What is Tinnitus?
Tinnitus (“TINN-a-tus” or “ti-NIGHT-us”) is the perception of sound when no actual external noise is present. It is commonly described as a ringing in the ears, but it can also sound like roaring, clicking, hissing, whistling, swooshing, or buzzing. It may be soft or loud, high pitched or low pitched. You might hear it in either one or both ears. Tinnitus can be both an acute (temporary) condition and/or a chronic (ongoing) problem.
Although bothersome, tinnitus usually isn’t a sign of something serious. Nevertheless, if it’s loud and doesn’t go away, it can cause fatigue, depression, anxiety, and problems with memory and concentration. For some, tinnitus can be a source of real mental and emotional anguish. While tinnitus is a symptom of a wide range of conditions, treating an identified underlying cause sometimes helps. Other treatments reduce or mask the noise, making tinnitus less noticeable.
What causes tinnitus?
There can be more than 200 causes for tinnitus. Some of the most common ones are the following but having tinnitus DOES NOT mean you ( your child) have one of these problems:
- Noise-induced hearing changes/loud noise exposure
- Atypical hearing
- Impacted earwax in the ear canal
- Middle ear problems
- Aging
- Head and neck traumas
- Temporomandibular joint disorder
- Meniere’s disease
- Sinus pressure and barometric trauma
- Traumatic brain injury
- Certain medications
- Cardiovascular disease
- Autoimmune diseases
- Hormonal changes in women
- Thyroid problems.
What should I (my child) do if I (my child) have tinnitus?
The first thing to do is to see your primary care doctor, who will check if anything, such as ear wax, is blocking the ear canal. Your doctor will ask you about your current health, medical conditions, and medications to find out if an underlying condition is causing your tinnitus.
If your doctor cannot find any medical condition responsible for your tinnitus, you may be referred to an otolaryngologist (commonly called an ear, nose, and throat doctor, or an ENT) and/or to an audiologist. The ENT will physically examine your head, neck, and ears. The audiologist will test your hearing to determine whether you have any hearing differences along with the tinnitus and can evaluate your tinnitus.
Before coming to see an audiologist, it would be very helpful if you complete the following questionnaire and bring it with you to the appointment. The answers to the questions will help the audiologist in the assessment. Click here for the questionnaire.
What treatments are available for tinnitus?
Tinnitus does not have a cure yet. The most effective treatment for tinnitus is to eliminate the underlying cause. As we mentioned above, tinnitus, in some cases, can be a symptom of a treatable medical condition. Unfortunately, in many cases, the cause of tinnitus cannot be identified, or medical or surgical treatment is not an option. In these cases, there are treatments that help people cope/manage better their tinnitus. One thing that it is important to consider is that a treatment that is useful and successful for one person may not be appropriate for another. Your audiologist and/or ENT physician may use or recommend one, or a combination of some of the following treatments/methods:
Hearing aids often are helpful for people who have hearing differences along with tinnitus. Using a hearing aid adjusted to carefully control outside sound levels may make it easier for you to hear. The better you hear, the less you may notice your tinnitus
Commercially available apps may be beneficial. Please refer to the resource section that follows for websites and apps that might be helpful.
Wearable sound generators are small electronic devices that fit in the ear and use a soft, pleasant sound to help mask the tinnitus. Some people want the masking sound to totally cover up their tinnitus, but most prefer a masking level that is just a bit louder than their tinnitus. The masking sound can be a soft “shhhhhhhhhhh,” random tones, or music.
Tabletop sound generators are used as an aid for relaxation or sleep. Placed near your bed, you can program a generator to play pleasant sounds such as waves, waterfalls, rain, or the sounds of a summer night. If your tinnitus is mild, this might be all you need to help you fall asleep.
Cochlear implants are sometimes used in people who have tinnitus along with severe hearing levels. A cochlear implant bypasses the damaged portion of the inner ear and sends electrical signals that directly stimulate the auditory nerve. The device brings in outside sounds that help mask tinnitus and stimulate change in the neural circuits.
Counseling (by a professional counselor) can be very helpful whenever the tinnitus becomes problematic. Counseling should be considered both as a primary approach, when appropriate, and as an adjunctive approach, to all treatment strategies. Counseling consists of gathering data through careful listening, making adjustments in one’s strategies based on that knowledge, and conveying information. Thus, it serves both a diagnostic and therapeutic function.
Cognitive Behavioral Therapy may be successful in helping people cope with tinnitus. This approach can help persons identify the way they react to their tinnitus and learn new responses, thereby minimizing the negative thoughts and behavior patterns that are associated with tinitus.
Biofeedback is a technique that trains people to improve their health by controlling certain bodily processes that normally happen involuntarily, such as heart rate, blood pressure, muscle tension, and skin temperature
Self-help and Support/Education Groups assist in staying informed on the latest information and share treatment experiences by talking to others with similar problems. These groups should be facilitated, or at least attended, by an audiologist or a psychologist (to prevent misinformation from being conveyed) and may include lectures from a variety of related disciplines
Habituation & Tinnitus Retraining Therapy is a method developed to facilitate habituation to tinnitus. It combines sound enrichment therapy with directive counseling. Sound is employed to reduce the contrast between silence or ambient noise and the perception of the tinnitus. It may be in the form of environmental sounds, amplification, or broadband sound generating devices. A reduction of the perception of the tinnitus (but not complete obliteration of it) is considered essential to the process of habituation. Counseling and education serve to demystify tinnitus, providing the patient with an intellectual and emotional framework in which habituation can occur.
Acoustic neural stimulation is a relatively new technique for people whose tinnitus is very loud or won’t go away. It uses a palm-sized device and headphones to deliver a broadband acoustic signal embedded in music. The treatment helps stimulate change in the neural circuits in the brain, which eventually desensitizes you to the tinnitus. The device has been shown to be effective in reducing or eliminating tinnitus in a significant number of study volunteers.
Antidepressants and antianxiety drugs might be prescribed by your doctor to improve your mood and help you sleep.
Other medications may be available at drugstores and on the Internet as an alternative remedy for tinnitus, but none of these preparations has been proven effective in clinical trials.
Other treatments could include:
- Stress management
- Relaxation therapy
- Habituation therapies
- Hypnosis
- Electrical stimulation