Tinnitus Categories
Tinnitus is unique to each individual, but common symptoms and causes often overlap. The condition is broadly categorised into two main types:
Objective Tinnitus
Objective tinnitus is when an external observer, such as an audiologist, can hear the noise that the patient hears. This type is rare and often related to physical sources within the body. Common causes include:
- Blood flow issues in large veins or arteries near the ear that are detectable with a stethoscope.
- High blood pressure.
- Aneurysms.
- Blockages in blood vessels.
Subjective Tinnitus
Subjective tinnitus is much more common and is perceived only by the individual. It can result from various causes, including:
- Age-related or noise-induced hearing loss
- Ear infections
- Earwax buildup
- Head or neck injuries.
Types of Tinnitus
Somatic Tinnitus
Somatic tinnitus is associated with changes in the somatosensory system, including sensory neurons responding to body changes such as movement, pressure, touch, temperature, or pain. They are often described as “creaking,” “popping,” or “clicking” sounds. Issues with bones, joints, muscles, or skin, nerve damage, and stress-induced muscle spasms can cause it.
Pulsatile Tinnitus
Pulsatile tinnitus is characterised by a rhythmic pulsing or whooshing sound that matches the heartbeat. Common causes include:
- Blood flow abnormalities
- Middle ear problems
- Head trauma
- Tumors pressing on blood vessels or nerves
Neurological Tinnitus
Neurological tinnitus occurs due to damage to the auditory nerves or the brain’s auditory pathways. Associated conditions include:
Meniere’s disease: a disorder of the inner ear characterised by episodes of vertigo, fluctuating hearing loss, tinnitus, and a feeling of fullness in the ear caused by abnormal fluid buildup.
Vestibular neuritis: an inflammation of the vestibular nerve, often resulting from a viral infection, leading to dizziness, balance issues, and sometimes tinnitus.
Acoustic neuroma: a benign tumour on the auditory (vestibulocochlear) nerve that connects the inner ear to the brain, causing progressive hearing loss, tinnitus, and balance problems.
The auditory system comprises the ear, auditory nerve, and brain; damage to any of these parts can result in tinnitus.
Musical Tinnitus
Musical tinnitus involves the perception of music or singing without an external source. It is more common in individuals with hearing loss or deafness. The condition can range from continuous to intermittent and may include other auditory hallucinations.
Musical tinnitus is believed to result from changes in the auditory system rather than a mental health disorder. Treatment typically focuses on managing the underlying cause if identifiable. In cases without a clear cause, coping and adaptability strategies are emphasised.
