Chronic sinusitis is linked to tinnitus: in a 2026 study, it had been present before tinnitus in 3.83% of 138,361 tinnitus patients against 2.15% of matched controls, an adjusted odds ratio of 1.63. Chronic rhinosinusitis (CRS) means inflammation of the sinuses lasting 12 weeks or more, and the best-supported route from it to the ear is the Eustachian tube, though it may not be the only one.
What a large 2026 study found
A 2026 nationwide study in Scientific Reports compared 138,361 people with tinnitus against 384,895 controls matched on propensity scores, and asked how many in each group had CRS or allergic rhinitis before the tinnitus appeared. CRS had been present in 3.83% of the tinnitus group against 2.15% of controls.
After statistically adjusting for a long list of other relevant factors — including hyperlipidemia, diabetes, hearing loss, obesity, anemia, alcohol abuse, tobacco use disorder, anxiety, depression, asthma and otitis media, several of which have their own dedicated articles on this site — CRS remained associated with tinnitus, with an odds ratio of 1.626. Allergic rhinitis was associated more strongly, at 1.813. The authors describe the highest risk as being in people with both conditions; on the adjusted figures, having both (1.751) sat between the two single conditions rather than above them.
That adjustment for other known tinnitus-related conditions is what makes the finding more than CRS coinciding with other risk factors. It is still an association: the design looks back at who had CRS, and no adjustment rules out every shared cause, so it does not show that sinusitis causes tinnitus.
Just how common ear-related symptoms are in CRS
A clinical review found otologic (ear-related) symptoms — including aural fullness, hearing loss, ear pain, and tinnitus — reported in up to 87% of chronic rhinosinusitis patients in some studies, with tinnitus specifically reported in roughly 15% to 42% of affected individuals across the literature the study reviewed. That's a wide range, reflecting real variation across different patient populations and how symptoms were measured, but even the low end of that range represents a substantial share of people with CRS experiencing tinnitus alongside their more commonly recognized sinus symptoms.
More than one possible mechanism
The research points to several possible explanations, not a single cause. Eustachian tube dysfunction is the one route the 2023 review of CRS and ear disease found robust evidence for; the other two are plausible but were not assessed there:
- Eustachian tube dysfunction — chronic nasal inflammation and congestion extending to where the Eustachian tube opens into the throat, causing swelling and obstruction that disrupts normal middle ear pressure and function
- Sleep apnea and sleep disturbance — CRS is frequently associated with obstructive sleep apnea, itself an independently established tinnitus risk factor covered in its own article, plausibly connected through the airway inflammation and increased nasal resistance during sleep that CRS causes
- Systemic inflammation — chronic inflammatory conditions, of which CRS is one example, are increasingly recognized as having effects beyond their primary site, potentially affecting the auditory pathway through broader inflammatory processes rather than a purely local, mechanical one
Why this matters beyond just symptom-spotting
Recognizing this connection has a practical upside: the review found that Eustachian tube function tends to improve after CRS itself is treated. Whether tinnitus improves along with it has not been established, so that is a reasonable hope rather than a demonstrated result — but it follows a pattern seen elsewhere, where tinnitus downstream of an identifiable, treatable condition is worth approaching through that condition as well as directly.
What this means practically
If you have diagnosed chronic rhinosinusitis — or the defining symptoms (nasal congestion, nasal discharge, facial pressure, and reduced sense of smell, generally lasting 12 weeks or more) — and also have tinnitus, it's worth raising both together with whoever manages your sinus care, rather than treating them as unrelated. This is particularly worth doing if you also have allergic rhinitis, sleep issues, or symptoms suggesting Eustachian tube dysfunction, since the research suggests these often cluster together and may share underlying mechanisms. Acid reflux has also been proposed as a route to the ear through the Eustachian tube, though that evidence is mostly observational.