Tinnitus is the hearing of sound when no external sound is present. While often described as a ringing, it may also sound like a clicking, hiss or roaring. Rarely, unclear voices or music are heard. The sound may be soft or loud, low pitched or high pitched and appear to be coming from one ear or both. Most of the time, it comes on gradually. In some people, the sound causes depression, anxiety or interferes with concentration. Tinnitus is not a disease but a symptom that can result from a number of underlying causes. One of the most common causes isnoise-induced hearing loss. Other causes include: ear infections, disease of the heart or blood vessels, Ménière’s disease, brain tumors, exposure to certain medications, a previous head injury and earwax. It is more common in those with depression. The diagnosis is usually based on the person’s description. Occasionally, the sound may be heard by someone else using astethoscope: in which case, it is known as objective tinnitus. A number of questionnaires exist that assess how much tinnitus is interfering with a person’s life.People should have an audiogram and neurological exam as part of the diagnosis. If certain problems are found, medical imaging such as with MRI may be recommended. Those who have tinnitus that occurs with the same rhythm as their heartbeat also need further testing. Prevention involves avoiding loud noise. If there is an underlying cause, treating it may lead to improvements. Otherwise, typically, management involves talk therapy. Sound generators or hearing aids may help some. As of 2013, there are no effective medications. It is common, affecting about 10-15% of people. Most, however, tolerate it well with its being a significant problem in only 1-2% of people. The word tinnitus is from the Latin tinnīre which means “to ring”.