What are the causes of objective tinnitus?

Comprehensive Guide to Tinnitus: Types, Causes, and Treatments

According to the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery, tinnitus is the perception of noise in the ears, such as whistling, ringing, buzzing, or humming. The society classifies tinnitus into two primary categories based on their nature and diagnostic source.

1. Types of Tinnitus

• Subjective Tinnitus: The most common form, where sounds are heard only by the patient.

• Objective Tinnitus: A rare form where the sounds are audible to others or can be measured by doctors using

•  specialized equipment. This type usually has a physical, internal source.

2. Causes of Objective Tinnitus

Objective tinnitus is typically caused by actual physical sounds produced within the body, such as:

• Vascular Disorders: The sound of blood flowing through narrowed vessels, heart valve diseases, atherosclerosis, or aneurysms. These symptoms often worsen in patients with uncontrolled high blood pressure and may be heard in both ears.

• Muscular Issues: Clicking or popping sounds caused by involuntary muscle spasms (myoclonus) in the middle ear, the palate, or tension in the jaw muscles.

• Middle Ear Tumors: Vascular-rich tumors, such as "Glomus tumors" (carotid body tumors). Because they are located near sensitive ear structures, they typically cause tinnitus in only one ear.

• Vascular Malformations: Abnormalities in the "dura mater" (the membrane surrounding the brain). If these are close to the ear, the blood flow may become audible.

3. Diagnostic Methods

To identify the exact source of the sound, specialists use several diagnostic tools:

• Clinical Examination: Using a stethoscope, specialized microphones, or an otoscope.

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• Radiological Imaging: Computerized Tomography (CT), Magnetic Resonance Imaging (MRI), and ultrasounds of the carotid arteries.

• Visual Observation: Specialists can sometimes see physical manifestations, such as the eardrum or palate twitching in cases of muscular spasms.

4. Treatment and Recovery

The advantage of objective tinnitus is that treating the underlying cause often eliminates the sound entirely. Options include:

• Surgery: To correct vascular disorders or arterial narrowing.

• Medication: To relieve muscle spasms and tremors.

• Corrective Therapy: Addressing blockages in the cervical vertebrae (neck) or correcting jaw misalignments.

Summary: Once the physical underlying cause is identified and treated, objective tinnitus usually disappears completely.