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Health Topics A-Z
Tinnitus
How Can I Find Out What's Causing My Tinnitus?
To determine whether an underlying medical condition is causing your tinnitus, your doctor will give you a general physical exam, including a careful examination of your ears. Be sure to inform your doctor of all medications you are taking because tinnitus can be a side effect of some drugs.
If the source of the problem remains unclear, you may be sent to an otologist or an otolaryngologist (both ear specialists) or an audiologist (a hearing specialist) for hearing and nerve tests. As part of your examination, you may be given a hearing test called an audiogram. An imaging technique, such as an MRI or a CT scan, may also be recommended to reveal any structural problem.
What Are the Treatments?
If your tinnitus is a symptom of an underlying medical condition, the first step is to treat that condition. But if the tinnitus remains after treatment or if it results from exposure to loud noise, health professionals recommend various non-medical options that may help reduce or mask the unwanted noise (See Masking Devices below.) Sometimes, tinnitus goes away spontaneously, without any intervention at all.
If you are having difficulty coping with your tinnitus, you may find counseling and support groups helpful. Ask your doctor for a referral.
If the cause of your tinnitus is excessive earwax, your physician will clean out your ears with a small curved instrument called a curette or flush it out with a rubber bulb syringe filled with warm water. If you have an ear infection, you may be given prescription eardrops containing hydrocortisone to help relieve the itching and an antibiotic to fight the infection.
In cases where otosclerosis or a tumor is diagnosed, surgery may be necessary. If your tinnitus is the result of temporomandibular joint syndrome, your doctor will probably refer you to an orthodontist or other dental specialist for appropriate treatment.
Medications
Many drugs have been studied for treating tinnitus. For some, treatment with anti-anxiety drugs such as valium or antidepressants such as Elavil help. Lidocaine, a medication used for the treatment of certain types of abnormal heart rhythms, has been shown to relieve tinnitus for some people, but it must be given intravenously and is therefore impractical.
Hearing Aids
If your tinnitus is accompanied by some hearing loss, a hearing aid may be helpful.
Masking Devices
Many people have also benefited from tinnitus maskers, devices resembling hearing aids that play a sound more pleasant than the internal noise produced by the tinnitus. A newer device is a tinnitus instrument, which is a combination of hearing aid and masker.
Tinnitus Retraining Therapy
TRT depends upon the natural ability of the brain to "habituate" a signal, to filter it out on a subconscious level so that it does not reach conscious perception. Habituation requires no conscious effort. People frequently habituate many auditory sounds we initially hear, for instance, air conditioners, computer fans, refrigerators, and gentle rain. The two elements that air conditioners, computer fans, refrigerators, and gentle rain have in common are that the signals they emit have no importance, and the signals are not perceived as "loud." Thus, the brain can screen them out.
This form of therapy has two parts:
- The sufferer will play some source of neutral sound everywhere they go, including wearing in-the-ear sound generators.
- Sufferers receive one-on one counseling.
Cognitive Therapy
This is a form of counseling that helps a person to modify their reaction to the tinnitus. It works best when combined with other forms of therapy such as masking or medication.
Biofeedback
This is a relaxation technique that helps people to manage stress by changing their reaction to it. Some people find it is helpful in reducing tinnitus.
Dental Treatment
If your tinnitus is caused by a problem with the temporomandibular joint (TMJ), a joint in the jaw, dental treatment may relieve your symptoms. This is because the muscles and nerves in the jaw are closely connected to those in the ear.
Cochlear Implants
Although these devices, implanted in the ear, are mostly used to treat near deafness, they appear to also help some people with tinnitus who have significant hearing loss. The device works by sending electrical signals from the ear to the brain.
Alternative Treatments
Although no vitamin supplements or other alternative therapies have been proven beneficial to treat tinnitus, some people try herbal preparations such as ginkgo biloba or minerals such as zinc with varying results. Others have experienced relief with acupuncture, magnets or hypnosis.
Talk to your doctor for before trying any of these treatments.
How Can I Prevent Tinnitus?
Your risk of developing tinnitus increases with exposures to loud noises. Hearing protection is an important intervention. If you are around a noise that is so loud you can not speak at a normal conversation level you should wear ear plugs, move away from the noise source or turn it down.
SOURCES: American Tinnitus Foundation. American Academy of Otolaryngology-Head and Neck Surgery. The Mayo Clinic. University of Texas Medical Branch.