Two main types of tinnitus:
Subjective tinnitus (95% of cases): Only you can hear the sound. It’s caused by issues in your auditory nerves, ear structures, or brain. This is the most common type.
Objective tinnitus (rare): A doctor can actually hear the sound when they listen with a stethoscope. This is usually caused by blood flow issues, muscle contractions, or middle ear bone conditions.
The vast majority of people with tinnitus have subjective tinnitus. The sound is real to you—but it’s generated by your own nervous system, not an external source.
What’s Actually Happening Inside Your Ear?
To understand tinnitus, you need to understand a little about how hearing works.
Sound waves travel through your ear canal and vibrate your eardrum. Those vibrations pass through tiny bones in your middle ear to your cochlea—a fluid-filled, snail-shaped structure in your inner ear.
Inside your cochlea, thousands of tiny hair cells convert those vibrations into electrical signals. Those signals travel along your auditory nerve to your brain, which interprets them as sound.
Here’s where tinnitus comes in.
When those hair cells are damaged—by loud noise, aging, medications, or other causes—they can send random electrical signals to your brain even when no sound is present. Your brain, confused by these signals, interprets them as a ringing, buzzing, or hissing sound.
It’s like a broken guitar string. Even if you’re not playing it, it might still vibrate and make noise.
