Last updated: June 15, 2023

Summarytoggle arrow icon

Tinnitus is a common condition in which sound (whistling, hissing, buzzing, ringing, pulsating) is perceived in the absence of an external source. It can be unilateral or bilateral, acute or chronic, and intermittent or constant. Tinnitus is not a specific disease but a symptom that can be connected to a wide variety of etiologies, most commonly conditions associated with hearing loss. Evaluation should include a detailed history of the tinnitus, as well as an ENT, neck, cardiac, and neurological examination. Patients should also undergo a complete audiological examination. Imaging is recommended for patients with unilateral tinnitus, asymmetric tinnitus, pulsatile tinnitus, and/or focal neurological deficits. If an underlying cause is identified, appropriate treatment should be initiated. However, most patients receive supportive therapy, which might include sound therapy (i.e., hearing aids, cochlear implants) and supportive counseling. The prognosis is favorable for individuals with acute tinnitus (∼ 80% recovery rate) but is significantly worse for those with chronic symptoms (∼ 25% recovery rate).

Epidemiologytoggle arrow icon

  • Prevalence:
    • Most people will experience tinnitus at some point in their lifetime.
    • ∼ 10–15% overall prevalence in the US adult population
    • Increases with age
    • More common in men and smokers
  • Associations: hearing loss, hyperacusis


Epidemiological data refers to the US, unless otherwise specified.

Etiologytoggle arrow icon

  • Tinnitus is a symptom, not a specific disease, and its presence can indicate an underlying abnormality.
  • Objective tinnitus; : tinnitus caused by sounds within by the body (e.g., carotid artery stenosis, stapedial myoclonus) that can be heard by an examiner
  • Subjective tinnitus; : tinnitus that is only heard by the affected individual; ; can have a variety of causes (e.g., otosclerosis, tumor, infections; , temporomandibular joint dysfunction)


Clinical featurestoggle arrow icon

  • Perceived sound without an external source (whistling, hissing, buzzing, ringing, pulsating, etc.)
  • Symptoms of an underlying disease may be present as well (e.g., hearing loss )


Diagnosticstoggle arrow icon


Treatmenttoggle arrow icon

  • After symptom onset, treatment should be started as early as possible to prevent the condition from becoming chronic.
  • Treat any underlying conditions.
  • Supportive treatment: counseling , cognitive behavioral therapy , sound therapy


Prognosistoggle arrow icon

In up to 80% of cases of acute tinnitus, symptom resolution occurs spontaneously or with treatment, whereas resolution occurs in only ∼ 25% of patients with chronic tinnitus.

Referencestoggle arrow icon

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  5. National Health and Nutrition Examination: Survey 2011-2012 Data Documentation, Codebook, and Frequencies: Audiometry. Updated: December 1, 2013. Accessed: July 27, 2017.
  6. Han BI, Lee HW, Kim TY, Lim JS, Shin KS. Tinnitus: characteristics, causes, mechanisms, and treatments. J Clin Neurol. 2009; 5 (1): p.11-19.doi: 10.3988/jcn.2009.5.1.11 . | Open in Read by QxMD
  7. Dinces EA, Deschler DG, Sullivan DJ. Etiology and Diagnosis of Tinnitus. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. Last updated: February 25, 2016. Accessed: July 27, 2017.
  8. Grapp M, Hutter E, Argstatter H , Plinkert PK, Bolay HV. Music therapy as an early intervention to prevent chronification of tinnitus. Int J Clin Exp Med. 2013; 6 (7): p.589-593.

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 Evidence-based content, created and peer-reviewed by physicians. Read the disclaimer