Tinnitus describes any abnormal sound heard in the ear. Tinnitus may be described as a high or low pitch, ringing, roaring, buzzing, humming, cricket-like, or pulsating, among various other descriptions. Tinnitus is most commonly caused by hearing loss, but may have multiple other causes - wax build-up, Meniere's disease, fluid in the ear, eardrum perforation, benign vascular causes, or least commonly, tumors. Treatment is aimed at the underlying cause - most commonly hearing loss. Hearing aids may help to mask the sound in cases associated with hearing loss. Other masking devices (produce sound to mimic and eventually desensitize the ear to the tinnitus sound) may offer relief as well. Some over-the-counter herbal remedies or antioxidant vitamins may be recommended. Anxiolytic / sedative medications may offer short-term control of symptoms, but are usually not recommended for long-term treatment. Steroids may be offered in cases associated with sudden hearing loss or vertigo. Surgery usually does not play a role in tinnitus management.