Straightforward Information About Tinnitus
Not all tinnitus is the same. Understanding the different types can help you communicate more effectively with your doctor and may influence which management approaches are most appropriate for you.
The most fundamental distinction in tinnitus classification is between subjective and objective tinnitus.
Subjective tinnitus is by far the most common type, accounting for roughly 99% of all cases. Only the person experiencing it can hear the sound. It is typically caused by changes in the auditory pathway — from the cochlea in the inner ear to the auditory cortex in the brain. Most of the information on this site relates to subjective tinnitus.
Objective tinnitus is rare. In these cases, a clinician can actually hear or detect the sound using a stethoscope or specialized equipment. Objective tinnitus is usually caused by a physical source within the body, such as turbulent blood flow near the ear, muscle contractions, or a vascular abnormality. Because it has an identifiable physical source, objective tinnitus can sometimes be treated directly.
Tonal tinnitus sounds like a continuous, near-constant tone. It might be a single pitch (like a sustained note) or overlapping tones. This is what most people mean when they describe "ringing in the ears."
Non-tonal tinnitus includes sounds described as buzzing, humming, hissing, crackling, or rushing. These sounds are more diffuse and lack a clear musical pitch.
Pulsatile tinnitus deserves special mention because it follows a rhythmic pattern, usually in sync with the heartbeat. It is often a form of objective tinnitus and is investigated differently because it may point to a vascular condition that requires treatment.
Acute tinnitus is tinnitus that has been present for less than three to six months (definitions vary). Many cases of acute tinnitus resolve on their own, especially those triggered by a temporary event like a loud concert, ear infection, or medication side effect. See Can Tinnitus Go Away on Its Own?
Chronic tinnitus is generally defined as tinnitus lasting longer than six months. At this stage, spontaneous resolution becomes less likely, and management strategies become more important. Most people who seek help for tinnitus have the chronic form.
Somatic tinnitus is tinnitus that can be modulated — made louder, softer, or changed in pitch — by movements of the head, neck, jaw, or eyes. This suggests involvement of the somatosensory system (the nerves that carry touch and movement information). TMJ disorders are one common cause. If you notice that clenching your jaw or turning your head changes your tinnitus, mention this to your doctor, as it may open up additional treatment options.
Some people hear recognizable melodies, songs, or musical fragments rather than simple tones or noise. This is sometimes called musical ear syndrome or musical tinnitus. It is more common in older adults and in people with significant hearing loss. It is not a sign of a psychiatric disorder, though it can be distressing.