WHAT ARE THE MEDICAL CAUSES OF TINNITUS?

Tinnitus has a wide variety of medical causes. Medical causes of tinnitus range from hearing loss to head trauma or underlying medical condition. Finding a solution to a medical cause of tinnitus can help to alleviate tinnitus symptoms and sometimes lead to complete tinnitus symptoms cessation.

Hearing Loss

Hearing loss as a medical cause of tinnitus is separated into two types: Sensorineural and conductive hearing loss.

Sensorineural hearing loss

Sensorineural hearing loss is caused by damage to the inner ear or auditory nerve. This type of hearing loss is caused by age or injury.

Sensorineural hearing loss is caused by damage to the inner ear or auditory nerve.

  • Head trauma or injury
  • Autoimmune conditions
  • Stroke
  • Multiple sclerosis
  • Encephalitis
  • Meningitis
  • Viral infections of the inner ear or auditory nerve
  • Meniere’s disease
  • Acoustic neuroma

Sensorineural hearing loss related to tinnitus is characterised by damage to the cochlea, which forms part of the inner ear. The inner ear is responsible for sending electrical sound signals to the brain for interpretation. When these signals are reduced, neurons in the brain can become oversensitive because they are searching for signals that are no longer being received from the inner ear.  This leads to hypersensitivity making the brain more aware of electrical noise from the neurons, which is what we know to be tinnitus. This electrical noise exists even in people with a healthy hearing function. However the difference is their filtering system filters out the electrical activity so that they are not aware of it.

Conductive hearing loss

Conductive hearing loss occurs when sounds cannot pass from the outer ear to the inner ear. This is usually caused by earwax or a blockage. The type of hearing loss that is usually associated with tinnitus is sensorineural. Conductive hearing loss is less common in causing tinnitus symptoms and in some cases can be treated relatively easily. Causes of conductive hearing loss include:

  • Earwax
  • Glue ear (Fluid build up in the ear)
  • Ear infection
  • Hearing bones damage
  • Perforated eardrum
  • Otosclerosis
  • Eustachian tube dysfunction
  • Malformation of the ear
  • Foreign body in the ear

Age Related Hearing Loss (Presbycusis )

Presbycusis or age related hearing loss usually begins at the age of 40 and increases steadily the older you get. Most people have significant hearing problems by the time they reach 80.  This type of hearing loss usually effects high frequency sounds and makes it harder to make out consonants. Having difficulties when trying to communicate in a room full of people is typical.

Noise related hearing loss

Noise induced hearing loss is common when there is damage to the hair cells in the cochlea caused by exposure to loud noise. Common causes of noise induced hearing loss over a period of time are: working with noisy building equipment, working in a nightclub for a period of time or listening to music through headphones at too high a volume.

Sudden exposure to loud noise can also cause hearing loss and subsequent tinnitus. This is often experienced as part of combat in the armed forces and is known as acoustic trauma.

Glue Ear

Glue ear is where the middle part of the ear fills with fluid. Glue ear can be caused by a middle ear infection which causes inflammation. Symptoms of glue ear include earache and or tinnitus.

Ear Wax Build Up

Earwax is produced by the skin of the ear canal in order to protect it. It can come in many colours or be sticky or hard. Skin migration pushes older cells from the eardrum down the wall of the ear canal. It also pushes dirt, dead skin and wax with it. Having a modest amount of earwax is therefore a necessary bodily function. Ear damage can cause us to lay down more ear wax. This causes conductive hearing loss meaning sound cannot pass through the ear canal efficiently. This can make us more aware of the inner workings of the ear and contribute to tinnitus symptoms.

Side Effect of Medication

Medication is a common cause of temporary tinnitus. Medication can cause or worsen tinnitus. Tinnitus often subsides after withdrawal from the drug. There are a number of medications which can contribute to tinnitus symptoms. Painkillers like Aspirin, Ibruprofin, Naproxin or Diclofenac can cause tinnitus. For a full break down of medication which can cause tinnitus please see our article Medication and Tinnitus. 

Hyperacusis

Hyperacusis is a condition that affects sound perception which can increase sensitivity to sounds. Everyday noises can be amplified to uncomfortable levels which can cause anxiety and depression. Hyperacusis can be caused by a medical condition, ear surgery, earwax removal, head injury, hearing damage, post-traumatic stress disorder or unknown cause.

Inner Ear Damage

Inner ear damage can cause tinnitus. Inner ear damage might be caused by the following:

  • Loud noise from music concerts and nightclubs,
  • Working with noisy construction equipment
  • Head trauma
  • Acoustic trauma from a sudden bang or loud noise
  • Age and natural hearing loss
  • Genetic abnormality
  • Viral infections of the inner ear or auditory nerve
  • Ménière’s disease
  • Acoustic neuroma; a benign non-cancerous growth
  • Meningitis
  • Encephalitis
  • Multiple sclerosis
  • An autoimmune condition
  • Malformation of the ear
  • Stroke

Early symptoms of inner ear damage might include dizziness or spinning sensation.

Perforated Ear Drum

An injury to the eardrum might be caused by changes in air pressure caused by flying or taking part in a sport like scuba diving. A perforated ear drum can also be caused by a blow to the head, poking a cotton bud too far into the ear drum or a sudden loud noise.

Otosclerosis

Otosclerosis is a hearing condition which can cause hearing loss. Otosclerosis occurs when a small bone in the middle ear called the stapes gets stuck. The stape gets stuck when bone tissue in the middle ear grows around it.

Labyrinthitis

Labrynthitis is an ear infection which causes the labyrinth to become inflamed. This can lead to vetigo, feeling sick and tinnitus symptoms.

Anaemia

Anaemia is a blood condition in which a person has a low level of haemoglobin in their blood or fewer red blood cells than normal. The most common type of anaemia is caused by iron deficiency, which results in fewer red blood cells. A low level of vitamin B12 can also cause Anaemia. Symptoms vary depending on the type of anemia you have and what causes it. The body uses iron to produce blood cells. These red blood cells store and carry oxygen around the body. If you have fewer red blood cells your bodies organs and tissues will receive less oxygen. One of the more common symptoms of anaemia is tinnitus and medical research shows a direct link between pulsatile tinnitus and iron deficient anaemia.

Head, Neck or Ear Injuries

Physical head trauma can damage the skull, neck, TMJ joint or hearing function. Trauma to the head can affect bones and nerves near to the ear causing tinnitus. It can also affect the nervous system contributing to tinnitus symptoms.

Excessive Noise exposure

Exposure to excessive noise can cause tinnitus. This might be a one off loud bang or continuous exposure to loud noise when using heavy machinery or tools at work or listening to music.

Emotional stress

Life experiences can be stressful and overwhelming. Having a short or prolonged period of high stress can trigger tinnitus.

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