Tinnitus affects males and females in equal numbers. It can affect individuals of any age, even children. Tinnitus, collectively, is a very common condition and estimated to affect approximately 10% of the general population. Rhythmic tinnitus occurs far less frequently than non-rhythmic tinnitus, accounting for approximately 1% of all cases of tinnitus and is considered relatively rare in the general population. The exact prevalence or incidence of rhythmic tinnitus is unknown. Rhythmic tinnitus due to pseudotumor and sinus wall anomalies is found most commonly in overweight women in their 3rd to 6th decade of life. The onset of tinnitus can be abrupt or develop slowly over time.
When there does not seem to be a connection with a disorder of the inner ear or auditory nerve, the tinnitus is called nonotic (i.e. not otic). In some 30% of tinnitus cases, the tinnitus is influenced by the somatosensory system, for instance people can increase or decrease their tinnitus by moving their face, head, or neck.[27] This type is called somatic or craniocervical tinnitus, since it is only head or neck movements that have an effect.[25]
Between 2007 and 2011, the researchers recruited 492 Dutch adults who had been diagnosed with tinnitus. The patients had to fulfil several criteria, including having no underlying disease that was causing their tinnitus, no other health issues that precluded their participation, and to have received no treatment for their tinnitus in the five previous years. Some 66% of adults originally screened for the study participated after screening.
Various techniques can help make tinnitus tolerable, although the ability to tolerate it varies from person to person. Many people find that background sound helps mask the tinnitus and helps them fall asleep. Some people play background music. Other people use a tinnitus masker, which is a device worn like a hearing aid that produces a constant level of neutral sounds. For the profoundly deaf, an implant in the cochlea (the organ of hearing) may reduce tinnitus but is only done for people with severe to profound hearing loss in both ears. If these standard techniques are not helpful, people may want to seek treatment in clinics that specialize in the treatment of tinnitus.
Tinnitus remains a symptom that affects the lives of millions of people. Research is directed not only at its treatment, but also at understanding why it occurs. Research by doctors at the University at Buffalo, The State University of New York, Dalhousie University (Canada), and Southeast China University have published research using electrophysiology and functional MRI to better understand what parts of the brain are involved in hearing and the production of tinnitus. Their research has found that much larger areas of the brain are involved with the process of hearing than previously believed, which may help direct future diagnostic and therapeutic options.

Age-Related Hearing Loss: Also known as presbycusis, age-related hearing loss results from the cumulative effect of aging on hearing. This permanent, progressive, and sensorineural condition is most pronounced at higher frequencies. It commonly impacts people over the age of 50, as all people begin to lose approximately 0.5% of the inner ear’s hair cells annually starting at age 40.

Overdosing on certain prescription drugs, recreational drugs or alcohol. This can sometimes cause permanent damage to nerves that affect hearing. In some cases when a pregnant women uses drugs during pregnancy, this can cause tinnitus to develop in her child. Common drugs that might contribute to tinnitus include ototoxics, psychotropic drugs, aminoglycosides, certain antibiotics and vancomycin.

CBT involves working with a therapist or counselor, typically once per week, to identify and change negative thought patterns. CBT was initially developed as a treatment for depression and other psychological problems, but it seems to work well for people with tinnitus. Several studies and meta-reviews, including one published in the Korean Journal of Audiology, have found that CBT significantly improves irritation and annoyance that often comes with tinnitus.
Almost everyone has had tinnitus for a short time after being exposed to extremely loud noise. For example, attending a loud concert can trigger short-lived tinnitus. Some medications (especially aspirin and other nonsteroidal anti-inflammatory drugs taken in high doses) can cause tinnitus that goes away when the drug is discontinued. When it lasts more than six months, it's known as chronic tinnitus. As many as 50 to 60 million people in the United States suffer from this condition; it's especially common in people over age 55 and strongly associated with hearing loss. Many people worry that tinnitus is a sign that they are going deaf or have another serious medical problem, but it rarely is.

Tinnitus (pronounced "tin-it-tus") is an abnormal noise in the ear (note that it is not an "itis" -- which means inflammation). Tinnitus is common -- nearly 36 million Americans have constant tinnitus and more than half of the normal population has intermittent tinnitus.   Another way to summarize this is that about 10-15% of the entire population has some type of constant tinnitus, and about 20% of these people (i.e. about 1% of the population) seek medical attention (Adjamian et al, 2009). Similar statistics are found in England (Dawes et al, 2014) and Korea (Park and Moon, 2014).
According to ATA, The American Tinnitus Association, 45 million Americans are struggling with tinnitus. In Germany the “Deutsche Tinnitus-Liga” estimates that 19 million Germans have experienced tinnitus, and that 2,7 million Germans have persistent tinnitus, of which 1 million have very severe tinnitus. The British Tinnitus Association estimates that 10% of the UK population suffers from tinnitus.  Read more about the prevalence of tinnitus.

Sound-masking devices provide a pleasant or benign external noise that partially drowns out the internal sound of tinnitus. The traditional sound-masking device is a tabletop sound machine, but there are also small electronic devices that fit in the ear. These devices can play white noise, pink noise, nature noises, music, or other ambient sounds. Most people prefer a level of external sound that is just slightly louder than their tinnitus, but others prefer a masking sound that completely drowns out the ringing.
CBT involves working with a therapist or counselor, typically once per week, to identify and change negative thought patterns. CBT was initially developed as a treatment for depression and other psychological problems, but it seems to work well for people with tinnitus. Several studies and meta-reviews, including one published in the Korean Journal of Audiology, have found that CBT significantly improves irritation and annoyance that often comes with tinnitus.
Therefore, the Department of Defense and Congress have taken an interest in furthering tinnitus research, adding it to a list of researchable conditions that impact the military. Both American Tinnitus Association and the Department of Defense fund tinnitus research. New research developments are reported in journals such as Tinnitus Today and the International Tinnitus Journal.

Sound Options Tinnitus Treatments Inc. addresses the need for an effective tinnitus treatment by offering a clinically validated, individually customized sound therapy. The sound therapy is based on leading neuroscience and tinnitus research that has been built into our software to produce a treatment that can be conveniently delivered via any music playing device. Sound Options is also heavily invested in community engagement. This includes educating and reaching out to seniors, veteran's groups, and police and firefighter associations, as these segments of our population are most affected by tinnitus. Sound Options is relentless about innovation and we are constantly seeking novel ways to help tinnitus sufferers. Our treatment has been designed with the tinnitus sufferer in mind: it is pleasantly effective, affordable, and individually customized.
People with warning signs should see a doctor right away. People without warning signs in whom tinnitus recently developed should call their doctor, as should people with pulsatile tinnitus. Most people with tinnitus and no warning signs have had tinnitus for a long time. They can discuss the matter with their doctor and be seen at a mutually convenient time.

Tinnitus can be extremely frustrating and can leave you feeling overwhelmed and unsure about your next steps. Remember that you are not alone - tinnitus, while not well-understood, is common. Make an appointment with a hearing care professional near you, preferably one who specializes in tinnitus treatment. Be prepared to discuss your symptoms in detail so you can get relief and regain your quality of life. 
Tinnitus (pronounced tih-NITE-us or TIN-ih-tus) is sound in the head with no external source. For many, it's a ringing sound, while for others, it's whistling, buzzing, chirping, hissing, humming, roaring, or even shrieking. The sound may seem to come from one ear or both, from inside the head, or from a distance. It may be constant or intermittent, steady or pulsating.
Copyright ©2019 NORD - National Organization for Rare Disorders, Inc. All rights reserved. NORD is a registered 501(c)(3) charity organization. Please note that NORD provides this information for the benefit of the rare disease community. NORD is not a medical provider or health care facility and thus can neither diagnose any disease or disorder nor endorse or recommend any specific medical treatments. Patients must rely on the personal and individualized medical advice of their qualified health care professionals before seeking any information related to their particular diagnosis, cure or treatment of a condition or disorder.
Cognitive Behavior Therapy (CBT) / Hypnotherapy. Another alternative treatment option worth considering is Cognitive Behavior Therapy (CBT), which is often simply referred to as hypnotherapy. The goal of CBT is to help lower any anxiety, anger or depression you are feeling toward your tinnitus, as well as to help retrain your brain to notice the ringing in your ears less. CBT is typically used in conjunction with sound stimulation therapies, like Neuromonics or Transcranial Magnetic Stimulation (TRT). When choosing your therapist, be sure they not only do they have previous experience working with patients with tinnitus, but also have Neural Linguistic Programming (NLP) training.
Sound therapies are one method that has previously been shown to reduce the severity of tinnitus. While not all sound therapies have gone through rigorous clinical testing, they have far greater traction and adoption in the tinnitus community. There are two types of sound therapy approaches: (1) maskers that are intended to block out the tinnitus and have the patient learn to ignore their tinnitus, and (2) sound therapies that utilize the same brain plasticity that is thought to be causing the tinnitus for the purpose of reducing it. Both approaches can be delivered via electronic devices that can produce sound. There has been an increase in tinnitus maskers that are built into hearing aids. These built-in maskers generate different sounds including white noise and random tones. Unfortunately, due to their design, hearing aids are still limited to providing masking at frequencies below 8 kHz.
Español: curar el tinnitus (zumbido de oídos), Deutsch: Tinnitus heilen, 中文: 治疗耳鸣, Italiano: Curare l’Acufene, Русский: вылечить тиннитус, Français: soigner des acouphènes, Português: Curar Zumbido no Ouvido, Bahasa Indonesia: Mengobati Tinitus, Nederlands: Tinnitus genezen, Čeština: Jak vyléčit tinnitus, العربية: علاج طنين الأذن, Tiếng Việt: Trị ù tai, 한국어: 이명을 치료하는 방법, हिन्दी: कर्णनाद (टिनिटस) का इलाज़ करें, 日本語: 耳鳴りの治療
We provide here a list of known ototoxic drugs and herbs that have been known to cause or exacerbate tinnitus. This list is for educational purposes only and is available as a resource to you to use in your discussions with your health care professional. We thank doctor Neil Bauman, Ph.D., for his expertise in this area and for compiling this list for us.
Tinnitus is a ringing, buzzing, hissing, swishing, clicking, or other type of noise that seems to originate in the ear or head. Most of us will experience tinnitus or sounds in the ears at some time or another. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), about 10% of adults in the U.S. - nearly 25 million Americans - have experienced tinnitus lasting at least five minutes in the past year. Tinnitus is identified more frequently in white individuals, and the prevalence of tinnitus in the U.S. is almost twice as frequent in the South as in the Northeast.
Some tinnitus sufferers have experienced relief through hearing aids, but studies indicate that such benefits are limited to those with low-frequency tinnitus.8 For those with a tinnitus pitch above 5–6 kHz or those with a hissing or buzzing tinnitus, the benefits of hearing aids are more limited or even nonexistent. This makes sense from a neuroscience point of view, as the hearing aid will typically not be making up for hearing loss at frequencies above 6–8 kHz; this prevents any possible effects on tinnitus types that are caused by changes to higher frequency regions in the auditory system. While hearing aids are essential to improving the lives of the hearing impaired, they are not typically the best option for tinnitus; especially when used alone.
If your mind is occupied with something absorbing, it is easier to forget about the tinnitus. Work, leisure pursuits and other interests can all help to provide a worthwhile focus. If you don't have a hobby, now might be the time to start something, many people say that painting or writing helps. Bear in mind however, that excessive activity may produce stress, so take time for relaxing activities and social interaction where possible.
The important thing to remember about tinnitus is that the brain’s response to these random electrical signals determines whether or not a person is annoyed by their tinnitus or not. Magnetoencephalography (MEG, for short) studies have been used to study tinnitus and the brain. MEG takes advantage of the fact that every time neurons send each other signals, their electric current creates a tiny magnetic field. MEG allows scientists to detect such changing patterns of activity in the brain 100 times per second. These studies indicated tinnitus affects the entire brain and helps with understanding why certain therapies are more effective than others.
Noise exposure. Exposure to loud noises can damage the outer hair cells, which are part of the inner ear. These hair cells do not grow back once they are damaged. Even short exposure to very loud sounds, such as gunfire, can be damaging to the ears and cause permanent hearing loss. Long periods of exposure to moderately loud sounds, such as factory noise or music played through earphones, can result in just as much damage to the inner ear, with permanent hearing loss and tinnitus. Listening to moderately loud sounds for hours at a young age carries a high risk of developing hearing loss and tinnitus later in life.

Tinnitus is commonly accompanied by hearing loss, and roughly 90% of persons with chronic tinnitus have some form of hearing loss (Davis and Rafaie, 2000; Lockwood et al, 2002). On the other hand, only about 30-40% of persons with hearing loss develop tinnitus. According to Park and Moon (2004), hearing impairment roughly doubles the odds of having tinnitus, and triples the odds of having annoying tinnitus.
The multidisciplinary approach required input from many different professionals including audiologists, psychologists, speech therapists and physical therapists. Which particular care elements of the intervention had the greatest effect is unknown. A multidisciplinary approach such as the intervention trialled here may have resource implications if it were introduced into standard clinical practice.
Tinnitus Control contains both a spray that is administered under the tongue three times a day and a gelatin capsule that is to be taken twice a day. Each package comes with a one month’s supply of the spray (1 fluid ounce) and capsules (60 capsules). Tinnitus Control is not currently available in local stores such as CVS, Walgreens and Rite Aid, but it is available directly from the manufacturer’s website at http://www.tinnituscontrol.com
Cochlear Implants. These implants are a treatment option for patients that have a severe hearing loss along with tinnitus. Cochlear implants are designed to bypass any damaged parts of the inner ear and send the electrical signals sound makes directly to the auditory nerve. By bringing in outside noise, these implants can effectively mask your tinnitus, as well as stimulate your neural circuits to change.
Copyright ©2019 NORD - National Organization for Rare Disorders, Inc. All rights reserved. NORD is a registered 501(c)(3) charity organization. Please note that NORD provides this information for the benefit of the rare disease community. NORD is not a medical provider or health care facility and thus can neither diagnose any disease or disorder nor endorse or recommend any specific medical treatments. Patients must rely on the personal and individualized medical advice of their qualified health care professionals before seeking any information related to their particular diagnosis, cure or treatment of a condition or disorder.
Exposure to loud noise: Loud noise exposure is a very common cause of tinnitus today, and it often damages hearing as well. Unfortunately, many people are unconcerned about the harmful effects of excessively loud noise from firearms, high intensity music, or other sources. Twenty-six million American adults have suffered noise-induced hearing loss, according to the NIDCD.
When tinnitus is unexpected and unwelcomed, it can lead to a negative reaction to the tinnitus. This can create a vicious cycle. When tinnitus is perceived, it can prompt emotions, including frustration, fear, unhappiness, etc.  These can, in turn, cause physical reactions such as anxiety and stress.  This reinforces the tinnitus and perpetuates the cycle. 

The cause of tinnitus may be difficult to determine. Your doctor will ask if you have been exposed to loud noise at work or home and will ask about medications you take, including all herbs and supplements. He or she may look in your ears to see if you have wax blockage or if the eardrum appears abnormal. If your hearing is affected, then your doctor may have you undergo a hearing test called an audiogram to measure your hearing ability in each ear.
Most experts refer to tinnitus as the condition that causes ringing in the ears, however other abnormal sounds and sensations can also be attributed to tinnitus. The definition of tinnitus is “the perception of noise or ringing in the ears.” Some also describe this condition as “hearing sounds in the ears when no external sound is present.” Although tinnitus is only a significant problem for about 1 percent to 5 percent of the population, up to 10 percent to 15 percent of all children and adults are believed to experience ringing in the ears at least from time to time.
Hyperactivity and deep brain stimulation. Researchers have observed hyperactivity in neural networks after exposing the ear to intense noise. Understanding specifically where in the brain this hyperactivity begins and how it spreads to other areas could lead to treatments that use deep brain stimulation to calm the neural networks and reduce tinnitus.
MRI (or magnetic resonance imaging) scan is a radiology technique which uses magnetism, radio waves, and a computer to produce images of body structures. MRI scanning is painless and does not involve X-ray radiation. Patients with heart pacemakers, metal implants, or metal chips or clips in or around the eyes cannot be scanned with MRI because of the effect of the magnet.
Vitamin Supplements. Vitamin supplements, like Lipo-Flavonoid Plus, contain the vitamins that some studies have shown to be beneficial to inner ear health. These include Vitamin C, B-1, B-2, B-6, B-12, zinc, niacin and calcium. And while I am a proponent of vitamins, I advise my patients to take a regular OTC multivitamin that costs $15, versus Lipo-Flavonoid Plus, which has the same ingredients, but costs up to $90 for the same number of pills, just because it’s packaged and marketed to people that suffer from 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). The ENT will physically examine your head, neck, and ears and test your hearing to determine whether you have any hearing loss along with the tinnitus. You might also be referred to an audiologist who can also measure your hearing and evaluate your tinnitus.
If you have tinnitus you also may suffer from anxiety, depression, or insomnia. Discuss treatments with your doctor. While tinnitus cannot always be cured, there are many treatments available for you to make it easier to live with tinnitus. See your doctor if tinnitus is accompanied by dizziness, fever, or headache; as this may signal a more serious condition.
Antibiotics, including erythromycin, neomycin, polymysxin B and vancomycin, as well as cancer medications, including mechlorethamine and vincristine, and water pills, including bumetanide, furosemide or ethacrynic acid all have the ability to cause or worsen tinnitus. Some patients will experience tinnitus after using antidepressants or quinine medications.

Currently there is no cure for most cases of tinnitus. Depending on the type of tinnitus, symptoms will tend to come and go over time. Stress level, diet, and exposure to noise can worsen tinnitus. Many people find their tinnitus annoying but can learn to adapt without difficulty. It is likely that if you have had tinnitus, you will have it again in the future.
Assessment of psychological processes related to tinnitus involves measurement of tinnitus severity and distress (i.e., nature and extent of tinnitus-related problems), measured subjectively by validated self-report tinnitus questionnaires.[18] These questionnaires measure the degree of psychological distress and handicap associated with tinnitus, including effects on hearing, lifestyle, health and emotional functioning.[62][63][64] A broader assessment of general functioning, such as levels of anxiety, depression, stress, life stressors and sleep difficulties, is also important in the assessment of tinnitus due to higher risk of negative well-being across these areas, which may be affected by or exacerbate the tinnitus symptoms for the individual.[65] Overall, current assessment measures are aimed to identify individual levels of distress and interference, coping responses and perceptions of tinnitus in order to inform treatment and monitor progress. However, wide variability, inconsistencies and lack of consensus regarding assessment methodology are evidenced in the literature, limiting comparison of treatment effectiveness.[66] Developed to guide diagnosis or classify severity, most tinnitus questionnaires have been shown to be treatment-sensitive outcome measures.[67]
To keep the brain activated and aware, Kilgard’s therapy involves stimulating the vagus nerve, which is actually a pair of nerves that runs inside the neck and into the brain. “All the stuff you brains learns about your body — it all comes in through the vagus nerve,” he says. “We trick the brain into thinking it’s learning something important by stimulating this nerve in the neck.”
We conducted a randomized, double-blind, placebo-controlled trial investigating the effects of the customized music-based sound therapy for reducing tinnitus. Participants (N = 50) who suffered from tinnitus were randomly allocated (with 1:1 ratio) to the treatment and placebo groups with assessments at baseline, 3, 6, and 12 months. The primary outcome was the differences in mean scores of the THI compared at four time intervals. Independent and paired samples t-tests were conducted to compare THI scores between and within groups, respectively.
Supporting the idea that central reorganization is overestimated as "the" cause of tinnitus, a recent study by Wineland et al showed no changes in central connectivity of auditory cortex or other key cortical regions (Wineland et al, 2012). Considering other parts of the brain, Ueyama et al (2013) reported that there was increased fMRI activity in the bilateral rectus gyri, as well as cingulate gyri correlating with distress. Loudness was correlated with values in the thalamus, bilateral hippocampus and left caudate. In other words, the changes in the brain associated with tinnitus seem to be associated with emotional reaction (e.g. cingulate), and input systems (e.g. thalamus). There are a few areas whose role is not so obvious (e.g. caudate). This makes a more sense than the Wineland result, but of course, they were measuring different things. MRI studies related to audition or dizziness must be interpreted with great caution as the magnetic field of the MRI stimulates the inner ear, and because MRI scanners are noisy.
Though the exact cause of tinnitus — as in the specific mechanism that creates these phantom sounds in some people — remains unknown, contributing factors and triggers have been identified. Excessive exposure to loud noise is often a factor because of the damage done to your auditory system. Tinnitus may also result from jaw-joint dysfunction (e.g., teeth grinding, temporomandibular joint disorder) or chronic neck muscle strain.
Hyperactivity and deep brain stimulation. Researchers have observed hyperactivity in neural networks after exposing the ear to intense noise. Understanding specifically where in the brain this hyperactivity begins and how it spreads to other areas could lead to treatments that use deep brain stimulation to calm the neural networks and reduce tinnitus.
We encourage you to avoid anything that can make your tinnitus worse. For instance, you may want to avoid smoking, drinking alcohol, or listening to loud noises. Another precaution is protection. If you’re a construction worker, airport worker, hunter, or regularly exposed to loud noise, you should wear custom earplugs or special earmuffs. Ear protection goes a long way towards preventing your tinnitus from getting worse.
Medication. Some medications are known to be ototoxic while others list tinnitus as a side effect without causing permanent damage to the ear structures. New medications come out so often that it is difficult to maintain an up to date listing; another option, if you are experiencing tinnitus and are curious if it could be your medication, is to talk to your pharmacist or look up your specific prescriptions online through a website such as www.drugs.com. You should never stop a medication without consulting with your physician, even if you think it may be contributing to your tinnitus.
There is no cure for tinnitus. However, it can be temporary or persistant, mild or severe, gradual or instant. The goal of treatment is to help you manage your perception of the sound in your head. There are many treatments available that can help reduce the perceived intensity of tinnitus, as well as its omnipresence. Tinnitus remedies may not be able to stop the perceived sound, but they can improve your quality of life.
There are, however, excellent tools to help patients manage their condition; treatments that reduce the perceived intensity, omnipresence, and burden of tinnitus. These currently available treatments are not “cures” — they neither repair the underlying causes of tinnitus, nor eliminate the tinnitus signal in the brain. Instead, they address the attentional, emotional, and cognitive impact of tinnitus. They help patients live better, more fulfilling, and more productive lives, even if the perception of tinnitus remains.

In addition to treating associated problems (such as depression or insomnia), there are several strategies that can help make tinnitus less bothersome. No single approach works for everyone, and you may need to try various combinations of techniques before you find what works for you. If you have age-related hearing loss, a hearing aid can often make tinnitus less noticeable by amplifying outside sounds.
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