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from the Latin word tinnītus meaning "ringing") is the perception of sound within the human ear in the absence of corresponding external sound. Tinnitus is not a disease, but a condition that can result from a wide range of underlying

causes: neurological damage (multiple sclerosis), ear infections, foreign objects in the ear, nasal allergies that

prevent (or induce) fluid drain, or wax build-up. Withdrawal from abenzodiazepine addiction may cause tinnitus as well.

In-ear headphones, whose sound enters directly into the ear canal without any opportunity to be deflected or absorbed

elsewhere, are a common cause of tinnitus when volume is set beyond moderate levels.

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Tinnitus Subjective Phenomena

Tinnitus may be an accompaniment of sensorineural hearing loss or congenital hearing loss, or it may be observed as a side effect of certain medications. However, the most common cause is noise-

induced hearing loss.As tinnitus is usually a subjective phenomenon, it is difficult to

measure using objective tests, such as by comparison with noise of known frequency an intensity, as in an audiometric test. The condition is often rated clinically on a simple scale from "slight" to "catastrophic"

according to the practical difficulties it imposes, such as interference with sleep, quiet

activities, and normal daily activities.[1]

Tinnitus is common: about 20% of people between 55 and 65 years old report symptoms on a general health questionnaire, and 11.8% on

more detailed tinnitus-specific questionnaires

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Cause of TinnitusObjective - in some cases, a clinician can perceive an actual sound (e.g., a bruit)

emanating from the patient's ears. This is called objective tinnitus. Objective tinnitus can arise from muscle spasms that cause clicks or crackling around the middle ear. Some people experience a sound that beats in time with the pulse

(pulsatile tinnitus, or vascular tinnitus).

Pulsatile tinnitus is usually objective in nature, resulting from altered blood flow or increased blood turbulence near the ear (such as from atherosclerosis or venous

hum, but it can also arise as a subjective phenomenon from an increased awareness of blood flow in the ear. Rarely, pulsatile tinnitus may be a symptom of potentially life-threatening conditions such as carotid artery aneurysm or carotid

artery dissection. Pulsatile tinnitus may also indicate vasculitis, or more specifically, giant cell arteritis. Pulsatile tinnitus may also be an indication of

idiopathic intracranial hypertension.

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Cause of TinnitusSubjective tinnitus

Subjective tinnitus can have many possible causes, but most commonly results from otologic disorders – the same conditions that cause hearing loss. The most

common cause is noise-induced hearing loss, resulting from exposure to excessive or loud noises. Tinnitus, along with sudden onset hearing loss, may have no obvious external cause. Ototoxic drugs can cause subjective tinnitus either

secondary to hearing loss or without hearing loss and may increase the damage done by exposure to loud noise, even at

doses that are not in themselves ototoxic.Subjective tinnitus is also a side effect of some medications, such as aspirin, and

may also result from an abnormally low level of serotonin activity. It is also a classical side effect of quinidine, a Class IA anti-arrhythmic. Over 260 medications have been reported to cause tinnitus as a side effect. In many cases, however, no

underlying physical cause can be identified.Tinnitus can also occur due to the discontinuation of therapeutic doses of

benzodiazepines as part of the benzodiazepine withdrawal syndrome. It can sometimes be a protracted symptom from benzodiazepine withdrawal and persist

for many months.

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