Table 1.

Causes of tinnitus (according to Lockwood)⁴

TYPE	CAUSES
Subjective tinnitus
Otologic	Noise-induced hearing loss, presbycusis, otosclerosis, otitis, impacted cerumen, sudden deafness, Ménière’s disease, and other causes of hearing loss
Neurologic	Head injury, whiplash, multiple sclerosis, vestibular schwannoma (commonly called an acoustic neuroma) or other cerebellar-pontine-angle tumors
Infectious	Otitis media and sequelae of Lyme disease, meningitis, syphilis, and other infectious or inflammatory processes that affect hearing
Drug-related	Common side effect of many drugs, such as salicylates, nonsteroidal antiinflammatory drugs, aminoglycoside antibiotics, loop diuretics, and chemotherapy agents (eg. platins and vincristine)
Other	Temporomandibular-joint dysfunction and other dental disorders
Objective Tinnitus
Pulsatile	Carotid stenosis, arteriovenous malformations, other vascular anomalies, vascular tumors (eg., of the glomus jugulare), valvular heart disease (usually aortic stenosis), states of high cardiac output (anemia and drug-induced high output), and other conditions causing turbulent blood flow
Muscular or anatomical	Palatal myoclonus, spasm of stapedius or tensor tympani muscle, patulous eustachian tube
Spontaneous	Spontaneous otoacoustic emissions

Note: Reproduced with permission from Lockwood AH, Salvi RJ, Burkard RF. Tinnitus. N Engl J Med. 2002;347(12):904–910. © 2002 The New England Journal of Medicine.