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Do you (or a loved one) experience a ringing in your ears that no one else can hear? If so, you are not alone.

Tinnitus is the perception of sound when no actual external noise is present. While it is commonly referred to as “ringing in the ears,” tinnitus can manifest many different perceptions of sound, including buzzing, hissing, whistling, swooshing, and clicking. In some rare cases, tinnitus patients report hearing music. Tinnitus can be both an acute (temporary) condition or a chronic (ongoing) health malady.

Sensorineural hearing loss is a commonly accompanied by tinnitus. Some researchers believe that subjective tinnitus cannot exist without some prior damage to the auditory system. The underlying hearing loss can be the result of:


Age-related hearing loss (presbycusis) - Hearing often deteriorates as people get older, typically starting around the age of 60. This form of hearing loss tends to be bilateral (in both ears) and involve the sensory loss of high-frequency sounds. Age-related hearing loss explains, in part, why tinnitus is so prevalent among seniors.
Noise-induced hearing loss - Exposure to loud noises, either in a single traumatic experience or over time, can damage the auditory system and result in hearing loss and sometimes tinnitus as well. Traumatic noise exposure can happen at work (e.g. loud machinery), at play (e.g. loud sporting events, concerts, recreational activities), and/or by accident (e.g. a backfiring engine.) Noise induced hearing loss is sometimes unilateral (one ear only) and typically causes patients to lose hearing around the frequency of the triggering sound trauma.


In general, there are two types of tinnitus:
Subjective Tinnitus:
Head or ear noises that are perceivable only to the specific patient. Subjective tinnitus is usually traceable to auditory and neurological reactions to hearing loss, but can also be caused by an array of other catalysts. More than 99% of all tinnitus reported tinnitus cases are of the subjective variety.
Objective Tinnitus:
Head or ear noises that are audible to other people, as well as the patient. These sounds are usually produced by internal functions in the body’s circulatory (blood flow) and somatic (musculo-skeletal movement)  systems. Objective tinnitus is very rare, representing less than 1% of total tinnitus cases.


In general, there are three ways to describe a patient’s personal perception of the tinnitus sound:
Tonal Tinnitus: The perception of near-continuous sound (or overlapping sounds) with well-defined frequencies. The perceived volume of the tinnitus often fluctuates. Tonal tinnitus is generally associated with subjective tinnitus.
Pulsatile Tinnitus: The perception of pulsing sounds, often in-beat with the patient’s heartbeat. Pulsatile tinnitus is often associated with objective and somatic tinnitus.
Musical Tinnitus: The perception of music or singing, sometimes the same tune on a constant loop. Also known as Musical Ear Syndrome, Musical Tinnitus is very rare.


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