It is very well accepted that tinnitus often is "centralized" -- while it is usually initiated with an inner ear event, persistent tinnitus is associated with changes in central auditory processing (Adjamian et al, 2009). Sometimes this idea is used to put forth a "therapeutic nihilism" -- suggesting that fixing the "cause" -- i.e. inner ear disorder -- will not make the tinnitus go away. This to us seems overly simplistic -- while it is clear that the central nervous system participates in perception of sounds, and thus must be a participant in the "tinnitus" process, we think that it is implausible that in most cases that there is not an underlying "driver" for persistent tinnitus.
While it’s definitely not a cure by any stretch of the imagination, if your tinnitus does not respond to Tinnitus Control, nor is there any identifiable underlying medical condition, then an effective way to drown out the sounds in your head is via noise suppression devices. These sound generators, in essence, mask the sounds of tinnitus so that you notice them less and can go about your daily life without going crazy over the annoying buzzing, whistling or ringing in your ears.
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.
Ototoxic drugs can also cause subjective tinnitus, as they may cause hearing loss, or increase the damage done by exposure to loud noise. Those damages can occur even at doses that are not considered ototoxic. Over 260 medications have been reported to cause tinnitus as a side effect. In many cases, however, no underlying cause could be identified.
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.
Acoustic Neural Stimulation. This relatively new treatment has shown to be effective in reducing, and in some cases eliminating, symptoms in patients whose tinnitus just won’t go away or is very loud. The treatment utilizes a device small enough to fit into the palm of your hand that delivers a broadband acoustical signal embedded in special music you can listen to via headphones. The treatment eventually desensitizes you to the ringing in your ears by stimulating changes in the neural circuits in your brain.
Research shows a frequent correlation between tinnitus and hearing loss. Because tinnitus is perceived differently by each sufferer, an exact diagnosis is essential. A doctor may conduct ENT, dental, orthodontic, and orthopedic examinations in order to establish whether a case can be medically treated or not. The pitch and volume of tinnitus can be determined by special diagnostic test, and a hearing test can reveal whether hearing loss is also involved. Treatment with hearing aids is often the first step to relief from tinnitus. Hearing aids compensate for hearing loss, which enables concentration on external sounds instead of internal noises.
Counseling helps you learn how to live with your tinnitus. Most counseling programs have an educational component to help you understand what goes on in the brain to cause tinnitus. Some counseling programs also will help you change the way you think about and react to your tinnitus. You might learn some things to do on your own to make the noise less noticeable, to help you relax during the day, or to fall asleep at night.
Identifying And Treating Any Vascular Issues. There is a very small chance that your tinnitus is being caused by an underlying blood vessel condition known as pulsatile tinnitus. Sometimes this condition is caused by pregnancy or strenuous exercise and other times it’s the result of a single blood vessel or a group of blood vessels experiencing increased blood flow that the rest of the body is not experiencing. On rare occurrences, the cause is a benign tumor known as an acoustic neuroma (AKA vestibular schwannoma). These tumors, although very rare, can cause the development of abnormal blood vessels which can result in pulsatile tinnitus. Treatment options include medication and surgery.
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Paquette et al (2017) reported a prospective study of 166 patients who had brain surgery involving removal of the medial temporal lobe. The prevalence of tinnitus increased from approximately from 10 to 20% post surgery. This study did not include a control -- a natural question would be -- suppose a different part of the brain were removed. One would also think that drilling of the skull from any source might increase tinnitus. We are presently dubious that the medial temporal lobe suppresses tinnitus.
We are all different and you may find you prefer one type of relaxation over another. You may find a class that teaches a type you like. However, you may not be able to get to classes or you may just prefer to do something yourself. Using some simple techniques regularly may help you to improve your quality of life and make a real difference to living with tinnitus. It does take practice to develop good relaxation techniques, and what may help one day, may not do so the next – so don’t give up if at first it does not seem to help.
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.
Exposure to loud noise. Loud noises, such as those from heavy equipment, chain saws and firearms, are common sources of noise-related hearing loss. Portable music devices, such as MP3 players or iPods, also can cause noise-related hearing loss if played loudly for long periods. Tinnitus caused by short-term exposure, such as attending a loud concert, usually goes away; both short- and long-term exposure to loud sound can cause permanent damage.