Still Tinnitus Logo
✓ No Waiting Time Rated 4.8/5✓ Proven results✓ Secure Payment

The Biology of Tinnitus: Healthy vs. Damaged Ears

by Roel van Gorkum
| August 23, 2022

Ear health plays a large role in whether or not a person is likely to develop tinnitus—find out how. 

Tinnitus is a condition that impacts millions of people around the world to different degrees. However, it is more than just a simple ringing in the ears. Behind every case of tinnitus, there is a distinct cause of the condition. In many cases, this often comes down to differences in what we perceive as “healthy” or “damaged” ears. When our ears experience damage in some way, we are more likely to experience tinnitus. In this article, we will discuss the differences between these two types of ears and how they can lead to tinnitus. 

The “Healthy” Ear

Healthy ears are a marvel of biological engineering. They have the ability to translate a major part of the world around us and can play a vital role in our interactions with our environment. For many of us, ears offer a sense that we are heavily dependent upon. Healthy ears are ears where there is no known interference and everything seems to be working accordingly. 

Healthy Ears Help Us:

  • Hear
  • Balance while walking or moving
  • Sense danger
  • React to and perceive our environments

Inside the Biology of the Ear

Our ears have three parts in total—the inner ear, the middle ear, and the outer ear. These three parts work together to help us absorb and process the sounds around us. Sound waves enter our ears and go through a series of systems that help us to convert those waves into what we hear as specific sounds. Hearing is surprisingly complex, which also means that there is a high potential for something to go wrong. 

Illustration showing tinnitus. Damaged hair cells inside cochlea, labeled

Understanding the Cochlea

The cochlea is a portion of your ear that is located in the inner ear. This area is responsible for auditory transduction—the process of converting sound waves into the electrical impulses that our brain can process. This conversion is responsible for allowing us to hear sounds around us as distinct and unique.

What is it?

The cochlea itself is a bone that exists inside the ear. The bone is shaped like a spiral and hollow. Due to its shape, the cochlea is able to carry different frequencies through the ear, which contributes to the differences that we hear in sounds

What is the Cochlear Nerve?

The cochlear nerve is a component related to the cochlea that is also commonly referred to as the acoustic nerve. This nerve is responsible for carrying sound impulses to the brain from the cochlea itself. It plays a key role in allowing us to hear and process sound.

How Does the Cochlear Nerve Work?

When sound waves enter our ears and strike the eardrum, electrical impulses are created. Independently, these impulses amount to nothing. However, when the cochlear nerve takes them and transports them to our brains, we are able to process the actual sound itself. When this sensory nerve is compromised, various problems with hearing and processing sound can arise. 

How Sound Travels Through the Ear

The ear has a surprising number of parts given its small size, and the inner workings all come together to pass signals to the cochlear nerve. Inside the cochlea, the average person has roughly 30,000 tiny hairs that pick up on sounds. These sounds are then transmitted to your brain as electrical signals. These signals pass through the cochlear nerve, allowing you to understand and “translate” the sounds from waves to the sounds that we perceive. 

The “Damaged” Ear

When our ears are entirely undamaged, we are able to process sounds at different levels and frequencies. This is something that plenty of people rely on, making it fairly difficult when the ear is compromised. Tinnitus is a condition that can occur when an ear is damaged in any capacity. There are many different ways for ears to be damaged, meaning that there are several conditions that make it possible to develop tinnitus. 

What Does it Mean When an Ear is Damaged?

The definition of a damaged ear is surprisingly broad. In truth, there are many different instances that can lead to an ear being considered damaged. What this really means is that, in some way, the ear is not working correctly. In the majority of cases, you will see this as some kind of issue with the ear’s primary function—absorbing and translating sound. 

Indications of Ear Damage:

  • Difficulty hearing
  • Difficulty processing sound
  • Difficult translating sounds
  • Difficulty hearing certain frequencies 
  • Hearing phantom sounds (tinnitus)

The Potential Impacts of Ear Damage

Ear damage, like other kinds of damage throughout the body, is known to lead to some fairly unique outcomes. When something goes wrong in the body, we automatically find ourselves experiencing symptoms—some that make sense and others that do not. Since ear damage can come from so many different sources that impact its systems individually, it should not come as a surprise that many people experience different symptoms with this type of damage. Let’s take a look at some of the more common types of damage present.

Missing Frequencies

Frequency is what we consider to be the tone or “pitch” of a sound. All living beings hear different frequencies and experience them in different ways. For example, dogs can often hear frequencies that we don’t, which is why dog whistles, which target those unreachable frequencies, are such a valuable tool. In addition to this, we often lose access to certain frequencies as we age. We see these same issues with ears that have been impacted by damage. Some frequencies are missed entirely, limiting the auditory range of the person with ear damage.

Limited Sounds or Difficulty Hearing

Hearing is something that we all do on a spectrum, and throughout our lives, this spectrum can change. When a component of the ear is damaged, it is possible for sounds to lose translation along the way. This can include partial or total hearing loss.

Indications of Hearing Limitations:

  • Being unable to hear soft or quiet noises
  • Struggling to hear certain voices
  • Finding it difficult to understand accents or certain speech patterns
  • Losing the ability to hear almost completely

Physical Pain or Discomfort

Damage to the ear doesn’t always present itself as pain or discomfort, but it can lead to pain or discomfort. The pain can be a physical response to damage to the ear. This is more common when it comes to direct physical damage to the ear and its three parts. However, the discomfort that some people experience is not always a result of physical damage.

Our ears have the ability to process our environment in a significant way. Chances are that you have certain sounds that cause you pain or discomfort when you hear them, like metal scratching against metal or nails on a chalkboard. Sometimes, when people have an ear that has experienced damage, they can be sensitive to certain sounds or even hear ongoing sounds that cause physical and emotional discomfort, like tinnitus. 

Causes of Damage to the Ear

Given the complexity of the ear’s biology, it should come as no surprise that there are several ways to damage our ears. Like all of our other sensory organs, ears are particularly sensitive. The systems at work that allow us to hear can be influenced significantly by our environments and other factors.


Growing older is something that we all hope to do, but it does come with its fair share of complications. Age-related hearing loss is a very real and even common occurrence. In fact, this type of hearing loss is one of the most commonly experienced conditions for the elderly.

When we get older, most of us experience our hearing getting worse in some capacity. Many of the factors that determine whether or not hearing loss is believed to be related to age are often related to common factors that we associate with the elderly, like certain medical conditions or general wear. A significant number of elderly individuals also experience tinnitus.

Exposure to Loud Noises

When we are old enough to watch tv or listen to music, most of us are warned about the dangers of loud noises. Headphones are often targeted as a culprit. There is a reason for it—it is a very real concern. In fact, some people might end up trading headphones for tinnitus earbuds if they are not careful.

Common Risks to Hearing Include:

  • Concert settings
  • Listening to loud music through speakers or headphones
  • Loud machinery
  • Consistent exposure to loud noises or noises at certain frequencies
  • Working with weapons or explosives

Hearing that has been damaged by loud noises can either be permanent or temporary. The damage associated with loud noises is often related to the cochlea. This is because loud noises can actually physically damage cells and overstimulate the hair cells present in our ears


Diseases are associated with a wide range of symptoms, but when asked, most people wouldn’t think about hearing. Surprisingly, there are a high number of diseases that can cause damage to our ears or influence our ability to hear and process sound. 

Some suspect that in the list of  culprits behind their tinnitus, COVID might be a problem. Tinnitus from allergies can even occur when our ears are plugged. Depending on the nature of the disease, these conditions might be able to be managed by surgery or medication.

Hearing Problems Related to Disease:

  • Difficulty hearing
  • Difficulty balancing
  • Ringing in the ears (tinnitus)
  • Headaches
  • Dizziness


Though medication can mend, it can also cause problems of its own. Even though medications can save lives, they often come with unexpected side effects. In fact, we know that some medications can cause side effects that influence our ears and our hearing–causing tinnitus along the way.

A surprising number of medications can cause hearing loss—even some household medications. For many people, medication-induced hearing loss is actually deeply associated with tinnitus. It is one of the first symptoms that many people experience when medication is the cause and can actually worsen with time or progress to other hearing-related symptoms. 

Identifying Damage

Since there are so many different components in the ear and so many different conditions associated with ear damage, identifying damage happens on a fairly broad spectrum. There are more confusing factors behind tinnitus than the tinnitus pronunciation. Not all ear damage shows up in the same way, and it does not always have the same causes. However, there are some methods that are commonly used to identify when ear damage is present.

Hearing Tests

A clear indicator of ear damage is hearing loss. This is why one of the most common ways to check for ear damage is to test someone’s hearing. A hearing test is designed to measure just how well someone can hear. It is used to gauge different levels of hearing loss and hearing capacity.

Woman Gets Hearing test tinnitus

Tinnitus Symptoms or a Tinnitus Test

Tinnitus is one of the more common indicators that an ear has been damaged in some capacity. Whether tinnitus is a byproduct of hearing a loud noise or a new medication, its presence clearly alerts us to the fact that something is happening in the ear that shouldn’t be. 

Common Sounds with Tinnitus:

  • Humming
  • Buzzing
  • Roaring
  • Ringing
  • Clicking
  • Static
  • Screeching

You can work through various tinnitus tests with an audiologist or doctor to confirm this condition. 

The Takeaway

Life with tinnitus can feel very difficult at times, particularly if you are suffering from chronic tinnitus. Tinnitus that is associated with distinct ear damage, as well as other lesser-known causes, can be treated with different approaches. At Still Tinnitus, I have crafted a dedicated method based on clinically-proven treatments and knowledge of tinnitus that can be used to help you find relief from chronic tinnitus. After living with tinnitus for several years, I decided it was time to start researching and was able to get rid of my tinnitus completely. Now, I use my method to help those who are also impacted by tinnitus. To learn more, explore my method today. 

Want Tinnitus Relief?

Join my online course to calm the ringing in your ears – in just 5 steps.

Roel van Gorkum Founder of Still Tinnitus

About me

I was suffering badly from the ringing in my ears. I battled and battled – only to make it worse. Then, I started learning and developed a solution. Now, I help others find tinnitus relief.

Ready to take action?

Subscribe to watch the free tinnitus masterclass.