Tinnitus: Our Current Understanding


  •   Kamlesh Kumar Dubey


Tinnitus is still very much a mystery with despite all the advances in science. Many theories and hypothesis proposed to explain the origin but still it is poorly understood. Still most common acceptation associated with tinnitus is that it is a type of phantom phenomenon. This article aimed to review tinnitus and our current understanding on definition, types, probable pathophysiological mechanisms, associated trigger factors and current available treatment options.

Keywords: Tinnitus, Pathophysiology, Classification, Treatment


Baguley D, Mcferran D, Hall D. 2013. Tinnitus. Lancet 382, 1600-1602.

Kochkin S, Tyler R, Born J. The Prevalence of Tinnitus in the United States and the Self-Reported Efficacy of Various Treatments. Hearing Review. 2011; 18(12): 10–26.

Nondahl DM, Cruickshanks KJ, Wiley TL, et al. Prevalence and 5-year Incidence of Tinnitus among Older Adults: The Epidemiology of Hearing Loss Study. J Am Acad Audiol. 2002; 13: 323–331.

Shargorodsky J, Curhan GC, Farwell WR. Prevalence and characteristics of tinnitus among US adults. Am J Med. 2010; 123(8): 711–718.

Park RJ, Moon JD. Prevalence and risk factors of tinnitus: the Korean National Health and Nutrition Examination Survey 2010–2011, a cross-sectional study. Clin Otolaryngol. 2014; 39(2): 89–94.

Jalessi M, Farhadi M, Asghari A, et al. Tinnitus: an epidemiologic study in Iranian population. Acta Med Iran. 2013; 51(12): 886–891.

Sindhusake D, Mitchell P, Newall P, et al. Prevalence and characteristics of tinnitus in older adults: The Blue Mountains Hearing Study. Int J Audiol. 2003b; 2003; 42: 289–294.

James A. Henry. Progressive Tinnitus Management: Clinical Handbook for Audiologists. 2010.

Dietrich S. Earliest historical reference of tinnitus is controversial. J Laryngol Otol. 2004 Jul ;118(7): 487-8.



Dauman R., & Tyler R. S. (1992). Some considerations on the classification of tinnitus. In Aran J.-M., & Dauman R. (Eds.), Proceedings of the Fourth International Tinnitus Seminar, Bordeaux, France (pp. 225–229). Amsterdam, the Netherlands: Kugler.

Schlee, W., Weisz, N., Bertrand, O., Hartmann, T., and Elbert, T. (2008). Using auditory steady state responses to outline the functional connectivity in the tinnitus brain.

Tunkel, D. E., Bauer, C. A., Sun, G. H., Rosenfeld, R. M., Chandrasekhar, S. S., Cunningham, E. R., et al. (2014). Clinical practice guideline: tinnitus. Otolaryngol. Head Neck Surg. 151, S1–S40.

Michiels, S., Ganz Sanchez, T., Oron, Y., Gilles, A., Haider, H. F., Erlandsson, S., et al. (2018). Diagnostic criteria for somatosensory tinnitus: a delphi process and face-to-face meeting to establish consensus. Trends Hear. 22:2331216518796403.

Henry, J. A., Roberts, L. E., Caspary, D. M., Theodoroff, S. M., and Salvi, R. J. (2014). Underlying mechanisms of tinnitus: review and clinical implications. J. Am. Acad. Audiol. 25, 5–22; quiz 126.

Byung In Han, Ho Won Lee, Tae You Kim, Jun Seong Li, Kyoung Sik Shin. Tinnitus: Characteristics, Causes, mechanisms, Treatments. J Clin Neurol. 2009 Mar; 5(1): 11-19.

Kemp DT. Physiologically active cochlear micromechanics--one source of tinnitus. Ciba Found Symp. 1981; 85: 54–81.

Kiang NY, Moxon EC, Levine RA. Auditory-nerve activity in cats with normal and abnormal cochleas. In: Sensorineural hearing loss. Ciba Found Symp. 1970: 241–273.

Baguley DM. Mechanisms of tinnitus. Br Med Bull. 2002; 63: 195–212.



Nuttal AL, Meikle MB, Trune DR. Peripheral process involved in tinnitus. In: Snow JB, editor. Tinnitus: theory and management. Ontario: BC Decker; 2004. pp. 52–68.


Eric Hofmann, Robert Behr, Tobias Neumann-Hafelin, Konrad Schwager. Pulsatile Tinnitus. Dtsch Arztebl Int. 2013 Jun; 110(26): 451-458.

Hall, D. A., Fackrell, K., Li, A. B., Thavayogan, R., Smith, S., Kennedy. (2018). A narrative synthesis of research evidence for tinnitus-related complaints as reported by patients and their significant others. Health and Quality of Life Outcomes, 16(1), 61.

Pierce, K. J., Kallogjeri, D., Piccirillo, J. F., Garcia, K. S., Nicklaus, J. E., & Burton, H. (2012). Effects of severe bothersome tinnitus on cognitive function measured with standardized tests. Journal of Clinical and Experimental Neuropsychology, 34(2), 126–134.

Nondahl, D. M., Cruickshanks, K. J., Dalton, D. S., Klein, B. E., Klein, R., Schubert, C. R., & Wiley, T. L. (2007). The impact of tinnitus on quality of life in older adults. Journal of the American Academy of Audiology, 18(3), 257–266.

Langguth, B., & Landgrebe, M. (2011). Tinnitus and depression. Textbook of Tinnitus, 2975(May), 493–498.

Emily J Watts, Kathryn Fackrell, Sandra Smith, Jacqueline Sheldrake, Haula Haider, Derek J Hoare. Why Is Tinnitus a Problem? A qualitative Analysis of Problems Reported by Tinnitus Patients. Trends in Hearing. Volume 22: 1-10.

Dongmei Tang, Huawei Li, Lin Chen. Advances in Understanding, Diagnosis and Treatment of Tinnitus. Adv Exp Med Biol. 2019; 1130: 109-128.

Byung In Han, Ho Won Lee, Tae You Kim, Jun Seong Lim, Kyoung Sik Shin. Tinnitus: Characteristics, Causes, Mechanisms, and Treatments. J Clin Neurol 2009; 5: 11-19.

Henry JA, Zaugg TL, Myers PM, et al. Progressive Tinnitus Management: Clinical Handbook for Audiologists. San Diego, Calif: Plural Publishing; 2010.

Tyler RS, ed. Tinnitus Treatment: Clinical Protocols. New York: Thieme Medical Publishers, Inc; 2005.

Vernon JA. Tinnitus Treatment and Relief. Needham Heights, Mass: Allyn & Bacon; 1998.

Jastreboff PJ, Hazell JWP. Tinnitus Retraining Therapy: Implementing the Neurophysiological Model. New York: Cambridge University Press; 2004.

Magdalena Sereda, Jun Xia, Amr Al Refaie, Deborah A Hall, Derek J Hoare. Cochrane Database Syst Review. 2018 Dec 2018(120.

Thomas Fuller, Rilana Cima, Berthold Langguth, Birgit Mazurek, Johan WS Vlaeyen, Derek J Hoare. Cognitive Behavioural Therapy for Tinnitus. Cochrane Database Syst Rev. 2020 Jan; 2020(1).

Department of Health. Provision of Services for Adults with Tinnitus. A Good Practice Guide. London: Central Office of Information, 2009.

Tunkel DE, Bauer CA, Sun GH, Rosenfeld RM, Chandrasekhar SS, Cunningham ER Jr, et al. Clinical practice guideline: tinnitus executive summary. Otolaryngology‐‐Head and Neck Surgery 2014; 151(4): 533‐41.

Maggie Kuhn, Selena E, Heman Ackah, Jamil A Shaikh, Pamela C Roehm. Sudden Sensorineural Hearing Loss: A review of Diagnosis, Treatment, and Prognosis.

Jayakumar A, et al. Treatment of idiopathic sudden sensorineural hearing loss. Acta Otolaryngol. 2006; 126: 708-713.

Sismanis A. Pulsatile tinnitus. Otolaryngol Clin North Am. 2003; 36: 389-402.

Lockwood AH, Burkard RF, Salvi RJ. Imaging tinnitus. In: Snow JB, ed. Tinnitus: Theory and Management. Lewiston, NY: BC Decker Inc; 2004: 253-264.

Charlotte Agrup, Michael Gleeson, Peter Rudge. The inner ear and neurologist. J Neurol Neurosurg Psychiatry. 2007 Feb; 78(20): 114-122.

Massimo Ralli, Vittorio D’Aguanno, et al. Audiovestibular Symptoms in Systemic Autoimmune Diseases. Journal of Immunology Research. 19 Aug 2018.

Traian S Ataman. Cholesteatoma of the Tympanic Part of the Temporal Bone. International Tinnitus Journal, Vol. 13, No. 1, 45-48 (2007).

Seidu A Richard. Li Qiang, Zhi Gang Lan, Yuekang Zhang, Chao You. A giant cholesteatoma of the mastoid extending into foramen magnum: A case report and review of literature.

Djalilian, Hamid R. Symptoms: Hearing Loss and Facial Paralysis. The Hearing Journal. May 2014, Volume 67, Issue 5, p. 11-14.

Watanabe I, Kumagami H, Tsuda Y. An Abnormal Phenomenon in the Course of Facial Nerve Paralysis and its Audiological Significance. ORL 1974; 36: 217-226.

Xiang Huang, Jian Xu, Lian-Fu Zhou, Rong Zhang, et al. Clinical features of intracranial vestibular schwannoma. Oncology Letters. January 2013, Volume 5 Issue 1.

Angelica A Nunez, Luis R Ramos-Duran, Albert C Cuetter. Glomus Jugulare Presenting isolated facial Nerve Palsy. Surgery Research and Practice. Volume 2014, Article ID 514086, 3 pages.

Newman CW, Sandridge SA, Jacobson GP. Psychometric adequacy of the Tinnitus Handicap Inventory (THI) for evaluating treatment outcome. J Am Acad Audiol. 1998; 9:153-160.

Abby McCormack, Mark Edmondson-Jones, Heather Fortnum, et al. Investigating the association between tinnitus severity and symptoms of depression and anxiety, while controlling for neuroticism, in a large middle-aged UK population.

House JW, Brackmann DE. Tinnitus: surgical treatment. Ciba Foundation Symposium 1981; 85: 204–216.

Teo Soleymani, Peter Pieton, Patrick Pezeshkian, Patrick Miller, et al. Surgical approaches to tinnitus treatment: A review and novel approaches. Surgical Neurology International. 2011; 2-154.

David J Eisenman, Taylor B Teplitzky. Neuroimaging Clinics. Volume 26, Issue 2, P279-288, May 1, 2016.

Paul Van de Heyning, Dirk de Ridder, Karolien Van der Kelen, et al. Surgical treatment of tinnitus. Audiological Medicine. 2004; 2: 83-87.

Park J, White AR, Ernst E. Efficacy of acupuncture as a treatment for tinnitus: A systematic review. Archives of Otolaryngology— Head & Neck Surgery 2000; 126(4): 489–492.

Dobie RA. A review of randomized clinical trials in tinnitus. Laryngoscope 1999;109(8):1202–1211.

Smith JA, Mennemeier M, Bartel T, Chelette KC, Kimbrell T, Triggs W, Dornhoffer JL. Repetitive transcranial magnetic stimulation for tinnitus: a pilot study. Laryngoscope 2007; 117(3): 529–534.


How to Cite
Dubey, K. K. (2021). Tinnitus: Our Current Understanding. European Journal of Clinical Medicine, 2(3), 1–4. https://doi.org/10.24018/clinicmed.2021.2.3.26