What is Tinnitus?
Tinnitus is the medical term for the perception of sound in one or both ears or in the head when no external sound is present. It is often referred to as "ringing in the ears," although some people hear hissing, roaring, whistling, chirping, or clicking. Tinnitus can be intermittent or constant-with single or multiple tones-and its perceived volume can range from subtle to shattering.

What causes tinnitus?
The exact physiological cause or causes of tinnitus are not known. There are, however, several likely sources, all of which are known to trigger or worsen tinnitus.

• Noise-induced hearing loss - Exposure to loud noises can damage and even destroy hair cells, called cilia, in the inner ear. Once damaged, these hair cells cannot be renewed or replaced. Hearing loss can also be caused by excessive noise exposure. Coincidentally, up to 90 percent of all tinnitus patients have some level of hearing loss.

• Wax build-up in the ear canal - The amount of wax ears produce varies by individual. Sometimes, people produce enough wax that their hearing can be compromised or their tinnitus can seem louder. If you produce a lot of earwax, speak to your physician about having excess wax removed manually-not with a cotton swab, but by an ear, nose, and throat doctor.

• Certain medications - Some medications are ototoxic-that is, the medications are toxic to the ear. Other medications will produce tinnitus as a side effect without damaging the inner ear. Effects, which can depend on the dosage of the medication, can be temporary or permanent. Before taking any medication, make sure that your prescribing physician is aware of your tinnitus, and discuss alternative medications that may be available.

• Ear or sinus infections - Many people, including children, experience tinnitus along with an ear or sinus infection. Generally, the tinnitus will lessen and gradually go away once the infection is healed.

• Jaw misalignment - Some people have misaligned jaw joints or jaw muscles, which can not only induce tinnitus, but also affect cranial muscles and nerves and shock absorbers in the jaw joint. Many dentists specialize in this temporomandibular jaw misalignment and can provide assistance with treatment.

• Cardiovascular disease - Approximately 3 percent of tinnitus patients experience pulsatile tinnitus; people with pulsatile tinnitus typically hear a rhythmic pulsing, often in time with a heartbeat. Pulsatile tinnitus can indicate the presence of a vascular condition-where the blood flow through veins and arteries is compromised-like a heart murmur, hypertension, or hardening of the arteries.

• Certain types of tumors - Very rarely, people have a benign and slow-growing tumor on their auditory, vestibular, or facial nerves. These tumors can cause tinnitus, deafness, facial paralysis, and loss of balance.

• Head and neck trauma - Physical trauma to the head and neck can induce tinnitus. Other symptoms include headaches, vertigo, and memory loss.

• Certain disorders, such as hypo- or hyperthroidism, lyme disease, fibromyalgia, and throacic outlet syndrome, can have tinnitus as a symptom. When tinnitus is a symptom of another disorder, treating the disorder can help alleviate the tinnitus.

Do children get tinnitus?
Tinnitus does not discriminate: people of all ages experience tinnitus. However, tinnitus is not a common complaint from children. Children with tinnitus are less likely than adults to report their experience, in part because children with tinnitus are statistically more likely to have been born with hearing loss. They may not notice or be bothered by their tinnitus because they have experienced it their entire lives.

Children, like people of all ages, can be at risk for tinnitus if they are exposed to loud noises. Recreational events like fairs or car races or sports games can all include high-decibels activities that can damage kids' ears. Hearing protection is always recommended, as is a discussion about the danger of loud noises and the choices kids have to turn it down or walk away.

My neighbor has tinnitus but says it doesn't bother her. Mine drives me nuts. Why the difference?
Not everyone experiences it to the same degree. Some people hear ringing or other noises in their ears immediately following exposure to excessive noise, like right after a concert, but the sound is temporary. Other people report hearing a slight noise all the time if they listen for it, but most of the time cannot distinguish the noise over all the other sounds in their environment. Other factors can affect the severity of the condition from patient to patient, such as different degrees of hearing loss and different kinds of noises heard. Interestingly, the loudness of the tinnitus, when measured in a laboratory setting, did not correlate to the severity of the tinnitus as rated by the patients themselves. Every person has his or her own level of tolerance to the tinnitus sounds. It is a very personal and individual experience.

Is tinnitus hereditary?
There appears to be a predisposition based on heredity for some people when they are exposed to loud sounds, but whether or not tinnitus is genetically indicated is not certain. Scientists working on the Human Genome Project, for example, have not discovered a "tinnitus gene," but they have identified genes that are responsible for a few rare varieties of hearing loss, temporomandibular joint (TMJ) dysfunction, Ménière's Disease, and acoustic Neuroma. These conditions frequently include tinnitus as a side effect, which suggests that there might be a connection. For now, however, a connection between your mother's tinnitus and your tinnitus is still unknown.