Tinnitus also always being described as ringing sound in the ear. The causes of the tinnitus could be due to the ears itself or due to other systemic causes. In hyper dynamic situation where the blood flow is increase especially during pregnancy and hyperthyrodism, patient might complaining of hearing their own blood flow which might be described as water or wind blowing sound. It is not a true tinnitus and the condition will resolved once the systemic problem is treated.
Other cause of tinnitus might be due to external ear condition where impacted wax or blocked ear canal which might cause tinnitus. Besides that, middle ear effusion or otitis media might be also being described as having tinnitus. Eustachian tube dysfunction and blockage which might later cause middle ear effusion are some of the cause of tinnitus. The commonest cause of tinnitus would be due to sensorineural hearing loss where adaptation and compensation mechanism is blamed to cause the tinnitus to occur. Rarely, middle ear tumour such as glomus tumour and intracranial tumour such as acoustic neuroma are the causes of the tinnitus. Abnormal vessel in the middle ear, skull base and intracranial especially compressing of the vestibulocochlear nerve might also cause tinnitus.
Complete examination of the ear, hearing system and vestibular system are important to assess the system involved and to help in localising the sites of the problem.
Treatment is depend of the cause, eradication of the cause might eradicate the tinnitus. Tinnitus cause by the hearing loss would be hard to be treated. Hearing aid in improving the hearing might reduced the tinnitus, laser therapy and adaptation therapy might be helpful in certain cases. Operation is reserved for any growth or tumour which is amendable with surgical excision.