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What does tinnitus actually sound like? More importantly — what does the specific sound you’re hearing tell a clinician about what’s causing it? The type of tinnitus matters. For some types, it changes the evaluation. For one type, it’s a medical emergency.
Dr. Layne Garrett, Au.D., CH-TM, ABAC walks through the 7 most clinically distinct tinnitus sound types — what causes each one, what the clinical implications are, and which types require urgent workup that shouldn’t be delayed.
TL;DR: Tinnitus sound type is diagnostically meaningful. High-frequency ringing is cochlear — often co-occurs with hearing loss even on a normal audiogram, and is the most common entry point for hearing aid benefit when fit with Real Ear Measurement. Hissing is similar but broader-band. Buzzing can be middle ear or medication-related. Low-frequency roar with fluctuation is a Meniere’s indicator. Pulsatile tinnitus that syncs with your heartbeat requires imaging before any other treatment — CT angiography is first-line. Clicking is middle ear myoclonus, an objective type measurable in clinic. Musical tinnitus is auditory deprivation, not psychiatric. Any sudden-onset tinnitus with sudden hearing loss is a same-day medical emergency.
Dr. Layne Garrett, Au.D., CH-TM, ABAC is the founder of Timpanogos Hearing & Tinnitus, Utah’s only full-time tinnitus specialty center. With more than two decades specializing in tinnitus and complex hearing loss, Dr. Garrett conducts REM-verified hearing aid fittings on every patient and uses Real Ear Measurement as standard practice — not an upgrade. Every tinnitus evaluation includes a complete medication history review.
Learning Center — detailed clinical guides on every tinnitus type:
https://utahhearingaids.com/learning-center
Schedule a comprehensive tinnitus evaluation in Utah County:
https://utahhearingaids.com/schedule
0:00 Why Your Tinnitus Sound Type Matters Clinically
0:49 Type 1: High-Frequency Ringing (Cochlear, Most Common)
2:08 Type 2: Hissing (Early Cochlear Damage, Normal Audiogram Warning)
2:52 Type 3: Buzzing (Middle Ear and Medication-Related)
3:32 Type 4: Low-Frequency Roar (Meniere’s Indicator)
4:16 Type 5: Pulsatile (Requires Imaging — Teresa’s Case)
5:09 Type 6: Clicking (Middle Ear Myoclonus — Objective Tinnitus)
6:01 Type 7: Musical Tinnitus (Auditory Deprivation, Not Psychiatric)
7:09 Clinical Decision Framework: What to Do Based on Your Sound Type
Research Referenced:
Maison, S.F. et al. (2023). Tinnitus and cochlear hair cell damage — Ear & Hearing (Mass Eye and Ear) No direct DOI provided; referenced from Mass Eye and Ear research output 2023
Krishnan, A. et al. (2021). CT angiography in pulsatile tinnitus — Radiology https://pubs.rsna.org/doi/10.1148/radiol.2021203883
Park, S.N. et al. (2013). Middle ear myoclonus — Laryngoscope https://onlinelibrary.wiley.com/doi/10.1002/lary.23731
Dobkin, B. et al. (2025). Musical tinnitus and auditory deprivation — Neurorehabilitation No direct DOI provided; referenced from Neurorehabilitation 2025 output
Note: verify these URLs are live before publishing.
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