Subjective tinnitus

In the case of subjective tinnitus, only the patient perceives the sound. You, the subject, hear a buzzing or humming, but an examiner has no way of hearing what you hear. A doctor can, however, observe your brain's reaction to what you are experiencing through an imaging examination. Generally caused by hearing loss, subjective tinnitus can appear suddenly and last from three to twelve months. Symptoms can come and go and vary in intensity. Sometimes, the whistling, buzzing, rumbling, or clicking becomes permanent. Subjective tinnitus is generally not curable, but some treatments can reduce the intensity of the sound and help those affected live more comfortably with the symptoms.

Non-pulsatile/non-rhythmic tinnitus

The medical community also refers to subjective tinnitus as non-pulsatile or non-rhythmic tinnitus, as it has no connection to the cardiovascular system. In other words, the sound is not related to the heartbeat or the circulation of blood in the arteries. The second, rarer type of tinnitus, objective tinnitus, is caused by abnormalities in the cardiovascular system. With objective tinnitus, also known as pulsatile or rhythmic tinnitus, the patient hears a rhythmic sound that beats with the heart. Subjective/non-pulsatile/non-rhythmic tinnitus is thus contrasted with objective/pulsatile/rhythmic tinnitus.

Causes of subjective tinnitus

Subjective tinnitus, the most common type of tinnitus, accounts for more than 90% of cases. It can be caused by conditions of the outer, middle, or inner ear, or by problems affecting the auditory nerves or auditory pathways of the brain.

Hearing loss – Subjective tinnitus most often results from hearing loss or damage related to noise exposure, such as loud music or machinery. It is the auditory and neurological reaction, or overreaction, to this hearing loss that creates this phantom noise.

Auditory pathways – Subjective or non-rhythmic tinnitus can also be caused by problems affecting the auditory nerves or the area of the brain that interprets nerve signals as sounds (the auditory pathways).

Otosyphilis – A rare but treatable cause of subjective tinnitus is otosyphilis, related to neurosyphilis. Otosyphilis, or otologic syphilis, also called syphilitic labyrinthitis, affects the inner ear. Syphilis, a venereal disease that has been on the rise in recent years, is treated with antibiotics. Treating syphilis generally eliminates tinnitus.

A doctor or examiner cannot hear your subjective tinnitus. Most often, this non-pulsatile or non-rhythmic tinnitus begins with injury or hearing loss. Treatments for subjective tinnitus aim to improve the quality of life of those who suffer from it.