Article from Bottomline Health by Thomas Balkany, MD, Chairman emeritus of the department of otolaryngology at the University of Medicine Miller School of Medicine.

Tinnitus is commonly referred to as “ringing in the ears”can also sound like whooshing, popping,buzzing,humming, clicking or musical melodies.  48 million Americans are affected .  For some suffers, the condition is caused by physical conditions.

Subjective Tinnitus accounts for more than 95% of all cases. The main cause is damaged cells in the cochlea, the spiral-shaped structure in the inner ear that converts external sound waves into electrochemical signals that you “hear” in the brain.  These cells can produce false signals that the brain interprets as sounds. 

Cell damage within the inner ear is usually due to long-term noise exposure or age-related hearing loss. Sometimes the cause may be due to buildup of earwax.  Tinnitus can also result from long-term use of aspirin or other medications , such as chemotherapy drugs or diuretics.

Objective Tinnitus is less ghost-like.. it can be heard by a doctor.. It is less common, affecting less than 5%.  The sound is mainly caused by the noisy movement of blood through abnormal veins/arteries in the head or neck.  These sounds are called pulse-synchronous because  it typically signals an underlying vascular disease, called vascular tinnitus such as atherosclerosis, brain aneurysm (a bulge in a weakened artery in the brain) or vascular tumor. This type of tinnitus is usually temporary and associated with stress or head trauma and rarely with multiple sclerosis or brain stem tumor.

                      Tinnitus Treatment

If you think you might have tinnitus, see an otolaryngologist(ear, nose and throat doctor) for an evaluation.The doctor will check your hearing and blood pressure.  If sounds are present, an MRI or CT scan may be needed. Knowing that tinnitus is not caused by anything serious goes a long way toward relief.

Deal with stress. Emotional stress is strongly linked to tinnitus.

Consume less caffeine.  Coffee, tea and caffeine-loaded soft drinks can make tinnitus worse.  Caffeine stimulates the nervous system and makes tinnitus louder.

Limit use of aspirin and other over-the-counter pain relievers. Aspirin is known to cause reversible damage to the nerve cells in the cochlea.  Tinnitus usually occurs only with regular high doses.

Improve sleep.  Good sleep hygiene (Going to bed at the same time  every night and getting restful sleep) is beneficial for overall health and can help alleviate tinnitus.

Sound therapy uses external sources of sound to reduce the severity, by introducing a louder sound, the softer sound of tinnitus can be blocked out. Some people keep a fan running or listen to low-volume background music.  If you mainly notice tinnitus at night, you can buy inexpensive pillow speakers that will mask the noises without bothering your bed partner..

Neurophysiology-based treatment.  One of the most recent and effective treatment. It uses sound therapy along with intensive counseling to dampen the anxiety associated with tinnitus sound.  

Fewer than 5% of tinnitus cases require surgery to manage a serious underlying condition, such as severe narrowing of the carotid artery, an aneurysm or a vascular tumor.  Botox is sometimes used to help spasms in the soft palate.