What is the primary cause of tinnitus?

The primary cause of tinnitus is damage to hair cells in the inner ear. Hair cells are crucial for converting sound vibrations into electrical signals that the brain can interpret as sound. When these hair cells are damaged, often due to exposure to loud noise, aging, or other factors, it can lead to abnormal auditory signals being sent to the brain. This is often experienced as a ringing, buzzing, or hissing sound that can be constant or intermittent, and may vary in volume.

While wax build-up in the ears, excessive ear infections, and injuries to the outer ear can contribute to hearing issues, they do not directly cause tinnitus in the same way that damage to inner ear hair cells does. Wax build-up can cause temporary hearing loss or discomfort, but it usually does not lead to the perception of phantom sounds. Similarly, while ear infections can affect hearing and cause discomfort, they are more often associated with pain and temporary hearing loss rather than the continuous sounds experienced in tinnitus. Injury to the outer ear can affect hearing but is less likely to result in the internal auditory experiences characteristic of tinnitus. Thus, damage to the inner ear mechanisms represents the most direct and significant cause of tinnitus.