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Tinnitus: Characteristics, Causes, Mechanisms, and Treatments Clin Neurol. 2009 March; 5(1): 11– 19. • Published online 2009 March 31. doi: 10.3988/jcn.2009.5.1.11. • PMCID: PMC2686891 Copyright © 2009 Korean Neurological Association • Byung In Han, MD, a Ho Won Lee, MD, b Tae You Kim, MD, c Jun Seong Lim, MD, d and Kyoung Sik Shin, MD e

Tinnitus: Characteristics, Causes, Mechanisms, and Treatments Clin Neurol. 2009 March; 5(1): 11–19. Published online 2009 March 31. doi: 10.3988/jcn.2009.5.1.11

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Page 1: Tinnitus: Characteristics, Causes, Mechanisms, and Treatments Clin Neurol. 2009 March; 5(1): 11–19. Published online 2009 March 31. doi: 10.3988/jcn.2009.5.1.11

Tinnitus: Characteristics, Causes, Mechanisms, and Treatments

•  Clin Neurol. 2009 March; 5(1): 11–19.• Published online 2009 March 31. doi: 

10.3988/jcn.2009.5.1.11.• PMCID: PMC2686891• Copyright © 2009 Korean Neurological 

Association• Byung In Han, MD,a Ho Won Lee, MD,b Tae You 

Kim, MD,c Jun Seong Lim, MD,d and Kyoung Sik Shin, MDe

Page 2: Tinnitus: Characteristics, Causes, Mechanisms, and Treatments Clin Neurol. 2009 March; 5(1): 11–19. Published online 2009 March 31. doi: 10.3988/jcn.2009.5.1.11

• Otologic causes – noise-induced hearing loss– Presbycusis– Otosclerosis– Otitis– impacted cerumen– sudden deafness–Meniere's disease

Page 3: Tinnitus: Characteristics, Causes, Mechanisms, and Treatments Clin Neurol. 2009 March; 5(1): 11–19. Published online 2009 March 31. doi: 10.3988/jcn.2009.5.1.11

• Neurologic causes include – head injury–  whiplash – multiple sclerosis– vestibular schwannoma (commonly called an 

acoustic neuroma)–  cerebellopontine-angle tumors.

Page 4: Tinnitus: Characteristics, Causes, Mechanisms, and Treatments Clin Neurol. 2009 March; 5(1): 11–19. Published online 2009 March 31. doi: 10.3988/jcn.2009.5.1.11

• Infectious causes include–  otitis media– sequelae of Lyme disease–  meningitis– syphilis

Page 5: Tinnitus: Characteristics, Causes, Mechanisms, and Treatments Clin Neurol. 2009 March; 5(1): 11–19. Published online 2009 March 31. doi: 10.3988/jcn.2009.5.1.11

•  Tinnitus is also a side effect of some oral medications– Salicylates– nonsteroidal anti-inflammatory drugs– aminoglycoside antibiotics– loop diuretics– chemotherapy agents (e.g., platins and 

vincristine). 

Page 6: Tinnitus: Characteristics, Causes, Mechanisms, and Treatments Clin Neurol. 2009 March; 5(1): 11–19. Published online 2009 March 31. doi: 10.3988/jcn.2009.5.1.11

• Temporomandibular-joint dysfunction– Clicking types of objective tinnitus can be caused 

by jaw joint misalignment (TMJ) problems or muscles of the ear or throat "twitching." 

• dental disorders

Page 7: Tinnitus: Characteristics, Causes, Mechanisms, and Treatments Clin Neurol. 2009 March; 5(1): 11–19. Published online 2009 March 31. doi: 10.3988/jcn.2009.5.1.11

– Pulsatile tinnitus is usually related to blood flow, either through normal or abnormal blood vessels near the ear. 

– pregnancy, anemia (lack of blood cells), overactive thyroid, or tumors involving blood vessels near the ear. 

– benign intracranial hypertension-an increase in the pressure of the fluid surrounding the brain.