Tinnitus and Hyperacusis

In many cases, the etiology of tinnitus and hyperacusis remains unknown. However, hearing loss of any etiology increases the likelihood of tinnitus and can also contribute to some forms of hyperacusis.


Causes and risk factors for objective tinnitus may include

  • anemia;
  • arterial bruit;
  • arteriovenous malformation;
  • atherosclerotic carotid arteries;
  • benign intracranial hypertension;
  • changes in blood flow in the vessels near the ear due to
    • pregnancy,
    • strenuous exercise, and/or
    • thyrotoxicosis;
  • Eustachian tube dysfunction;
  • glomus tumors;
  • head or neck trauma or injury;
  • microvascular compression of the vestibulocochlear nerve (VIII);
  • middle ear muscle spasms; and
  • palatomyoclonus (contraction of soft palate muscles).

Causes and risk factors for subjective tinnitus may include

  • acoustic trauma;
  • barotrauma;
  • cerumen blockage;
  • ear/sinus infection;
  • endocrine disorder;
  • hearing loss;
  • hormonal changes;
  • medication side effects;
  • Ménière's disease;
  • metabolic disorder;
  • migraine headache;
  • mineral and vitamin deficiencies;
  • multiple sclerosis;
  • noise-induced hearing loss (NIHL);
  • otitis media;
  • otosclerosis;
  • presbycusis;
  • temporomandibular joint (TMJ) disorder;
  • traumatic brain injury (TBI);
  • tumors (e.g., vestibular schwannoma, meningioma);
  • viral infections of the inner ear; and
  • whiplash.


Causes and risk factors for hyperacusis may include

  • autoimmune disorders;
  • endocrine disorders;
  • fibromyalgia;
  • head or neck trauma or injury;
  • Lyme disease;
  • medication side effects and withdrawal symptoms;
  • Ménière's disease;
  • metabolic disorders;
  • migraine headache;
  • neurologic conditions;
  • noise exposure and acoustic trauma;
  • ototoxins;
  • perilymph fistula;
  • PTSD;
  • sudden sensorineural hearing loss;
  • superior canal dehiscence;
  • TMJ disorder;
  • TBI;
  • viral infections of the inner ear or facial nerve; and
  • Williams syndrome.

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