acoustic trauma
presbycusis (age-associated hearing loss)
Ménières disease
endolymphatic hydrops
superior canal dehiscence
acoustic neuroma
mercury or lead poisoning
ototoxic medications
neurologic disorders:
Arnold–Chiari malformation
multiple sclerosis
head injury
giant cell arteritis
temporomandibular joint dysfunction
metabolic disorders:
vitamin B12 deficiency
iron deficiency anemia
psychiatric disorders
depression
anxiety disorders
other factors:
vasculitis
Some psychedelic drugs can produce temporary tinnitus-like symptoms as a side effect
5-MeO-DET
diisopropyltryptamine (DiPT)
benzodiazepine withdrawal
intracranial hyper or hypotension caused by, for example, encephalitis or a cerebrospinal fluid leak

Objective tinnitus
Objective tinnitus can be detected by other people and is sometimes caused by an involuntary twitching of a muscle or a group of muscles (myoclonus) or by a vascular condition. In some cases, tinnitus is generated by muscle spasms around the middle ear.Spontaneous otoacoustic emissions (SOAEs), which are faint high-frequency tones that are produced in the inner ear and can be measured in the ear canal with a sensitive microphone, may also cause tinnitus. About 8% of those with SOAEs and tinnitus have SOAE-linked tinnitus, while the percentage of all cases of tinnitus caused by SOAEs is estimated at 4%. Pediatric tinnitus
Children may be subject to pulsatile or continuous tinnitus. With pulsatile tinnitus involving anomalies and variants of the vascular parts. While continuous affecting the middle/inner ear structures. CT scans are able to check for integrity of the structures, and MR scans can evaluate the nerves and potential masses or malformations. Early diagnosis can prevent long term impairments to development, imaging and categorizing whether it nonpulsatile or pulsatile tinnitus help create an efficient diagnosis. Pulsatile tinnitus
Some people experience a sound that beats in time with their pulse, known as pulsatile tinnitus or vascular tinnitus.
These questionnaires measure the degree of psychological distress and handicap associated with tinnitus, including effects on hearing, lifestyle, health and emotional functioning. A broader assessment of general functioning, such as levels of anxiety, depression, stress, life stressors and sleep difficulties, is also important in the assessment of tinnitus due to higher risk of negative well-being across these areas, which may be affected by or exacerbate the tinnitus symptoms for the individual. Overall, current assessment measures are aimed to identify individual levels of distress and interference, coping responses and perceptions of tinnitus to inform treatment and monitor progress. However, wide variability, inconsistencies and lack of consensus regarding assessment methodology are evidenced in the literature, limiting comparison of treatment effectiveness. Developed to guide diagnosis or classify severity, most tinnitus questionnaires have been shown to be treatment-sensitive outcome measures. Pulsatile tinnitus
If the examination reveals a bruit (sound due to turbulent blood flow), imaging studies such as transcranial doppler (TCD) or magnetic resonance angiography (MRA) should be performed. Differential diagnosis
Other potential sources of the sounds normally associated with tinnitus should be ruled out. For instance, two recognized sources of high-pitched sounds might be electromagnetic fields common in modern wiring and various sound signal transmissions. A common and often misdiagnosed condition that mimics tinnitus is radio frequency (RF) hearing, in which subjects have been tested and found to hear high-pitched transmission frequencies that sound similar to tinnitus. Prevention
Prolonged exposure to loud sound or noise levels can lead to tinnitus. Custom made ear plugs or other measures can help with prevention.