health topics

What Is the Most Effective Treatment for Tinnitus?

Tinnitus is a condition that causes a person to hear a noise, usually a ringing, coming from inside their head or ear(s), which can occur in one or both ears. Treatment for tinnitus can include hearing aids, cochlear implants, surgery, behavioral therapies, masking devices, medication changes, and more.
Tinnitus is a condition that causes a person to hear a noise, usually a ringing, coming from inside their head or ear(s), which can occur in one or both ears. Treatment for tinnitus can include hearing aids, cochlear implants, surgery, behavioral therapies, masking devices, medication changes, and more.

Tinnitus is a condition in which people perceive a noise that seems to originate in the ear or head in the absence of an external source. The tinnitus sound may be heard in one or both ears, may sound as if it’s within or around the head, or be perceived as an outside distant noise. The noise may be constant or intermittent. 

Tinnitus is usually a symptom of another underlying condition and while it can be annoying, it is not usually a sign of a serious problem. 

There is no cure for tinnitus, but there are a number of treatments that can help. There is not a single most effective treatment for tinnitus, but rather, treatments vary based on the patient’s overall health, the underlying cause, the severity of the condition, and the patient’s preferences.

Treatment of tinnitus includes: 

  • Treatment for hearing loss 
    • Hearing aids 
    • Cochlear implants 
    • Surgery to the outer or middle ear
  • Behavioral therapies to cope with tinnitus
    • Tinnitus retraining therapy (TRT): retraining the brain to accept tinnitus sounds as normal and natural, rather than annoying, so patients become less aware of their tinnitus
    • Masking devices 
      • Devices that resemble hearing aids which produce low-level sounds to help reduce or eliminate tinnitus noise 
      • White noise, such as from a white noise machine, fan, or radio on low volume can also help mask tinnitus
    • Biofeedback and stress reduction 
    • Cognitive behavioral therapy: teaches patients to manage psychological responses to tinnitus using coping strategies, distraction skills, and relaxation techniques
  • Stopping medications that are causing the tinnitus (don’t stop taking a prescribed medication without first talking to your doctor)
  • Treatment for temporomandibular joint (TMJ) disorder 
    • Bite realignment
    • Dental treatment 
  • Other therapies 
    • Acupuncture
    • Electrical stimulation: certain parts of the inner ear are stimulated using electrodes placed on the skin or using acupuncture needles 
    • Repetitive transcranial magnetic stimulation (rTMS) (experimental)
  • Treatment for depression that may accompany tinnitus
  • Treatment for insomnia that may accompany tinnitus
    • Behavioral changes to improve sleep
    • Sleep medicines

What Are Symptoms of Tinnitus?

Tinnitus involves the perception of sound in the absence of an external source for that sound. 

The sound from tinnitus may be characterized as: 

  • A high-pitched steady tone (ringing) 
  • A pulsation that is rushing or humming 
  • Buzzing
  • Chirping
  • Clicking
  • Hissing
  • Roaring
  • Swishing
  • Whistling
  • Sound can vary in intensity with exercise or changing body position

Symptoms that may accompany tinnitus include:

  • Depression
  • Insomnia

What Causes Tinnitus?

Tinnitus is usually a symptom of a problem with the auditory (hearing) system. It may be a result of:

  • Hearing loss
    • Age-related 
    • Noise-induced, such as from loud music, machinery, gunfire, or even a short blast of very loud noise
    • Ear trauma
    • Drug-induced
  • Other health conditions
    • Stiffening of the bones in the middle ear (otosclerosis)
    • Brain tumors
    • Blood vessel or heart disease
    • Jaw joint (temporomandibular joint) disorders 
    • Genetic or inherited inner ear disorders
    • Neck injuries
    • Neurologic disorders
    • Severe anxiety
    • Tumors within the auditory system
    • Certain medications
      • Aspirin (if overused)
      • Aminoglycoside antibiotics
      • Quinine
    • Ear and sinus infections
    • Ménière’s disease
    • Hormonal changes in women
    • Thyroid abnormalities

How Is Tinnitus Diagnosed?

In addition to a patient history, a physical exam is performed to check for earwax that may be blocking the ear canal. 

Tinnitus is usually caused by another underlying disorder. Tests used to diagnose the cause of tinnitus include: 

  • Blood pressure may be taken
  • Hearing tests, including audiogram or auditory brainstem response (ABR)
  • Brain imaging 
  • Blood tests for hyperthyroidism 
  • Spinal tap to measure the fluid pressure in the skull and spinal cord (in rare cases)

What Are Complications of Tinnitus?

About 25% of tinnitus patients report increased tinnitus severity over time. Chronic tinnitus usually does not go away completely.
References
https://www.uptodate.com/contents/tinnitus-ringing-in-the-ears-beyond-the-basics?search=tinnitus&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2

https://www.ata.org/