Causes of Tinnitus

Tinnitus is one of those conditions about which too little is known to be able to unequivocally identify the causes. This is also true for the possible remedies, medicines or therapies. There are only theories and assumptions. Simply put, people don't know what causes tinnitus or how to mute it. You can find what is known on this website.

That does not mean that the tinnitus patient has to despair. On the contrary, there are many cases where certain remedies have helped with certain types of tinnitus, and it is up to you, as a tinnitus patient, to find your way around this maze and maximize your chances of recovery. Tinnitus House also aims to help you with this.

There are two types of tinnitus: subjective tinnitus and objective tinnitus. Subjective tinnitus is the most common type and is the perception of sound without actual sound being present and is only perceived by the patient. Objective tinnitus is less common and occurs as a result of sound passing through certain areas near the ear. The causes of objective tinnitus are usually fairly easy to detect by examination in the hospital. It is of course important to find out quickly whether you have subjective or objective tinnitus. See also the description of subjective and objective tinnitus.

As mentioned in What is Tinnitus? with subjective tinnitus, only the patient can hear the sounds in the ear. If the doctor listens to these patients' ears, he will hear nothing. But the person who is bothered by it certainly hears it. It is therefore much more difficult to determine the cause of subjective tinnitus than it is with objective tinnitus. However, it is known that this type of tinnitus is often associated with hearing loss, especially hearing loss caused by hearing impairment. Because the cause is so difficult to determine, this type of tinnitus is difficult to treat. Hearing loss, and then especially hearing loss caused by hearing damage. Because the cause is so difficult to identify is this form of tinnitus difficult to treat.

Indicated below are the most commonly suspected conditions associated with objective and subjective tinnitus.

Possible Causes of Tinnitus

OtologicalPulsatingAnatomicalSpontaneousNeurologicalInfectionMedicationOther Causes


The most well-known suspected cause of tinnitus is hearing loss due to age-related deafness or external noise. Notorious is the "buzzing" that lasts for days after visiting a pop concert. Furthermore, there are working with noisy machines, otoschlerosis, middle ear infections, wax build-up, sudden deafness, Meniere's disease and other causes of hearing loss.

Pulsating Tinnitus

With pulsating tinnitus, the sounds originate somewhere in the body, for example in the ear or in the skull. It is common in this form of tinnitus to hear the blood flow through the vessels. Causes can include a narrowing of the carotid artery, an abnormality of blood vessels, a heart valve defect (often the aortic valve), an increased heart rate, for example due to medicines, anemia or an overactive thyroid gland. Once the cause is found, this form of Tinnitus can often be cured

Muscular or Anatomical Tinnitus

Anatomical Tinnitus manifests itself as a fast rhythmic clicking sound. This may be due to the involuntary contraction of the muscles attached to the ossicles (tiny middle ear bones). Other causes of this type of objective tinnitus are: head injury, whiplash, multiple sclerosis, vestibular schwannoma (also called acoustic neuroma), or bridge angle tumor

Spontaneous tinnitus

Spontaneous tinnitus can develop as a consequence of, for example, a middle ear infection, Lyme disease, meningitis, syphilis, or other infectious diseases that can affect hearing.

Neurological Tinnitus

Head injury, whiplash, multiple sclerosis, vestibular schwannoma (also called acoustic neuroma), bridge angle tumor

Tinnitus caused by infection

Infectious tinnitus is tinnitus due to a middle ear infection, Lyme disease, meningitis, syphilis, or another infectious disease that can affect hearing Spontaneous tinnitus can develop as a result of, for example, middle ear infection, Lyme disease, meningitis, syphilis, or other infectious diseases that affect impair hearing.


Well-known Tinnitus triggers are aspirin, NSAIDs (nonsteroidal anti-inflammatory drugs) such as Ibubrufen, certain antibiotics, diuretics (water tablets) and cytostatics (chemotherapy).

Other Causes

Jaw (Temporo-mandibular) joint problems and some dental abnormalities can also cause tinnitus.

Source: Lockwood AH, Salvi RJ, Burkard RF. Tinnitus. N Engl J Med. 2002;347(12):904–910. © 2002 The New England Journal of Medicine.

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