Tinnitus is sound that is heard without any external cause. It can be high or low pitched. It may sound like humming, clicking, buzzing, whistling, chirping or roaring. Tinnitus can be of short or long duration. It may be constant or it may come at intervals. It can occur in one or both ears. Almost everyone has experienced tinnitus, or ringing in the ears, at one time or another. Of the nearly 50 million people who are bothered by tinnitus, 20% have severe symptoms. Tinnitus occurs most often in individuals between 20-40 years old. Most tinnitus can be heard only by the person who experiences it. The cause of this type of tinnitus is generally unknown. More than 90% of these cases have hearing problems, usually "nerve deafness" for high-pitched sounds. Some other causes of subjective tinnitus are:
* cardiovascular disorders, such as high blood pressure,
* metabolic abnormalities, such as low thyroid levels,
* neurologic disorders, such as multiple sclerosis,
* head trauma, such as a skull fracture,
* dental disorders,
* drug side effects caused by drugs such as aspirin, antibiotics or quinine, and
* psychologic factors, such as depression or stress.

Sometimes tinnitus can be heard by an examiner with a stethoscope. This is not common, but can result from blood vessel problems or from mechanical problems of the middle ear. Tinnitus is a symptom, not a disease. It is not threatening to one's health. Many types of treatment have been suggested for relief of tinnitus, but it may not be possible to eliminate it. Tinnitus usually decreases or goes away with time and will persist in only 25% of cases. Treatment of the underlying causes of symptoms may eliminate tinnitus. Discontinuing some drugs, treating vascular abnormalities or treating depression may decrease symptoms. Other management of tinnitus can include:
* avoidance of loud noise, caffeine, smoking, aspirin,
* use of music to mask symptoms when trying to sleep, and
* psychologic testing for depression and anxiety.

More aggressive management can involve:
* hearing aid, tinnitus instrument or masker,
* stress management through biofeedback or behavior modification,
* medication, electrical stimulation, and surgery,

If you experience tinnitus, call your healthcare provider.

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