Not everyone with hearing loss has tinnitus, and not everyone who has tinnitus has a hearing loss. Tinnitus is a phantom head or ear noise that the person perceives with no outside sound source present. Tinnitus refers to sounds that are heard in the head or ears. Tinnitus can be in one ear or both. It can be present all of the time or come and go. However, tinnitus generally accompanies a sensorineural hearing loss. Tinnitus can be very low in volume and difficult to hear unless the environment is quiet and the person stops to "listen for it". Tinnitus may seem to be solely an "ear" problem, but more often than not; it may invoke anxiety, sleep disruption or difficulty concentrating. Tinnitus can begin after noise exposure, head or neck trauma from a car accident/sports injury, ear infection, sinus problems, after taking medications that are toxic to the ear/hearing, certain types of auditory, nerve or facial tumors, jaw misalignments, and even smoking. Although there is no cure for tinnitus that works for everyone, there are ways to manage it. Approximately 6 out of 10 hearing aid users report complete freedom or reduction in tinnitus while using their hearing aids. It is a sensation of sound not produced by any external source. Tinnitus hearing loss management requires regular relaxation techniques that can help you manage the stress that is often associated with tinnitus. Many diseases such as heart disease and diabetes can be associated with tinnitus. Since the damage which causes tinnitus can occur anywhere along the auditory pathway, it can be difficult to prescribe appropriate treatment. Covering over the internal sounds with stimulating specific frequencies is not always successful in making tinnitus disappear but acts as a "bandage". There are individuals with no significant hearing loss, but they do have constant moderate to severe tinnitus. Some describe the sound as ringing, hissing, buzzing, chirping, frying, cricket/cicada/mosquito insect noises, pulsing, whooshing, and some even hear music. Among these, a feeling of fullness or stuffiness, hearing loss, and tinnitus are the most common – and the most bothersome.