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This is the most common type of tinnitus. It occurs when only the affected individual can hear the sound. It is usually caused by issues in the outer, middle, or inner ear. It may also be linked to problems with the auditory nerves or brain pathways. Subjective tinnitus is often related to exposure to loud noise, hearing loss, or ear infections. This is a rarer form of tinnitus where both the affected person and a healthcare provider can hear the sound during an examination. It is typically caused by blood vessel issues, muscle contractions, or a problem with the bones in the middle ear. In this type, the person hears rhythmic pulsing sounds, often in sync with their heartbeat. This type is usually related to blood flow changes near the ear or increased awareness of blood flow in the vessels. Causes may include high blood pressure, turbulent blood flow, or vascular disorders. This type is related to bodily movements and muscle contractions. Certain head or neck movements may change or worsen the tinnitus sounds. It is often associated with neck injuries or issues with the jaw (e.g., temporomandibular joint disorder, or TMJ). The most common symptom is a persistent ringing or buzzing sound in one or both ears. The sound can vary in pitch and maybe a high-pitched tone, a clicking, or a hissing sound. Whooshing or Humming, Hissing or Static Noise, Muffled Hearing or Ear Fullness, and Sensitivity to Loud Sounds (Hyperacusis).
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