​Subjective Tinnitus

Subjective tinnitus is a form of tinnitus in which the perceived sound cannot be heard by anyone else and has no external source. It is the most common type of tinnitus, accounting for 95-98% of all tinnitus cases. Unlike objective tinnitus, where the sound can be measured or heard by an external observer (often a healthcare provider), subjective tinnitus is entirely internal to the individual experiencing it.

Causes of Subjective Tinnitus

The causes of subjective tinnitus are varied and can be linked to a range of underlying conditions or triggers:

Auditory Damage

Exposure to loud noises, either as a one-time event or over an extended period, can damage the hair cells in the cochlea, leading to tinnitus.

Hearing Loss

Age-related hearing loss or presbycusis often comes with tinnitus as a secondary symptom.

Ototoxic Medications

Some medications are toxic to the auditory system and can induce tinnitus. These include certain antibiotics, diuretics, and high doses of aspirin.

Earwax Blockage

Excessive earwax can cause hearing loss or irritate the eardrum, leading to tinnitus.

Medical Conditions

Conditions like hypertension, diabetes, or disorders of the thyroid gland can be associated with tinnitus.

Psychological Factors

Stress and anxiety are often correlated with worsening tinnitus symptoms, though the exact relationship is still under study.

Unknown Causes

In some cases, the cause of tinnitus remains unidentified despite extensive evaluation.

Diagnosing subjective tinnitus involves a detailed medical history, audiometric tests, and sometimes imaging studies like MRI or CT scans to rule out other conditions. An Ear, Nose, and Throat (ENT) specialist or audiologist typically conducts these evaluations.

Treatment and Management

Because subjective tinnitus often lacks a measurable external cause, treatment usually focuses on management rather than a cure.

Sound Therapy

Using external noise to mask the internal sound can offer temporary relief. This can include white noise machines, hearing aids with tinnitus masking features, or even a fan running in the background.

Cognitive Behavioral Therapy (CBT)

This psychological approach aims to change the way a person thinks about their tinnitus to reduce stress and the psychological impact of the condition.


While there is no medication to cure tinnitus, some drugs may be prescribed off-label to alleviate symptoms. Antidepressants and antianxiety medications are sometimes used to manage the psychological impacts of tinnitus.

Lifestyle Changes

Stress management, sleep hygiene, and avoiding triggers like caffeine and loud noise can be part of a comprehensive management strategy.

Support and Counseling

Ongoing educational and emotional support can help individuals better understand and cope with tinnitus.

Hearing Aids

For individuals who have both hearing loss and tinnitus, hearing aids can sometimes improve tinnitus symptoms by improving hearing and providing additional stimulation to the auditory system.

Subjective Tinnitus – Most Common Form Of Tinnitus

Subjective tinnitus is a condition in which an individual perceives sound that has no external source and cannot be heard by others. It is the most common form of tinnitus and can be caused by a variety of factors, from auditory damage and hearing loss to ototoxic medications and underlying medical conditions.

Diagnosis typically involves a thorough evaluation by a healthcare provider, and treatment focuses on symptom management rather than a cure. A range of treatments, from sound therapy and cognitive behavioral therapy to medications and lifestyle changes, can help manage the symptoms and improve the quality of life for individuals with subjective tinnitus.

Consultation with healthcare providers for diagnosis and a tailored treatment plan is crucial for effective management.