What Causes Tinnitus? A Comprehensive Clinical Guide

Tinnitus is the perception of sound in the absence of an external source. From a clinical perspective, as experienced at our private audiology clinic in High Wycombe, Loudwater, we understand that tinnitus is not a disease itself, but a symptom of an underlying condition. The most common cause is damage to the delicate hair cells in the cochlea, the hearing organ in the inner ear. These cells are responsible for converting sound waves into electrical signals that are sent to the brain. When these cells are damaged, they can send spurious signals to the brain, which are interpreted as sound, or tinnitus.

Hearing Loss

Sensorineural hearing loss, often due to aging (presbycusis) or noise exposure, is the most prevalent cause of tinnitus. As hearing sensitivity declines, the brain's auditory pathways can become overactive, generating the perception of sound. At our clinic in Loudwater, we often see patients who are unaware of their hearing loss until it is identified during a tinnitus evaluation.

Noise Exposure

Exposure to loud noise, either from a single traumatic event or over a prolonged period, can damage the delicate structures of the inner ear, leading to hearing loss and tinnitus. This is a significant risk factor for individuals in noisy occupations or those who listen to loud music through headphones.

Earwax Blockage and Ear Infections

Blockages in the ear canal, such as excessive earwax or fluid from an ear infection, can alter the pressure in the ear and cause tinnitus. This is often a temporary cause, and the tinnitus resolves once the blockage is removed or the infection is treated.

Head and Neck Injuries

Trauma to the head or neck can damage the inner ear, auditory nerves, or the parts of the brain responsible for processing sound. This can result in tinnitus, which is often unilateral (in one ear).

Medications

Certain medications are known to be ototoxic, meaning they can damage the inner ear and cause tinnitus. These include some antibiotics, chemotherapy drugs, high doses of aspirin, and loop diuretics. It is crucial to discuss any new medications with your audiologist or GP if you experience tinnitus.

Meniere's Disease

This inner ear disorder is characterized by a triad of symptoms: vertigo, hearing loss, and tinnitus. It is thought to be caused by an imbalance of fluid in the inner ear.

Temporomandibular Joint (TMJ) Disorders

Problems with the jaw joint, such as teeth grinding or clenching, can cause tinnitus. The proximity of the TMJ to the ear means that inflammation or muscle tension in this area can affect the auditory system.

Acoustic Neuroma

This is a benign tumor that grows on the vestibulocochlear nerve, which connects the inner ear to the brain. As the tumor grows, it can press on the nerve, causing hearing loss, tinnitus, and balance problems.

Blood Vessel Disorders

In some cases, tinnitus can be caused by turbulent blood flow in the arteries and veins of the head and neck. This type of tinnitus, known as pulsatile tinnitus, is often described as a rhythmic whooshing or pulsing sound that is in time with the heartbeat.

Other Medical Conditions

• Metabolic disorders: such as thyroid problems and diabetes.
• Autoimmune disorders: such as rheumatoid arthritis and lupus.
• Cardiovascular disease: such as high blood pressure and atherosclerosis.

As audiologists at Buckinghamshire Hearing, our role is to conduct a thorough evaluation to identify the underlying cause of your tinnitus. This includes a comprehensive hearing test, a detailed case history, and, if necessary, referral for further medical investigation. Understanding the cause of your tinnitus is the first step towards effective management.