What is Tinnitus?

Tinnitus can be defined as a sound that a patient can hear and relates it to the ear, head or both the ear and the head, while there is no such sound outside theear of tinnitus patient head (in a subjective tinnitus), or a structure inside the chronic tinnitus
head is generating a noise (in objective tinnitus).

Subjective tinnitus may be heard as a sound that come from a source that is located outside the head. The sound is simple and has no meaning of language. In that aspect these sounds are different from auditory hallucinations.

When the sound can be heard or recorded by someone else (usually pulsatile sound) it is called objective tinnitus.

When the Tinnitus exists more then 6 months it is considered Chronic Tinnitus.

Features of Subjective Tinnitus

The short Videos of the Gynecologist Dr. Arie Yagoda (tinnitus after flu), the Biologist Dr. O'Donovan Patricia (tinnitus of unknown cause) and the Muscician and oboe player Mr. Amir Backman (tinnitus and hyperacusis after Barotrauma) can help to understand the symptoms.

The patient may tell about sounds of sea waves, high voltage cables, electric engine such as the engine of a refrigerator, discharge of air under pressure, sounds of birds or insects. The spectrum of sound can be from weak and non-disturbing to severe and intractable.

For more details – see "main associated symptoms" below.

Features of Objective Tinnitus

objective tinnitusObjective tinnitus

The objective tinnitus can be heard by another person with or without instruments for amplification of the sound.

In most cases the objective tinnitus is pulsatile.

The pulsations can have the same rate as the heart beats or have a different counts per minutes than the heart beats of the patient.

The main Associated Symptoms

Insomnia (disturbance to sleep), irritability, inability to concentrate on intellectual activities, fatigue, exhaustion, deterioration in ability to work, disturbance to family life, detachment from social life, anhedonia (inability to derive pleasure from life), anxiety, depression, hyperacusis (sensitivity to noise), palpitations, hypertension and hearing impairement.

It is impossible to distinguish between cause and effect.

The main Associated Factors

The causes of Tinnitus are not known. Some of the main associated factors are: all types of noise exposure, car crush, work accidents, medications and pathology of the auditory system. In most of the patients the cause of the tinnitus is not known.


I do not know of any statistical research about Tinnitus in Israel. In the USA the estimation is that 40 million Americans report of tinnitus, and 10 to 12 millions suffer from severe Tinnitus. If we apply it to Israel, most probably 80000 Israelis are suffering from Tinnitus.

About 30% of the Tinnitus patients are also suffering from vertigo.

Medical Approach to treatment of Tinnitus

Treatments can be classified to 3 categories:

Paliative Treatments

Psychotropic medications, H2-Blockers, Psychotherapy (hypnosis, cognitive behavioral therapy, bio-feedback, relaxation exercises), sound therapy (Tinnitus Maskers, TRT, hearing aids).

Curative Treatments

Surgery for tumors, surgery for blood vessels abnormality, drainage of abscesses, Drainage of infection, antibiotic therapy for bacterial infections, removal of Otto-Toxic medication and Metabolic Intervention which is the main part in my medical approach.

Treatments with unknown mechanism

Homeopathic treatments, herbal treatments, acupuncture.

Treatments with unknown success rate

magnets, low energy LASER, food supplements, acupuncture.