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Causes of Tinnitus

The most common cause of tinnitus is damage to the hearing nerves in the ear (cochlea or inner ear).  We hear things through a stream of nerve impulses going from the cochlea to the auditory system in the brain. If the tiny nerves in the ear are damaged or destroyed, this produces an abnormal stream of impulses, which the brain interprets as a sound. This causes the noise associated with tinnitus.

Tinnitus in older people is usually caused by natural hearing loss (presbyacusis), which lessens the sensitivity of hearing nerves.  In younger people it is most often caused by damage to hearing as a result of excessive noise.

However, there are a number of other causes of tinnitus. It is not always possible to identify the exact cause even after examination by a specialist.

Other common causes include:

  • excessive wax in the ear causing it to become blocked;
  • middle ear infection (otitis media) or glue ear (serous otitis media);
  • otosclerosis (stiffening of the tiny bones which transmit sound from the eardrum to the sound-detecting organ, the cochlea);
  • Ménière's disease (a condition causing problems with balance)
  • anaemia (in which the thinner blood circulates so rapidly it produces sound); and
  • pierced eardrum.

Less commonly, tinnitus may also develop as a result of:

  • exposure to sudden or very loud noise (eg gunfire, explosion);
  • a head injury;
  • impacted wisdom teeth (when wisdom teeth haven’t completely moved into the normal position);
  • adverse reactions to certain drugs such as antibiotics, diuretics, aminoglycosides, quinine and aspirin, (this is more likely when the dosage is exceeded), and also allergic reactions;
  • solvent abuse, alcohol abuse and other drug abuse;
  • high blood pressure and narrowing of the arteries (atherosclerosis); and
  • overactive thyroid gland.

Tinnitus is rarely a symptom of a more serious problem but there can be other causes such as tumours, spasm, and abnormal blood flow.

Some people relate their tinnitus to stressful events in their life, such as bereavement.