Adolescent Hearing Loss

Adolescent Hearing Loss and Development

Adolescent Hearing Loss. It is well recognized that hearing is critical to speech and language development, communication, and learning. Children with listening difficulties due to hearing loss or auditory processing problems continue to be an underidentified and underserved population.

The earlier hearing loss occurs in a child’s life, the more serious the effects on the child’s development. Similarly, the earlier the problem is identified and intervention has begun, the less serious the ultimate impact.

There are four major ways in which hearing loss affects children:

  1. It causes a delay in the development of receptive and expressive communication skills (speech and language).
  2. The language deficit causes learning problems that result in reduced academic achievement.
  3. Communication difficulties often lead to social isolation and poor self-concept.
  4. It may have an impact on vocational choices.

Hearing Loss – Adolescent Hearing Loss Specific Effects

Vocabulary & Adolescent Hearing Loss

  • Vocabulary develops more slowly in children who have hearing loss.
  • Children with hearing loss learn concrete words like cat, jump, five, and red more easily than abstract words like before, after, equal to, and jealous. They also have difficulty with function words like the, an, are, and a.
  • The gap between the vocabulary of children with normal hearing and those with hearing loss widens with age. Children with hearing loss do not catch up without intervention.
  • Children with hearing loss have difficulty understanding words with multiple meanings. For example, the word bank can mean the edge of a stream or a place where we put money.

Sentence Structure & Adolescent Hearing Loss

  • Children with hearing loss comprehend and produce shorter and simpler sentences than children with normal hearing.
  • Children with hearing loss often have difficulty understanding and writing complex sentences, such as those with relative clauses (“The teacher whom I have for math was sick today.”) or passive voice (“The ball was thrown by Mary.”)
  • Children with hearing loss often cannot hear word endings such as -s or -ed. This leads to misunderstandings and misuse of verb tense, pluralization, nonagreement of subject and verb, and possessives.

Speaking & Adolescent Hearing Loss

  • Children with hearing loss often cannot hear quiet speech sounds such as “s,” “sh,” “f,” “t,” and “k” and therefore do not include them in their speech. Thus, speech may be difficult to understand.
  • Children with hearing loss may not hear their own voices when they speak. They may speak too loudly or not loud enough. They may have a speaking pitch that is too high. They may sound like they are mumbling because of poor stress, poor inflection, or poor rate of speaking.

Academic Achievement & Adolescent Hearing Loss

  • Children with hearing loss have difficulty with all areas of academic achievement, especially reading and mathematical concepts.
  • Children with mild to moderate hearing losses, on average, achieve one to four grade levels lower than their peers with normal hearing, unless appropriate management occurs.
  • Children with severe to profound hearing loss usually achieve skills no higher than the third- or fourth-grade level, unless appropriate educational intervention occurs early.
  • The gap in academic achievement between children with normal hearing and those with hearing loss usually widens as they progress through school.
  • The level of achievement is related to parental involvement and the quantity, quality, and timing of the support services children receive.

Social Functioning & Adolescent Hearing Loss

  • Children with severe to profound hearing losses often report feeling isolated, without friends, and unhappy in school, particularly when their socialization with other children with hearing loss is limited.
  • These social problems appear to be more frequent in children with mild or moderate hearing losses than in those with a severe to profound loss.

What You Can Do About Adolescent Hearing Loss

Recent research indicates that children identified with a hearing loss who begin services early may be able to develop language (spoken and/or signed) on a par with their hearing peers. If a hearing loss is detected in your child, early family-centered intervention is recommended to promote language (speech and/or signed depending on family choices) and cognitive development. An audiologist, as part of an interdisciplinary team of professionals, will evaluate your child and suggest the most appropriate audiologic intervention program.

Source: ASHA.Org

5 Signs of Hearing Loss

Hearing loss is serious business. Unlike vision loss that can often be corrected with eyeglasses, once your hearing begins to fail, you can’t easily restore hearing to its original state.

That’s why it is strongly recommended you protect your hearing by using noise-reducing headphones, earphones, and earplugs and avoiding loud, persistent sounds.

If you are already experiencing hearing loss, it’s important to continue to protect your hearing and see an audiologist or hearing aid specialist. The Dr. Hear, California Hearing Center has helped many patients improve quality of life.

There are common signs of hearing loss. Today we’re looking at 5 symptoms of hearing loss to help you recognize hearing problems before they negatively impact your quality of life.

1. You Hear People Speaking But Don’t Understand the Words – Hearing Loss Your eyes and ears don’t lie. If you see people speaking and hear sounds coming from their mouths but can’t clearly understand what they are saying, you likely have hearing loss.

2. You Regularly Ask People to Repeat What They Just Said – Hearing Loss This one is closely related to the first hearing loss symptom. If you’re asking people to repeat their words, you may have hearing loss. Most people (besides teenagers) don’t mumble. If you can’t hear the words people are saying, your ears need help and learning to read lips is NOT the answer.

3. You Play the TV, Radio or Music Louder Than Necessary – Hearing Loss This one is easy to diagnose: when people enter a room where you’re watching TV or listening to music, do they immediately turn down the volume? If this sounds like a familiar situation, you may have a serious hearing loss. Increasing the volume may make it easier to hear, but it may be driving the people around you nuts. It’s time to call an audiologist for a hearing test.

READ: What to Expect in a Hearing Test

4. You No Longer Hear Dogs Bark, Birds Chirp or the Wind Blow – Hearing Loss Whether you live in a city or the countryside, our world is filled with constant and satisfying sounds. The roar of a distant crowd at a football game. The sound of rain on your rooftop. The wind blowing through the trees. These can all be immensely enjoyable sounds. Yet if you’re suffering from hearing loss, you may be missing more than you might imagine. A hearing test can help reveal how your hearing has changed over time.

5. You Miss Phone Calls or the Doorbell Ringing – Hearing Loss Hearing loss can lead to isolation as you avoid restaurants and other social settings where it may be difficult to hear. But if your hearing loss is severe, you may be missing one-on-one visits to your home simply because you can’t hear a friend knocking on your door or ringing the doorbell. And though you can set a cell phone to vibrate, hearing loss may be causing you to miss phone calls when your phone isn’t at your side.
Schedule a Hearing Test

Hearing loss can be treated. Don’t delay and miss out on conversations and the social events that make life enjoyable.

California Audiologist Dr. Robert Weissman offers the best hearing aids in California. A licensed audiologists Dr. Robert Weissman can diagnose hearing loss and recommend hearing aids or assistive listening devices that can immediately enhance your quality of life.

Understanding the Facts of Tinnitus

Tinnitus Facts

Do you (or a loved one) experience a ringing in your ears that no one else can hear? If so, you are not alone. You have tinnitus, an audiological and neurological condition experienced by nearly 45 million Americans.

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.

Millions of Americans experience tinnitus, often to a debilitating degree, making it one of the most common health conditions in the country. The U.S. Centers for Disease Control estimates that nearly 15% of the general public — over 45 million Americans — experience some form of tinnitus. Roughly 20 million people struggle with burdensome chronic tinnitus, while 2 million have extreme and debilitating cases.1

Tinnitus is not a disease in-and-of-itself, but rather a symptom of an underlying health issue. While tinnitus is a symptom of a wide range of conditions, it is most frequently the result of some level of hearing loss.

In general, there are two types of tinnitus:

  1. 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.
  2. 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.

There is currently no scientifically-validated cure for most types of tinnitus. There are, however, treatment options that can ease the perceived burden of tinnitus, allowing patients to live more comfortable, productive lives.  ATA is leading the charge in the ongoing search for a definitive tinnitus cure.

The word tinnitus is of Latin origin, meaning “to ring or tinkle.” Tinnitus has two different pronunciations, both of which are correct and interchangeable:

  • ti-NIGHT-us :: typically used by patients and laypeople
  • TINN-a-tus :: typically used by clinicians and researchers


1. Data derived from the 2011 – 2012 National Health and Nutrition Examination Survey, conducted by the U.S. Centers for Disease Control.

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Tinnitus Symptoms And You

Tinnitus Symptoms

While commonly referred to as “ringing in the ears,” tinnitus can actually manifest in a variety of different perceived sounds, both tonal and pulsing.

In almost all cases, tinnitus is a subjective noise, meaning that only the person who has tinnitus can hear it. People describe hearing different sounds: ringing, hissing, static, crickets, screeching, whooshing, roaring, pulsing, ocean waves, buzzing, dial tones, even music.

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.

There is some scientific evidence that a patient’s tonal perception of tinnitus is influenced by the etiology (the underlying cause) of their tinnitus. However, current science has not identified a definitive correlation.

Listen to Sample Tinnitus Sounds

ATA has compiled a playlist of the most common tinnitus sounds, to provide an example of what tinnitus patients hear on an everyday basis.  If you have tinnitus, you can use this playlist to find the sound that best matches your own condition. You can also share this resource with your primary care provider, audiologist, family, and friends, so they get a sense of the noise in your head.

Please Note: Turn down the volume on your speakers or headphones before playing any of the sound files. The recordings, like tinnitus itself, are can be quite loud and irritating.


Tinnitus Symptoms Sound 1:

Tinnitus Symptoms Sound 2:

Tinnitus Symptoms Sound 3:

Tinnitus Symptoms Sound 4:

Tinnitus Symptoms Sound 5:

Tinnitus Symptoms Sound 6:

Tinnitus Symptoms Sound 7:

Tinnitus Symptoms Sound 8:

Source: ATA.ORG

Tinnitus Related Conditions

Tinnitus Related Conditions

Tinnitus is affiliated with a range of comorbid conditions, including vestibular disorders, audiological problems, and behavioral health issues.

Tinnitus is a symptom of a wide range of underlying health issues. It is also a condition that often exists comorbidly (concurrently, at the same time) with other health maladies. Below is a list of the health issues most frequently associated with tinnitus, and most often reported as comorbid conditions by tinnitus patients.

The causal relationship between tinnitus and each comorbid condition is variable and complex. In some instances the comorbid condition is itself the primary cause of tinnitus. This is certainly true with hearing loss and Ménière’s Disease, in which tinnitus is one of several symptoms caused by the parent disorder.  In some situations tinnitus may exacerbate the comorbid condition, as is the case with hyperacusis.  And, in other instances, tinnitus and the comorbid condition have shared causality. This appears to be the case with behavioral health issues, which can be the product of burdensome tinnitus, but also a cause of it.

The following health conditions are commonly associated with tinnitus:

Hearing Loss

Hearing loss is the primary catalyst for tinnitus symptoms; it is common for patients to experience both conditions simultaneously. The prevalence of comorbid hearing loss and tinnitus fluctuate widely. One large research project stated that 56% of all tinnitus patients reported some hearing loss. In a 2014 survey of ATA’s membership, 39% of respondents said they experienced hearing loss.  However, many researchers and clinicians believe that subjective tinnitus cannot exist without some prior loss of hearing — even if such loss is not discernable by the patient. If true, the reported prevalence of hearing loss and tinnitus in conjuction is severely underreported.

Ménière’s Disease

Sometimes called endolymphatic hydrops, Ménière’s Disease is a vestibular disorder in the inner ear that can affect hearing and balance. Patients with Ménière’s often experience bouts of mild-to-severe vertigo, along with sporadic tinnitus. It is estimated that approximately .02% of the U.S. population (615,000 individuals) has Ménière’s.1 3% of  ATA’s membership reported being diagnosed with the condition.


Hyperacusis is an abnormal, extreme sensitivity to noise, including ordinary environmental sounds presented at a normal volume. Patients experiencing hyperacusis experience physical pain (as opposed to emotional annoyance) when exposed to sound.  Estimates for the prevalence of hyperacusis range from 7.7-15% of the population. 12% of ATA’s members report having hyperacusis symptoms.


Also known as selective sound sensitivity, misophonia is an abnormal negative emotional reaction to specific sounds. Patients with misophonia feel extreme anger, disgust, or fear toward select noises. They may often have similar reactions to particular visual stimuli. The prevalence of misophonia on the population level is unknown, but it is estimated that 4-5% of tinnitus patients experience some form of the condition. Less than 1% of ATA’s members self-identified as having misophonia.


Phonophobia is a fearful emotional reaction specific to loud sounds. The prevalence of phonophobia, both within the general population and the tinnitus population, is unknown.

Depression and Anxiety

Psychiatric issues can be both a contributing factor to burdensome tinnitus and a consequence of burdensome tinnitus. Tinnitus symptoms often generate feelings of despair and anxiety in many patients. Current estimates suggest that 48-78% of patients with severe tinnitus also experience depression, anxiety or some other behavioral disorder. 13% of ATA’s membership self-identified as being diagnosed with a mental health issue. At the same time, pre-existing behavioral conditions may make it more likely that the patient will experience tinnitus as a burdensome condition.   For example, one large population study posits that people with generalized anxiety disorder are nearly 7 times more likely to experience chronic, burdensome tinnitus.

Other Vestibular Conditions

The vestibular system, which manages balance and spatial orientation, is closely connected with the auditory system, which controls hearing functions. Several structures in the inner ear play key roles in both sensory systems. As such, damage to one system (as evidenced by tinnitus) is often mirrored by a correlated vestibular condition.


1. Meniere’s disease: identifying classic symptoms and current treatments

Tinnitus Demographics

Tinnitus Demographics

Millions of Americans experience tinnitus. While anyone can develop tinnitus, some populations have a higher risk of exposure due to age, occupational hazards, and/or recreational activities.

Over 45 million Americans struggle with tinnitus, making it one of the most common health conditions in the United States.

Each year, the U.S. Centers for Disease Control conducts its National Health and Nutritional Examinations Survey, a longitudinal study of the health of the American population. In the 2011-2012 Survey (the most recent year from which data is available) the CDC included several questions on tinnitus, to ascertain the full scope and severity of the condition on a population level. The survey discovered:

  • 15% of all survey respondents experienced some form of tinnitus
  • 67% of people reporting tinnitus had regular symptoms for over a year
  • 26% of people reporting tinnitus had constant or near constant tinnitus
  • 30% of people reporting tinnitus classified their condition as a “moderate” to “very big” problem in their life

Extrapolating these findings to the national population suggests that nearly 20 million people are dealing with burdensome tinnitus on a regular basis; and approximately 2 million people are struggling with severe, sometimes debilitating, tinnitus.

Tinnitus Demographic Trends

Tinnitus is primarily caused by environmental and behavioral factors, with noise exposure and hearing loss being the main catalysts for the condition. There are very few known genetic-based catalysts for tinnitus. However, for a variety of reasons, certain demographic groups appear to be more susceptible to both acute and chronic tinnitus on the population level.

The following data is derived from Shargorodsky, Curhan, and Farwell’s 2010 analysis, Characteristics of Tinnitus among U.S. Adults, originally published in the American Journal of Medicine.

Males get tinnitus more often than females

This disparity may be attributable to males being more represented in the workforce, particularly in loud professions such as manufacturing, construction, and military service. Men are also more likely to participate in high hearing-risk behavior, such as hunting and motorsports.

Tinnitus is more common in older populations

The prevalence of tinnitus grows as people get older, peaking for the age 60-69 cohort. The increase is probably due to both age-related hearing loss and accumulative noise-induced hearing loss. It is unclear why incidents of tinnitus appears to decrease in cohorts older than 69.

Caucasians are more likely to have tinnitus

For an unknown reason, white, non-hispanics report a higher prevalence of tinnitus than other racial and ethnic groups.

High-Risk Groups – Tinnitus Demographics

While anyone, at any time, can develop tinnitus, there are some groups that are more vulnerable to acquiring the condition. Below are some of the groups that are at particular risk of developing tinnitus.

Senior Citizens
The primary catalyst of tinnitus is hearing loss, and age-related hearing loss tends to accelerate after the age of 60. As such, seniors are particularly prone to developing tinnitus as they age.  Research suggests that roughly 30% of seniors experience tinnitus symptoms.

Active Military Personnel and Veterans
Tinnitus is a huge (and growing) problem for America’s military personnel. Exposure to gunfire, explosives and loud machinery puts active military personnel at a high risk of noise-induced hearing loss and subsequent tinnitus. The consequences of in-duty noise exposure can last a lifetime. Tinnitus is the leading service-related disability among U.S. veterans, with 9.7% of all vets receiving service-related disability compensation for the condition in 2012.

People Employed in Loud Workplace Environments
For nearly 30 years, noise-induced hearing loss has been one of the most prevalent occupational health problems in the United States. Workers involved in agriculture, mining, construction, manufacturing, and transportation are particularly at-risk because of their loud work environments; but tinnitus can be a significant problem in almost any workplace.  By some estimates, more than 125,000 workers have suffered permanent hearing loss since 2004.

Musicians and Music Lovers
Professional musicians, who spend their working life playing loud, amplified music are in particular danger of developing tinnitus. (Many famous musicians acknowledge they have the condition.) Music enthusiasts are also in jeopardy, as listening to loud music, whether at live concerts or via recording, can contribute to noise induced hearing loss.

Motorsports and Hunting Enthusiasts
Proximity and repeated exposure to loud engines and firearms make these activities particularly risky for future development of tinnitus symptoms.

People with a Prior Behavioral Health Issues
Patients with a history of depression, anxiety, and obsessive-compulsive disorder may be particularly prone to experiencing burdensome tinnitus. While these behavioral health issues do not cause tinnitus, per se, they do exacerbate symptoms.

Measuring Tinnitus

Tinnitus is generally a subjective condition, but there are clinical ways to measure its audiometric qualities and impact on the patient.

The first step in treating tinnitus is appropriately diagnosing and measuring tinnitus. Below are some of the tests hearing health professionals can perform to evaluate tinnitus.

Audiometric Evaluations for Hearing Loss and Tinnitus

Trained audiologists and other hearing health professionals have tools and clinical protocols to help evaluate and diagnose tinnitus.  Because tinnitus is so often caused by hearing loss, most audiologists will begin with a comprehensive audiological evaluation that  measures the patient’s overall hearing health. General hearing tests include:

Speech recognition test: A subjective measure of how well the patient hears and can repeat certain words. Sometimes called speech audiometry.

Pure tone audiogram: A subjective test that measures the patient’s hearing across multiple frequencies (measured in Hertz) and volumes (measured in decibels).

Tympanogram: An objective  test that measures the functioning of the middle ear, specifically the mobility of the tympanic membrane and the conduction bones.

Acoustic reflex testing: An objective test that measures the contraction of the middle ear muscles in response to loud sounds.

Otoacoustic emission testing: The use of very sensitive microphones to objectively measure the movement of hair cells within the middle ear.

It is important to determine the specific gaps in a tinnitus patient’s hearing, because this often correlates to the nature and quality of their particular tinnitus. (For instance, high-frequency hearing loss often corresponds with high-frequency tinnitus.) Moreover, specific hearing markers may inform different potential treatment options for tinnitus.

When evaluating tinnitus cases, hearing health professionals use a supplemental set of tests. While there is currently no way to objectively test for tinnitus, there are several protocols to measure the patient’s subjective perception of tinnitus sound, pitch, and volume. Specifically, the doctor may test:

Tinnitus sound matching: The presentation of common tinnitus sounds back to patients, to help them identify their specific perception of tinnitus. The health professional may adjust the pitch and layer multiple sounds to create an exact audio recreation of the the tinnitus.  Sound matching provides an important baseline for subsequent tinnitus management therapies, which are often customized for each patient.

Minimum masking level: The volume at which an external narrowband noise masks (or covers) the perception of tinnitus. Determining the minimum masking level provides an approximate measure of how loud a patient perceives his/her tinnitus and can be used in subsequent tinnitus masking and sound therapies.

Loudness discomfort level: The volume at which external sound becomes uncomfortable or painful for a tinnitus patient. This measurement informs the feasibility of sound therapy, masking, and hearing aids as potential tinnitus treatments. Determining loudness discomfort levels is particularly important for patients with hyperacusis, an extreme sensitivity to noise.

A hearing health professional may administer additional tests, depending on the patient’s specific symptoms, medical history, and/or attenuating risk factors.  In some extreme situations, an MRI (magnetic resonance imaging) may be appropriate for someone experiencing tinnitus; however, MRIs should only be administered in cases when independent clinical evaluation suggests specific (and rare) tinnitus etiologies.

Tests For Measuring Tinnitus Burden

Tinnitus doesn’t just impact hearing; it can cause a cascade of negative mental, cognitive, and physical consequences. The difference between tinnitus being a minor or major issue of the patients’ is less often related to how loud tinnitus is, but rather how the tinnitus impacts other facets of patients’ lives.

As such, clinicians and researchers have developed inventory tests to measure the subjective burden a patient experiences because of tinnitus. There are several varieties of these tests, but they all operate by quantifying the patient’s personal reaction to tinnitus:

  • Tinnitus Handicap Inventory
  • Tinnitus Reaction Questionnaire
  • Tinnitus Functional Index
  • Tinnitus Severity Index
  • Visual Analog Scales

Please refer to our Tinnitus Handicap Inventory (THI), which you can DOWNLOAD and use to evaluate your own relative tinnitus burden. Please note: this form is provided for general informational purposes only and should not be used for self-diagnosis or self-treatment. Dr. Robert Weissman recommends that you share your completed form with your her prior to taking any action.

Causes of Tinnitus

Tinnitus is a symptom associated with an array of health conditions. In most cases, tinnitus is the result of some form of hearing loss.

Tinnitus is not a disease in and of itself, but rather a symptom of some other underlying health condition. In most cases, tinnitus is a sensorineural reaction in the brain to damage in the ear and auditory system. While tinnitus is most often triggered by hearing loss, there are roughly 200 different health disorders that can generate tinnitus as a symptom. Below is a list of the most common catalysts for tinnitus.

Please note: Tinnitus, by itself, does not necessarily indicate any one of the items listed below. Patients experiencing tinnitus should see their physician or a hearing health professional for a full examination to diagnose the underlying cause of symptoms. In some cases, resolving the root cause will alleviate the perception of tinnitus.

Hearing Loss – Causes of Tinnitus

Sensorineural hearing loss is, by far, the most common cause of tinnitus. Some researchers believe that subjective tinnitus cannot exist without some prior loss of hearing. 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. 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. It also tends to accumulate over time, so even moderate sound exposure can sometimes lead to permanent hearing damage.

It is important to note that existing hearing loss is sometimes not directly observable by the patient, who may not perceive any lost frequencies. But this this does not mean that hearing damage has not been done. A trained audiologist or other hearing health professional can perform sensitive audiometric tests to precisely measure the true extent of hearing loss.

The exact biological process by which hearing loss leads to tinnitus is still being investigated by researchers. However, we do know that the sensory loss of certain sound frequencies leads to specific changes in how the brain processes sound. In short, as the brain receives less external stimuli around a specific frequency, it begins to adapt and change. Tinnitus may be the brain’s way of filling in the missing sound frequencies it no longer receives from the auditory system.

Obstructions in the Middle Ear – Causes of Tinnitus

Blockages in the ear canal can cause pressure to build up in the inner ear, affecting the operation of the ear drum. Moreover, objects directly touching the ear drum can irritate the organ and cause the perception of tinnitus symptoms. Common obstructions include:

  • Excessive ear wax (ceruminosis)
  • Head congestion
  • Loose hair from the ear canal
  • Dirt or foreign objects

In many cases, the removal of the blockage will alleviate tinnitus symptoms. However, in some situations, the blockage may have caused permanent damage that leads to chronic tinnitus.

Head and Neck Trauma – Causes of Tinnitus

Severe injury to the head or neck can cause nerve, blood flow, and muscle issues that result in the perception of tinnitus. Patients who ascribe their condition to head and neck trauma often report higher tinnitus volume and perceived burden, as well as greater variability in both sound, frequency, and location of their tinnitus.

Tinnitus related to head, neck, or dental issues is sometimes referred to as somatic tinnitus. (“Somatic” derives from the Greek somatikos, meaning “of the body.”)

Temporomandibular Joint Disorder – Causes Of Tinnitus

Another example of somatic tinnitus is that caused by temperomandibular joint disorder. The temporomandibular joint (TMJ) is where the lower jaw connects to the skull, and is located in front of the ears. Damage to the muscles, ligaments, or cartilage in the TMJ can lead to tinnitus symptoms. The TMJ is adjacent to the auditory system and shares some ligaments and nerve connections with structures in the middle ear.

Tinnitus patients with a TMJ disorder will experience pain in the face and/or jaw, limited ability to move the jaw, and regular popping sounds while chewing or talking.  A dentist, craniofacial surgeon, or other oral health professional can appropriately diagnose and often fix TMJ issues. In many scenarios, fixing the TMJ disorder will alleviate tinnitus symptoms.

Sinus Pressure and Barometric Trauma – Causes of Tinnitus

Nasal congestion from a severe cold, flu, or sinus infection can create abnormal pressure in the middle ear, impacting normal hearing and causing tinnitus symptoms.

Acute barotrauma, caused by extreme or rapid changes in air or water pressure, can also damage the middle and inner ear. Potential sources of barotrauma include:

  • Diving / Snorkeling / Scuba
  • Flying (only during extreme, abnormal elevation changes; normal commercial air travel is generally safe)
  • Concussive explosive blasts

Traumatic Brain Injury (TBI) – Causes of Tinnitus

Traumatic brain injury, caused by concussive shock, can damage the brain’s auditory processing areas and generate tinnitus symptoms. TBI is one of the major catalysts for tinnitus in military and veteran populations. Nearly 60% of all tinnitus cases diagnosed by the U.S. Veterans Administration are attributable to mild-to-severe traumatic brain injuries.

Ototoxic Drugs – Causes of Tinnitus

Tinnitus is a potential side-effect of many prescription medications. However, in most cases and for most drugs, tinnitus is an acute, short-lived side-effect; if the patient stops taking the medication, the tinnitus symptoms typically receed. However, there are some ototoxic drugs known to cause more permanent tinnitus symptoms. These include:

  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
  • Certain antibiotics
  • Certain cancer medications
  • Water pills and diuretics
  • Quinine-based medications

If you are worried about tinnitus as a side effect of your medications, please consult your subscribing physician or pharmacist. You should not stop taking any medication without first consulting with your healthcare provider. The risks of stopping a medication may far exceed any potential benefit.

Other Diseases & Medical Conditions – Causes of Tinnitus

  • Tinnitus is a reported symptom of the following medical conditions:
  • Metabolic Disorders: HypothyroidismHyperthyroidismAnemia
  • Autoimmune Disorders: Lyme DiseaseFibromyalgia
  • Blood Vessel Disorders: High Blood PressureAtherosclerosis
  • Psychiatric Disorders: DepressionAnxietyStress
  • Vestibular Disorders: Ménière’s Disease,Thoracic Outlet SyndromeOtosclerosis
  • Tumor-Related Disorders (very rare): Acoustic NeuromaVestibular Schwannoma, other tumorous growths

A person experiencing tinnitus should not assume that he/she has one of the medical conditions listed above. Only a trained healthcare provider can appropriately diagnose the underlying cause of tinnitus.

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Impact of Tinnitus

Tinnitus incurs significant personal, social, and financial costs, both for individual patients and for society at-large.
Tinnitus is a diverse condition that manifests in many forms; it can be acute or chronic, tonal or pulsatile, constant or irregular. As such, the impact and burden of tinnitus is relative to the individual patient’s experience. While the majority of people perceive tinnitus only as a mild distraction, still millions struggle with severe cases of tinnitus that significantly detract from their quality of life.

On the whole, tinnitus has huge negative costs, both in terms of human impact and economic impact. These costs are felt at the individual patient level and by the population at-large.

Tinnitus Impact on Humans
Tinnitus can be a debilitating condition, that negatively affects a patient’s overall health and social well-being. Even moderate cases can interfere with the ability to work and socialize. People with tinnitus often experience:

Frequent mood swings
Sleep disturbances
Irritability or frustration
Poor concentration
Pain (particularly when tinnitus is accompanied by hyperacusis)
In 2014, ATA conducted a survey of its membership, to evaluate how ATA members experience tinnitus. Over 1,100 people responded to the survey, providing perspective on how the condition affects their lives. Results of several relevant survey questions are included below.

On a scale of 1-10 (1=low; 10=high) how much does tinnitus impact your life on a daily basis?


What BEST DESCRIBES how tinnitus affects your day-to-day life?



Do you have any of the above health conditions?

Of course, the human impact of tinnitus extends beyond the patient. Family, friends, and coworkers may also be affected as they attempt to support someone with tinnitus. Loud ringing and a sensitivity to noise can make it difficult for tinnitus patients to socialize and communicate normally with others — even with spouses, children, and close friends. As such, supporters often have their own feelings of irritability, frustration, and confusion as they struggle to understand and help the tinnitus patient.

Tinnitus Impact on the Economy

The financial consequences of tinnitus are significant. Personal economic loss to an individual with tinnitus–including lost earnings, productivity, and health expenses–can be up to $30,000 annually. The cost to society as a whole has been estimated at upwards of $26 billion annually.

Some of the most accurate accounting of tinnitus monetary costs comes from the U.S. Veterans Administration. Through 2012, the VA awarded disability compensation for tinnitus to approximately 972,000 veterans. The annual aggregate cost of these disability payments is nearly $1.5 billion. The estimated costs for delivering tinnitus-related healthcare services to these patients is much higher.

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