Tinnitus (Ear Ringing)

Overview

Tinnitus is the subjective experience of having a sound, ringing, or noise in the ears. Tinnitus has many causes. Almost every type of hearing disorder can have ringing associated with it. Virtually all of us experience this ringing sensation at some point. Yet, it is felt that 50 million people in the United States have a significant degree of tinnitus, with 12 million of the cases so severe that these individuals seek medical help. The American Tinnitus Association, a non-profit group that assists tinnitus patients, estimates that these patients spend as much as 20% more annually than the average citizen on health care costs. For some, tinnitus is certainly a perplexing condition.

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Causes

Though tinnitus is very real, the actual event, cause or mechanism that creates the disorder is often unknown. Research continues to seek cures for cases of tinnitus that cannot be alleviated through surgery. Until that time, many strategies do work for tinnitus sufferers.

Treatments

Several forms of treatment are available to assist individuals for whom tinnitus has become bothersome. The first step would be to obtain a thorough evaluation by an otolaryngologist (Ear, Nose and Throat Doctor) in order to determine whether there is a medical condition for which treatment would relieve or cure the symptoms.

Interventions

  • Medical or Surgical treatments are available for some tinnitus conditions. Surgery is not recommended in all circumstances but may be an option with conditions such as Meniere's disease, otosclerosis or auditory nerve tumors.
  • Wax removal eliminates wax in the ear canal that can cause tinnitus. This can be easily removed by your physician.
  • Medication can be prescribed for middle-ear infections, abnormal middle-ear pressure or muscle spasms.

Non-Surgical Treatment Strategies

After counseling with one of our physicians, should medical treatment not be appropriate, several non-surgical methods can be initiated. Several forms of treatment are available.

  • Amplification or the use of hearing aids is often the most effective method in reducing or limiting tinnitus associated with hearing loss.
  • Masking devices look much like a hearing aid. Instead of amplifying sound, however, they produce a band of noise that can be placed into the patient's ear. The idea behind masking units is that they provide a more tolerable sound than tinnitus. Consultation with our office should assist you in the decision making process for both the use of hearing aids or masking units for tinnitus.
  • Biofeedback is a relaxation process that has proven effective in controlling headaches and is now being used with tinnitus patients. It helps reduce stress (mentioned above) and lessens the noticeable effects of tinnitus. We can provide you, upon request, with further information regarding this effective technique.
  • Electrical stimulation is an experimental technique where electrodes are placed behind or in the ear. This has been an effective technique for some patients but for others it has worsened the tinnitus. We do not advocate the use of electrical stimulation at this time.
  • Dental treatment is effective for tinnitus provoked by problems with the Temporal Mandibular Joint (TMJ). Consultation with your dentist can determine whether or not your ear pain and tinnitus is related to TMJ disorders.
  • Medications (anti-anxiety or tranquilizing drugs) have proven effective in certain situations. Many of these drugs, as with electrical stimulation are still in the experimental stage.
  • Distraction techniques can be used in the treatment of tinnitus. A low level sound will often ‘distract’ the ear from ringing. If sleeping is problem, for example, try listening to a radio at a low level as you fall asleep.

Avoidance of Tinnitus Triggering Agents

Regardless of the type of intervention employed, avoidance of tinnitus-triggering agents is recommended. The following lists many of the major tinnitus offenders:

  • Exposure to loud sounds is known to aggravate tinnitus.
    • Hearing protection should be worn around sounds such as guns, motorcycles, and work place noise. Should you need to obtain earplugs to protect your hearing, please contact our office and we can outline the effectiveness of several types of noise protection plugs.
  • Caffeine and nicotine also have an adverse effect on tinnitus. Patients are encouraged to eliminate caffeine or nicotine for a one month period to determine if the tinnitus is reduced.
  • Avoidance of excess alcohol consumption can reduce tinnitus.
  • Reduction or elimination of aspirin (typically higher doses) or some antibiotics will also reduce tinnitus.
  • If you are taking these medications for a physical condition, perhaps other medications could be substituted. Consultation with your prescribing physician will enable you to know if a non-tinnitus providing substance could be used instead. (Lists of tinnitus provoking drugs are available from the American Tinnitus Association; P.O. Box 5; Portland, Oregon 97207). Prescribed medications SHOULD NOT be eliminated or replaced without consent of the prescribing physician.
  • Stress. Finally, stress reduction seems to have a beneficial effect on tinnitus and allows an individual to cope more effectively with the disorder. Biofeedback, mentioned earlier, has proven to be one method of reducing stress.

 

Resources

For further information regarding tinnitus, please consult your otolaryngologist or the American Tinnitus Association (www.ata.org).