Tinnitus is defined as “the hearing of sound when no external sound is present.” It is one of the most common complaints reported to hearing healthcare professionals. Certainly, tinnitus is associated with hearing loss. That doesn’t mean, though, that if one has tinnitus, hearing loss is also present.
 

Why tinnitus and hearing loss typically come as a matched set

 
To hear, sound is funneled through the outer and middle ear to the inner ear. Microscopic hair cells inside the inner ear are responsible for carrying sound through auditory nerves to the brain. Hearing loss can occur at any stage of this process: the outer ear, the middle ear, the hair cells, the auditory nerve or the brain.
 
Interestingly, tinnitus, too, can be caused at any point in the process! For example, tinnitus can be caused by a wax impaction in the ear canal; it can be caused by middle ear disease such as fluid or Meniere’s Syndrome; it can be caused by damage to the hair cells in the inner ear; and it can be caused by inappropriate firing of nerve cells within the brain.
 

It's likely that what’s causing your tinnitus is also causing hearing loss

 
Because both hearing loss and, likely, tinnitus are caused or triggered by the same “malfunction” in our hearing system, there’s a good chance that if you have tinnitus, you’ll also experience hearing loss. We see that often. But not always.
 
Why? Because there are other triggers for tinnitus that aren’t caused by problems with the ear. For instance, medications (particularly high doses of aspirin), stress, high blood pressure, heart disease and temporomandibular joint (TMJ) disfunction can cause tinnitus.
 

Get it checked out

 
If you are experiencing tinnitus, a visit with qualified hearing healthcare professional should be the first stop in finding a cause for your tinnitus. Because hearing loss is often associated with tinnitus, ruling out hearing loss makes sense. If hearing loss is detected, it is likely that the tinnitus is related to the hearing loss. If no hearing loss is detected, it’s time for a visit with your primary care physician to explore other possibilities.