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Tinnitus (pronounced ti-ni-tis), or ringing in the ears, is the sensation of hearing ringing, buzzing, hissing, chirping, whistling, or other sounds.
Some instances of tinnitus are caused by infections or blockages in the ear, and the tinnitus can disappear once the underlying cause is treated. Constant noise in the head -- such as ringing in the ears -- rarely indicates a serious health problem, but it sure can be annoying. Almost everyone has had tinnitus for a short time after being exposed to extremely loud noise. Sound waves travel through the ear canal to the middle and inner ear, where hair cells in part of the cochlea help transform sound waves into electrical signals that then travel to the brain's auditory cortex via the auditory nerve.
Tinnitus can arise anywhere along the auditory pathway, from the outer ear through the middle and inner ear to the brain's auditory cortex, where it's thought to be encoded (in a sense, imprinted). Most tinnitus is "sensorineural," meaning that it's due to hearing loss at the cochlea or cochlear nerve level.
If you're often exposed to loud noises at work or at home, it's important to reduce the risk of hearing loss (or further hearing loss) by using protectors such as earplugs or earmuff-like or custom-fitted devices.
The Brain: "Ringing in the Ears" Actually Goes Much Deeper Than ThatResearch on tinnitus has shown that it's rooted in the very way we process and understand sound.
Clearly the auditory cortex is just an early stop on the journey that sound takes from the outside world to our awareness. Once signals travel from the ear to the auditory cortex, caudate, and putamen, they eventually make their way to regions of the brain that carry out more sophisticated sound information processing: connecting the sounds with memories, interpreting their meaning, giving them emotional significance. In fact, some people with tinnitus experience no difficulty hearing, and in a few cases they even become so acutely sensitive to sound (hyperacusis) that they must take steps to muffle or mask external noises.
But ringing in the ears that does not get better or go away is an ear condition called tinnitus.
For many, it's a ringing sound, while for others, it's whistling, buzzing, chirping, hissing, humming, roaring, or even shrieking. When hair cells are damaged — by loud noise or ototoxic drugs, for example — the circuits in the brain don't receive the signals they're expecting.


Things that cause hearing loss (and tinnitus) include loud noise, medications that damage the nerves in the ear (ototoxic drugs), impacted earwax, middle ear problems (such as infections and vascular tumors), and aging. Pulsatile tinnitus calls for a thorough evaluation by an otolaryngologist (commonly called an ear, nose, and throat specialist, or ENT) or neurotologist, especially if the noise is frequent or constant.
Masking devices, worn like hearing aids, generate low-level white noise (a high-pitched hiss, for example) that can reduce the perception of tinnitus and sometimes also produce residual inhibition — less noticeable tinnitus for a short time after the masker is turned off. Other treatments that have been studied for tinnitus include transcutaneous electrical stimulation of parts of the inner ear by way of electrodes placed on the skin or acupuncture needles, and stimulation of the brain using a powerful magnetic field (a technique called repetitive transcranial magnetic stimulation, or rTMS). Some were convinced it was caused by wind that got trapped inside the ear and swirled around endlessly, so they tried to liberate the wind by drilling a hole into the bones around the ear or using a silver tube to suck air out of the ear canal. Surveys show that between 5 and 15 percent of people say they have heard some kind of phantom noise for six months or more; some 1 to 3 percent say tinnitus lowers their quality of life. The vibrations cause nerve hairs in the inner ear to shiver, and that triggers electric signals that travel along the auditory nerve into the brain. Things may start to go awry when toxic drugs, loud noises, or even whiplash cause damage to the nerve hairs in the ears. The experience left him with partial hearing loss and a high-pitched ringing in his ears that plagued him for 40 years. It is often worse when background noise is low, so you may be most aware of it at night when you're trying to fall asleep in a quiet room. The noise causes permanent damage to the sound-sensitive cells of the cochlea, a spiral-shaped organ in the inner ear. Tinnitus can also be a symptom of Mnire's disease, a disorder of the balance mechanism in the inner ear.
She or he will also ask you to describe the noise you're hearing (including its pitch and sound quality, and whether it's constant or periodic, steady or pulsatile) and the times and places in which you hear it. Tinnitus, in other words, extends beyond the ear, beyond a hearing-specialized part of the brain, beyond even any single piece of neural real estate. To do so, they edited recordings of music, filtering out the frequencies of the ringing in the ears of their patients, who then listened to the filtered music an average of 12 hours per week.

Your clinician will review your medical history, your current and past exposure to noise, and any medications or supplements you're taking. These feedback controls allow us to sift through incoming sounds for the most important information, so that we are not overwhelmed by meaningless noise. In 2004 Louis Lowry, an ear-nose-and-throat doctor at Thomas Jefferson University in Philadelphia, discovered that the caudate and the putamen play an important role in tinnitus by studying an unusual patient—himself. The most common cause of tinnitus is hearing loss that occurs with aging, but it can also be caused by living or working around loud noises. The resulting electrical noise takes the form of tinnitus — a sound that is high-pitched if hearing loss is in the high-frequency range and low-pitched if it's in the low-frequency range.
A device is inserted in the ear to generate low-level noise and environmental sounds that match the pitch, volume, and quality of the patient's tinnitus.
Recent research suggests why: Tinnitus is a lot more complicated than just a ringing in the ears. As the brain’s feedback controls get rewired, the neurons end up in a self-sustaining loop, producing a constant ringing. The Roman writer Pliny the Elder suggested that earthworms boiled in goose grease be put in the ear.
There are a variety of causes of hearing loss besides congenital hearing loss, including ear infections, genetic disorders, illnesses that trigger hearing loss, head injuries, medications, and more.
Some children may develop hearing loss because of listening to loud music or other loud noises.

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