What Causes Tinnitus? Most tinnitus comes from damage to the inner ear, specfically the cochlea (the snail like thing on the right). Tinnitus can also arise from damage to the nerve between the ear and brain (8th nerve, labelled 6, auditory nerve), much more rarely from injury to the brainstem (Lanska et al, 1987), and extremely rarely, to the brain itself. There are specific causes. Ear wax can rarely cause tinnitus. Other causes include middle ear infection or fluid, Meniere's disease, microvascular compression syndrome, and tumors of the 8th nerve. Patients with Meniere's disease often describe a low pitched tinnitus resembling a hiss or a roar. Pulsatile tinnitus (tinnitus that beats with your pulse) can be caused by aneurysms, increased pressure in the head (hydrocephalus), and hardening of the arteries. Anything that increases blood flow or turbulence such as hyperthyroidism, low blood viscosity (e.g. anemia), or tortuous blood vessels may cause pulstitle tinnitus. Vitamin B12 deficiency is common in tinnitus patients.
Loud noise is the leading cause of damage to the inner ear. Most patients with noise trauma describe a whistling tinnitus (Nicholas-Puel et al,. 2002) Advancing age may also be accompanied by inner ear damage and tinnitus. Many medications also can cause tinnitus (see list below). Generally this is thought to arise from their effect on the cochlea (inner ear).
Drugs that commonly cause or increase tinnitus
NSAIDS (motrin, naproxen, relafen, etc)
aspirin and other salicylates
Lasix and other "loop" diuretics
"mycin" antibiotics
quinine and related drugs
Chemotherapy such as cis-platin
Rarely, some of the SSRI antidepressants