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Tinnitus is the sensation of hearing sounds, usually ringing, when no sound is actually present.

While tinnitus is most often associated with ringing, a buzzing, roaring, clicking or hissing sound may also be heard.

There are two forms of tinnitus, subjective and objective. Subjective tinnitus is the most common type and occurs when only you hear the sounds. Objective tinnitus happens when you and your doctor can both hear the sounds; this type is rare.

Tinnitus is thought of as a symptom of another condition rather than as a condition itself. Because of that, any number of issues can cause tinnitus. The most common cause of tinnitus is inner ear damage. If the small hair cells in your inner ear are damaged, they can “leak” random electrical impulses to your brain, causing it to hear sounds that are not there. Age-related hearing loss, exposure to loud noises and earwax blockage can all cause damage to the inner ear. Disorders such as Meniere’s disease, blood vessel disorders and temperomandibular joint (TMJ) disorder, head injury, high blood pressure and a number of antibiotics and other medications can also lead to tinnitus.

Since there is such a variety of issues that can cause tinnitus, the best way to treat the symptoms is to determine the cause.

The first thing your doctor will do is to order a series of hearing tests, such as speech recognition, pure-tone audiogram, tympanogram, acoustic reflex testing and optoacoustic emission testing. By running a series of hearing tests, your doctor will be able to determine where the gap in your hearing is. Determining this is instrumental in treating the underlying condition. To rule out a blood vessel disorder, your doctor will check your eyes, jaw, neck and arm movement and may even order imaging tests, such as a CT scan or an MRI. Your doctor may also go through some trial and error by changing your medication or removing any earwax, hoping these changes cause the symptoms to improve.

If the cause has not been determined, trying to decrease the noise to a manageable state is the next step. White noise machines help to cover up noise, especially while sleeping. Masking devices are worn in the ear and produce a low-level white noise that can also cover up the distraction. Tinnitus retraining devices are individually programmed with a specific tone to cover up the frequencies of the tinnitus symptoms you are experiencing. The retraining device’s goal is that over time, you will become accustomed to the tinnitus and the symptoms will no longer bother you.