Understanding Traumatic Brain Injury (TBI): How It Impacts Hearing, Auditory Function, and Sensory Health

Introduction

Traumatic brain injury (TBI) is a significant public health concern that affects millions of people around the world every year. TBIs can range from mild concussions to severe injuries that permanently affect how a person thinks, feels, and interacts with the world. One less-discussed yet important aspect of TBI is its impact on the way we hear and process sound, including issues such as ringing in the ears (tinnitus), hearing loss, and difficulty tolerating everyday noise. These symptoms can significantly impact a person’s quality of life, making it more challenging to communicate, work, or simply enjoy daily activities.

This article will explain what a TBI is, explore how it affects the ears and brain, and examine symptoms such as tinnitus. Additionally, the article features insights from Dr. Alexander Jimenez, a nurse practitioner and chiropractor from El Paso, who specializes in treating injuries resulting from accidents, sports, and workplace incidents. Drawing on scientific research and Dr. Jimenez’s clinical practice, this blog aims to help patients, families, and interested readers gain a deeper understanding of TBI and its impact on sensory health.

What Is Traumatic Brain Injury (TBI)?

Traumatic brain injury (TBI) occurs when a sudden blow or jolt to the head disrupts the brain’s normal functioning. This kind of injury can happen during falls, car crashes, sports accidents, or even violent assaults. TBIs are often classified as mild, moderate, or severe, depending on the force of impact and how long a person loses consciousness or experiences confusion (National Institute of Neurological Disorders and Stroke, 2023).

Common symptoms of TBI include headaches, confusion, dizziness, memory problems, and changes in mood. However, TBIs can also have specific effects on the sensory systems, especially hearing and balance.

How TBI Causes Symptoms Like Ringing in the Ears, Hearing Loss, and Noise Disturbances

The Connection Between TBI and the Auditory System

The auditory system includes the ears, auditory nerves, and the parts of the brain that process sound. When the head receives a blow, the impact can damage any of these parts. For example, the force may injure the delicate inner ear structures or the nerves that transmit sound signals to the brain. Even if there is no direct injury to the ear, the brain’s processing centers can be affected, leading to hearing problems and abnormal sound perception.

How TBI Leads to Ringing in the Ears (Tinnitus)

A common problem after a TBI is tinnitus, which is the sensation of hearing sounds (such as ringing, buzzing, or hissing) that are not caused by an external source. Tinnitus can be either temporary or long-lasting, and it often accompanies hearing difficulties or sensitivity to certain noises. Researchers have found that up to 53% of TBI patients experience some form of tinnitus, particularly after concussions or blast injuries (Moleirinho-Alves et al., 2023).

TBI may trigger tinnitus in several ways:

• Damage to the inner ear or cochlea

• Injury to the auditory nerve

• Disruption in the brain’s sound-processing areas

• Changes in blood flow around the ear and brain

These changes confuse the nervous system, leading it to interpret random signals as sound, which the brain perceives as tinnitus.

Hearing Loss and Noise Sensitivity After TBI

Hearing loss is another common symptom of TBI. It can range from mild difficulty understanding words to complete deafness in one or both ears. After a TBI, people may also notice:

• Sounds seem much louder than before (hyperacusis)

• Difficulty focusing on conversations in noisy environments

• Sensitivity to sudden or loud noises

Some patients develop misophonia, a strong negative reaction to specific sounds, which can occur or worsen after TBI. These noise issues stem from damage to the auditory nerves, the cochlea, or disruptions in the brain’s auditory pathways.

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Personal Injury Rehabilitation- Video

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How TBI Symptoms Affect Sensory and Cognitive Function

TBIs can disrupt more than just hearing. Because the brain is the body’s control center, damage can interfere with how we process all types of sensory information—including sight, touch, balance, and sound. Some ways TBI disrupts sensory function include:

• Difficulty filtering out background noise: This makes it harder to focus and can lead to feeling overwhelmed in crowds or busy environments.

• Auditory processing issues: Even if hearing is normal, the brain may misinterpret sounds, making it difficult to understand words, remember instructions, or follow conversations in complex situations.

• Cognitive challenges: Memory loss, poor attention, and slower thinking are also common after TBI, especially when sensory symptoms like tinnitus become distracting or distressing.

Associated Symptoms Affecting the Head, Neck, and Ears

Patients with TBI may also experience:

• Headaches or migraines

• Pain or pressure in the ears

• Vertigo (a sensation of spinning or dizziness)

• Jaw pain or tightness in the neck muscles

These symptoms often occur together, making it challenging for patients to pinpoint which one is most troubling. The interconnected nerves in the head, neck, and ears mean that an injury to one area can trigger symptoms in the others.

What Is Tinnitus? Causes, Symptoms, and Their Association with TBI

Tinnitus is the medical term for hearing sounds that originate from within the body, not from an external source. It is not a disease, but rather a symptom of an underlying condition, such as hearing loss, ear injury, or a problem in the circulatory system. It can sound like:

• Ringing

• Buzzing

• Hissing

• Roaring

• Clicking or pulsing

For many people, tinnitus is a temporary condition, but in some cases, it becomes persistent and distressing.

Causes of Tinnitus

Common causes of tinnitus include:

• Exposure to loud noises

• Age-related hearing loss

• Ear infections or injuries

• Medications (especially some antibiotics and cancer drugs)

• Head or neck injuries (including TBI)

When a TBI is involved, the causes are often:

• Damage to hair cells in the cochlea (inner ear)

• Injury to the nerves carrying sound signals

• Problems in the brain’s auditory centers that interpret these signals

TBIs are uniquely associated with cases where tinnitus begins suddenly after trauma, often alongside headaches, dizziness, or other symptoms.

Symptoms That Often Happen with Tinnitus After TBI

Ringing in the ears can come with other issues, including:

• Hearing loss

• Difficulty concentrating

• Trouble sleeping

• Irritability, anxiety, or depression

When these symptoms cluster together, they can significantly disrupt daily life. For people with TBI, tinnitus is not just a simple annoyance—it can be a constant reminder of their injury and complicate recovery.

How TBI-Related Auditory Symptoms Are Diagnosed and Treated

Clinical Insights From Dr. Alexander Jimenez, DC, APRN, FNP-BC

Dr. Alexander Jimenez is a nurse practitioner and chiropractor practicing in El Paso with a unique dual-scope practice. He frequently encounters patients with various head, neck, and spine injuries from:

• Work incidents

• Sports accidents

• Personal or home injuries

• Motor vehicle accidents (MVAs)

His approach combines medical diagnosis with chiropractic care, focusing on the whole body’s recovery—not just a single symptom or injury.

A TBI Symptom Questionnaire Example:

Dual-Scope Diagnosis and Advanced Imaging

Dr. Jimenez’s clinic starts with a comprehensive evaluation, which may include:

• Physical and neurological exams

• Advanced imaging such as MRI or CT, to assess brain, spine, and ear structures

• Specialized auditory and vestibular function tests to pinpoint hearing and balance problems associated with TBI

This thorough assessment helps distinguish between injuries that directly affect the ear (such as a ruptured eardrum) and those that impact the brain’s processing of sound.

Integrative Treatment Strategies

After diagnosis, Dr. Jimenez uses a combination of evidence-based care options, such as:

• Targeted chiropractic adjustments to support neck and spine alignment, which may alleviate headaches and ear pressure

• Physical therapy and custom exercise programs to improve balance, coordination, and general brain function

• Massage therapy to reduce muscle tension in the neck and jaw, which can worsen auditory symptoms

• Integrative medicine, including acupuncture, nutritional counseling, and stress management, supports the natural healing of injured nerve tissues and reduces chronic pain

• Medical management, coordinated with other providers, for severe or persistent symptoms

Dr. Jimenez’s team works closely with patients to address not only the physical symptoms but also the cognitive and emotional challenges that accompany TBI. Legal documentation and communication with attorneys or employers are provided as needed for those dealing with workplace or accident-related injuries.

Real-Life Impact: How TBI Symptoms Can Disrupt Daily Living

Living with a TBI is challenging, especially when auditory problems like tinnitus or hearing loss develop. Everyday situations, such as talking with friends in a crowded restaurant or watching TV at a comfortable volume, can become stressful. For some, the persistent ringing of tinnitus makes it difficult to concentrate or relax enough to fall asleep. These issues, combined with headaches, neck pain, or vertigo, can affect a person’s mood and relationships, sometimes leading to anxiety or depression.

Promoting Recovery and Preventing Long-Term Problems

While not every TBI symptom can be cured, early intervention and comprehensive care can make a huge difference. Steps that help include:

• Early and accurate diagnosis, including detailed assessment of hearing and sensory function

• Personalized treatment plans that integrate medical, rehabilitative, and holistic approaches

• Ongoing support for both physical and emotional needs, as recovery can be a long process

• Safe return-to-activity programs, especially for those injured during sports or work

Prevention is also crucial. Wearing helmets, using seatbelts, and practicing safety in sports and workplaces can reduce the risk of TBIs and the sensory problems that may follow.

Conclusion

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References

1. Moleirinho-Alves, P. et al. (2023). “Traumatic brain injury and tinnitus: prevalence, risk factors, pathophysiology, and treatment.” https://pubmed.ncbi.nlm.nih.gov/38775672/

2. Brenner, L.A. et al. (2022). “Cognitive and hearing function after traumatic brain injury.” https://pubmed.ncbi.nlm.nih.gov/35612496/

3. Lee, L. et al. (2023). “Neurocognitive outcomes following auditory dysfunction in traumatic brain injury.” https://pubmed.ncbi.nlm.nih.gov/37742111/

4. Bamiou, D.-E. et al. (2020). “Central auditory processing deficits following traumatic brain injury.” https://pubmed.ncbi.nlm.nih.gov/32941367/

5. Cleveland Clinic. (n.d.). “Tinnitus: Symptoms & causes.” https://my.clevelandclinic.org/health/symptoms/14164-tinnitus

6. Stamper, G.C., & Johnson, T.A. (2024). “Noise exposure, auditory brainstem response, and tinnitus following TBI.” https://pubmed.ncbi.nlm.nih.gov/38709830/

7. Lew, H.L. et al. (1994). “Vestibular and auditory disorders after mild traumatic brain injury.” https://pubmed.ncbi.nlm.nih.gov/8172707/

8. Sano, M. et al. (2003). “Head and neck symptoms following traumatic brain injuries in different populations.” https://pubmed.ncbi.nlm.nih.gov/12792317/

9. NeuroTucson. (2024). “Traumatic brain injury and the ear.” https://neurotucson.com/traumatic-brain-injury-and-the-ear/

10. Dr. Alexander Jimenez, DC, APRN, FNP-BC. (2025). “Clinical observations and treatment approach.” https://dralexjimenez.com/

11. Dr. Alexander Jimenez, DC, APRN, FNP-BC. (2025). “Professional profile and clinical practice.” https://www.linkedin.com/in/dralexjimenez/