Tinnitus is one of those symptoms that slips into your life quietly, almost politely at first. A faint tone. A soft hum. A sound that does not belong to the world around you. And before you realise it, it becomes something that follows you from place to place.
For many acoustic neuroma patients, tinnitus becomes a companion they never asked for. Sometimes it appears long before diagnosis. Sometimes it settles in after treatment. Sometimes it changes shape as the weeks go by. Whatever form it takes, it can alter the way you experience silence, rest, concentration and comfort.
This blog explains what tinnitus is, why it happens, why it affects most acoustic neuroma patients, and why a significant number never develop it at all. It is grounded in science but written for those who live with the condition. You deserve clarity without fear and honesty without clinical coldness.
What tinnitus actually is?
Tinnitus is the perception of sound when no external sound is present. Patients describe it in many forms. A sharp ring. A high pitched whistle. A buzzing that rises at night. A humming that fills the space where silence used to sit. A pulsing sound that grows louder when the world around them becomes quiet.
The important truth is simple.
Tinnitus is not created by the ear.
It is created by the brain.
When the brain stops receiving clear, balanced input from the ear, it reacts by producing its own internal noise. This noise becomes the sound you hear.
How common is tinnitus in acoustic neuroma
Research shows that between sixty and seventy per cent of acoustic neuroma patients experience tinnitus. Some studies report it in more than seventy per cent of those with measurable hearing loss on the tumour side.
You are not alone.
You are not imagining it.
This is a recognised neurological effect of the tumour.
Why tinnitus happens: the science in simple language
Tinnitus appears when sound signals become weak, unstable or distorted. Here are the most common reasons.
Hearing loss
Most tinnitus cases involve some form of hearing loss. When hearing fades on one side, the brain senses the missing information and attempts to fill the silence. It fills it with internal noise.
Damage to inner ear hair cells
These delicate sensory cells convert sound into electrical signals. Once damaged, they cannot recover. When the signal becomes weaker, the brain increases its sensitivity and creates phantom sound.
Problems in the auditory nerve
The vestibulocochlear nerve carries sound to the brain. When a tumour presses on it, the signal becomes unclear. The brain interprets this confusion as tinnitus.
Hyperactivity in the auditory cortex
Reduced sound input causes the brain’s hearing centre to become overactive. Neurons fire spontaneously. Groups of neurons fire together and create a constant tone.
Emotional and chemical influences
Stress, anxiety and fatigue do not cause tinnitus, but they can intensify it. The brain’s emotional centre and hearing centre are closely linked. When emotions are heavy, the internal noise often feels louder.
Why tinnitus is so common in acoustic neuroma
Acoustic neuroma grows on the nerve that carries hearing and balance information. As it enlarges, it presses on the cochlear fibres and disrupts the sound signal long before hearing is completely lost.
Many patients describe the early stage as:
• voices sounding distant
• the good ear working harder
• difficulty following conversations
• a faint ringing that appears in silence
• noise that increases with tiredness
This is not imagination.
This is the nerve struggling.
This is the brain trying to make sense of a signal that no longer arrives cleanly.
Why some acoustic neuroma patients never develop tinnitus
It is important to remember that around thirty to forty per cent of acoustic neuroma patients never experience tinnitus. This does not mean their tumour is unusual or dangerous. It simply means their auditory system reacts differently.
Here are the reasons.
Their hearing loss is stable rather than chaotic
Tinnitus thrives on unstable input. If hearing declines slowly and evenly, the brain may not respond with phantom sound.
The tumour affects balance fibres more than hearing fibres
The vestibulocochlear nerve has two branches. In some patients, the tumour presses mainly on the balance branch, sparing the hearing fibres and preventing tinnitus.
Their brain filters internal noise more effectively
Some people naturally have stronger sensory filtering. Their brain does not create sound in response to reduced input.
Complete deafness can reduce tinnitus
When the nerve stops functioning completely, there are no chaotic signals to interpret. Silence is easier for the brain to understand than distortion.
Tinnitus needs a perfect combination of nerve irritation, unstable signals and a brain that reacts strongly. If any one of these elements is missing, tinnitus may never appear.
What happens after surgery when hearing is lost on one side
Many acoustic neuroma surgeries result in total hearing loss on the tumour side. This affects tinnitus in different ways.
It may rise at first
Sudden silence shocks the auditory system. The brain becomes alert and tinnitus may become louder in the first weeks.
It may remain the same
If the nerve was already failing before surgery, the brain may not respond strongly to the final loss.
It may soften or disappear
A damaged nerve sends chaotic signals. A silent nerve sends none. Once the chaos ends, the brain sometimes settles and the tinnitus becomes quieter or fades completely.
The remaining ear becomes the anchor
Your good ear becomes your world. When it becomes tired or overstimulated, the tinnitus may feel more noticeable. This is not failure. It is your brain learning a new way to hear.
The emotional truth behind tinnitus
This part is rarely spoken about in appointments, yet every patient recognises it.
Tinnitus does not simply affect hearing. It affects your relationship with quiet.
It makes bedtime harder.
It interrupts calm moments.
It tests your patience.
It drains your focus.
It makes you more protective of your remaining hearing.
It can make you feel vulnerable in ways you did not expect.
But here is something that matters just as much.
The brain adapts.
Slowly. Quietly. Steadily.
The noise does not always disappear, but its power over you does.
Your fear softens.
Your emotional response becomes calmer.
Your brain stops interpreting the sound as danger.
You begin to recognise it without reacting to it.
This is not denial.
This is healing.
This is neuroplasticity.
The brain learns to live with what it cannot change.
The tinnitus may stay.
But you stop feeling threatened by it.
And that is the point where life becomes lighter again.
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Your Turn
Before you leave, I would love to hear from you.
What does tinnitus feel like for you
When is it at its worst
Has it changed over time
Share your experience in the comments.
Your words may help someone who is reading this in the middle of their own difficult night.
I will try to explain in a better way about my tinnitus problem which disturbed my life and health since last once years. First time I fell it the time I driving with close windows alone that same thing going wrong in my ears. The sound like jangle or Fields in the midnight. The sound of kerrai the name I don’t know in English but in Pushto we call it kerrai. Later my focus go deeper about that sounds because everywhere I feel it and my tension goes higher. The I visited a hospital in Qatar and they go me appointment of ENT specialist. The result they give that my hearing power is getting very low that’s why the sound accrued. And give the advise that I used the ears machine. Then later during my vacation in Pakistan I visited another ENT specialist he checked and given some medicine for three months and said your internal 👂 is ok you just used the medicine then it will ok. But still the sound same is before. This sounds is 24 hours some time it increases but not decreasing for a minute. I have problems in conversation, focus, before sleeping time and mostly when I’m alone in a very silent or calm environment. I have no idea what to do. Now this time I’m writing with tinnitus. Thanks
Thanks for sharing your experience. That constant noise is so annoying
Hi everyone!
I do have tinnitus.
I am SSD after surgery and radiation for my AN.
I dont really “feel” deaf on one side. Thats because i have adopted easily ss my doc says.
Tinnitus enhances when i am in loud places. But its ok… i can handle it.
I do have problems following conversations. And it’s tiring.
But its ok… its manageable at the moment.
Thank you for sharing this – so interesting.
I developed tinnitus years ago – about a year before being diagnosed with an acoustic neuroma. It bothered me more than the hearing loss and though I have now somewhat adjusted, the same is true.
I remember when I first realised it was permanent; it felt somehow claustrophobic and I had several panic attacks.
I was interested to read that the brain deals better with total deafness than with chaotic signals. My hearing is now described as profound on the AN sound but there is some slight hearing; I’m now wondering if the injections given to people before AN surgery to kill the nerve might be a possible way forward.
Thanks for the valuable information had intense Tinnitus for about 8 years now Acoustic Neroma not grow since found stayed 2mm in size thank you x
Thanks so much for sharing. It definitely helps reading other people’s experoences. I developed tinnitus due to my AN – initially it was high pitched ringing that was loudest when it was quiet so trying to sleep was hard! Since my surgery and the removal of my AN I now have SSD and the tinnitus remains but it is different. It no longer rings as loudly when it is quiet but it is now exacerbated by other noises. The ringing is bad in noisy places, when other people are talking loudly and unfortunately also when I am talking, which is incredibly irritating and distracting. It is also worse when I’m tired.
Thanks for this blog, interesting. I think I’ve had tinnitus on and off for a long time and I didn’t notice it so much until COVID, when I spent a lot of time at home in the quiet. Then, going back to work in an empty office I noticed my tinnitus was the same volume and pitch as the loud pinging of the lifts. It feels a little bit like there’s a barrier between me and the world, sort of similar to when I take my glasses off and can’t see, but it can’t be corrected like my sight can.