Understanding the Two Types of Tinnitus

Tinnitus is more commonly referred to as ringing in the ears. To be clear though, it doesn't have to be ringing. Any perception of a sound that isn't there, (that doesn't have an actual external source), can be defined as tinnitus such as clicking, tapping, ringing, buzzing, or whistling. It's basically a phantom noise that can be annoyingly persistent. Tinnitus is not considered a disease in and of itself but rather a symptom of another condition. Hearing loss is a common condition resulting in tinnitus.

Prevalence 

Tinnitus can occur in one or both ears and in individuals of all ages, gender, and race. Many individuals experience brief periods of tinnitus that spontaneously resolve at some point in their life. Additionally, according to some sources as many as 1 in 5 people experience tinnitus for which they seek treatment, of those, another 1 in 5 reports that their tinnitus is more than just a nuisance but causes serious disruption to their lives.

types of tinnitus
Verywell / Gary Ferster

Types 

Most cases of tinnitus are cases of subjective tinnitus. This consists of sounds that are heard in the head or ears and are perceived only by the patient, they cannot be heard by anyone else. Another type of tinnitus, called objective tinnitus is very rare. In the case of objective tinnitus, persistent noises in the ear or head are heard by both the patient and can be audible to other people. These noises are usually produced by the body, for example, the circulatory system. This is also sometimes called pulsatile tinnitus.

Many conditions are associated with tinnitus include:

Other conditions, not of the auditory system, may also cause, worsen or somehow contribute to the development of tinnitus including TMJ, depression, anxiety, migraines, and insomnia. Additionally, some sources say that lifestyle choices such as smoking can contribute to tinnitus, while caffeine intake may lower the risk of developing tinnitus for some people.

About Tinnitus

The physiology of tinnitus is not well understood but recent studies suggest that many parts of the brain, in addition to almost the entire auditory cortex, are involved in tinnitus which is not associated with the usual interpretation of sounds. Researchers in this particular study concluded that the many regions of the brain involved making tinnitus particularly hard to treat.

There is no specific diagnosis for tinnitus as it cannot easily or routinely be measured. Doctors rely on the patient's report of symptoms.

There is no cure for tinnitus, but many people experience improvement or cessation of tinnitus after a period of time. If an underlying cause of tinnitus can be found that treatment has a much better chance of being successful. Some therapies aim to help individuals better cope with tinnitus rather than to cure it. Treatments for tinnitus for which an underlying cause can not be found or cured include:

  • the use of hearing aids to treat hearing loss
  • Sound therapy
  • Cognitive behavioral therapy
  • Counseling

Experts recommend against the following treatments for tinnitus: dietary supplements including vitamins, gingko biloba, melatonin, or zinc. Other treatments such as acupuncture and transcranial magnetic stimulation have not been studied enough to determine if they are effective or not.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Atik A. Pathophysiology and treatment of tinnitus: an elusive disease. Indian J Otolaryngol Head Neck Surg. 2014 Jan;66(Suppl 1):1-5. doi: 10.1007/s12070-011-0374-8.

  2. Dawes P, Cruickshanks KJ, Marsden A, Moore DR, Munro KJ. Relationship Between Diet, Tinnitus, and Hearing DifficultiesEar Hear. 2020;41(2):289-299. doi:10.1097/AUD.0000000000000765

  3. Sedley W, Gander PE, Kumar S, et al. Intracranial Mapping of a Cortical Tinnitus System using Residual InhibitionCurr Biol. 2015;25(9):1208-1214. doi:10.1016/j.cub.2015.02.075

  4. Tunkel DE, Bauer CA, Sun GH, et al. Clinical practice guideline: tinnitus executive summaryOtolaryngol Head Neck Surg. 2014;151(4):533-541. doi:10.1177/0194599814547475

Additional Reading
  • American Academy of Otolaryngology - Head and Neck Surgery. Tinnitus. ​

  • American Speech-Language-Hearing Association. Tinnitus.

  • American Tinnitus Association. About Tinnitus.

Kristin Hayes

By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.