roaring, or whistling tinnitus or a combination of these sounds. He may also report progressive hearing loss, which may lead to bilateral deafness, and vertigo.

Presbycusis.Presbycusis produces tinnitus and a progressive, symmetrical, bilateral sensorineural hearing loss, usually of high-frequency tones.

Tympanic membrane perforation.With tympanic membrane perforation, tinnitus and hearing loss go hand-in-hand. Tinnitus is usually the chief complaint in a small perforation; hearing loss is usually the chief complaint in a larger perforation. These symptoms typically develop suddenly and may be accompanied by pain, vertigo, and a feeling of fullness in the ear. If the patient has had otitis media, the perforation will cause drainage and relief of pain.

Other causes

Drugs and alcohol.An overdose of salicylates commonly causes reversible tinnitus. Quinine, alcohol, and indomethacin may also cause reversible tinnitus. Common drugs that may cause irreversible tinnitus include the aminoglycoside antibiotics (especially kanamycin, streptomycin, and gentamicin) and vancomycin.

Noise.Chronic exposure to noise, especially high-pitched sounds, can damage the ear's hair cells, causing tinnitus and a bilateral hearing loss. These symptoms may be temporary or permanent.

READ FULL BOOK TEXT ONLINE »

Tinnitus as a complication of other conditions:

Other conditions that might have Tinnitus as a complication may, potentially, be an underlying cause of Tinnitus. Our database lists the following as having Tinnitus as a complication of that condition:

Tinnitus as a symptom:

Conditions listing Tinnitus as a symptom may also be potential underlying causes of Tinnitus. Our database lists the following as having Tinnitus as a symptom of that condition:

Medications or substances causing Tinnitus:

The following drugs, medications, substances or toxins are some of the possible causes of Tinnitus as a symptom. This list is incomplete and various other drugs or substances may cause your symptoms. Always advise your doctor of any medications or treatments you are using, including prescription, over-the-counter, supplements, herbal or alternative treatments.

See full list of 30 medications causing Tinnitus


Related information on causes of Tinnitus:

As with all medical conditions, there may be many causal factors. Further relevant information on causes of Tinnitus may be found in:


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