Tinnitus

Persistent ringing, buzzing, or hissing in the ears can be frustrating and disruptive, but proper evaluation can help identify the cause and guide effective management.

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Understanding Tinnitus and Your Treatment Options

Tinnitus is the perception of a sound in your ears or head. This can often be described as ringing, buzzing, roaring, clicking, or hissing. Tinnitus is not caused by an external sound, and others around you cannot hear it. Roughly 25 million Americans suffer from tinnitus yearly.

Causes

Tinnitus is a symptom; it is not a disease. It is a symptom that something is wrong in the auditory system, which includes the ear, the auditory nerve that connects the inner ear to the brain, and the parts of the brain that process sound. The most common cause is sensorineural hearing loss. Tinnitus is often the first sign of hearing loss. Many health conditions can cause or exacerbate tinnitus. Other common causes of tinnitus are:

Noise-induced hearing loss
Ear and sinus infections
Diseases of the heart or blood vessels
Meniere's disease
Brain tumors
Thyroid abnormality

Diagnosis

To help identify the cause of your tinnitus, the doctor will likely ask you about your medical history and examine your ears, head, and neck. Common tests include:

Hearing (audiological) exam- During the test, you'll sit in a soundproof room wearing earphones that transmit specific sounds into one ear at a time. This can help rule out or identify possible causes of tinnitus.
Imaging tests-Depending on the suspected cause of your tinnitus, you may need imaging tests such as CT or MRI scans.
Lab tests- Blood draw to check for anemia, thyroid problems, heart disease, or vitamin deficiencies might be recommended.

Treatment

Treatment for tinnitus depends on the underlying cause of your tinnitus. Examples include:

Earwax removal - removing a blockage can decrease tinnitus symptoms.
Changing your medications - if a medication you're taking appears to be the cause of tinnitus, your doctor may recommend stopping or reducing the drug.
Hearing loss - if tinnitus is a result of hearing loss (noise-induced or age-related), use of hearing aids may help improve your symptoms.

Personal Hearing Aids / Maskers - These are one of the most effective ways to help manage annoying tinnitus and are fit by an audiologist. Maskers are sounds that can help to cover or minimize the perception of the tinnitus.
- Hearing Aids Alone (no masking sound) - Hearing aids provide stimulation to the auditory pathway, and this alone can be very beneficial in masking tinnitus.
- Hearing Aid Maskers - Special settings within the hearing aid that provide masking sounds in addition to the amplified sounds of the hearing aid, or masking sounds alone without amplification (for those with normal hearing).
Maskers and Home Masking Devices other than hearing aids
- Phone Apps
- Sound Machines - i.e. Sound Oasis "Bluetooth Tinnitus Therapy Sound" or Key Idea "White Noise Machine" (both available at Amazon, along with many other options.)
- Sound pillow http://www.soundpillow.com
- TV Music channels
- House fan - An all-time classic for a reason. Simple white noise is very helpful for many people as a masking sound.

Counseling

Counseling / Cognitive Behavioral Therapy / Relaxation Therapy / Stress Management

Some people who experience tinnitus need additional help to adapt and manage the tinnitus. This may take the form of relaxation therapy, stress management, or more structured counseling or behavioral therapy with a trained psychologist.

Referral to a professional who specializes in tinnitus treatment. There are several recognized approaches which can be beneficial: Tinnitus Retraining Therapy (TRT), Mindfulness-Based Tinnitus Stress Reduction (MBTSR), and Tinnitus Activities Treatment. If you find the tinnitus to be stressful despite attempts at management, you should talk with one of the physicians or audiologists at our office for a referral to a specialist in tinnitus treatment.