Wearable sound generators are small electronic devices that fit in the ear and use a soft, pleasant sound to help mask the tinnitus. Some people want the masking sound to totally cover up their tinnitus, but most prefer a masking level that is just a bit louder than their tinnitus. The masking sound can be a soft “shhhhhhhhhhh,” random tones, or music.
Tinnitus is the perception of sound when no actual external noise or sound is present. It is often referred to as “ringing” in the ears. I have even heard some people call it “head noises.” While ringing sounds are very common, many people will describe the sound they hear as buzzing, hissing, whistling, swooshing, and clicking. In some rare cases, tinnitus patients report hearing music. I hear about 2,000 crickets all going at once! 
Experts believe that tinnitus is associated with neural (brain and nerve) injuries that affect the auditory pathway and therefore someone’s ability to hear sounds. (10) Most of the time, tinnitus is a result of a disorder that affects parts of either the outer, inner or middle ear. The good news is that the majority of cases are not linked to any serious illness, although some cases are.
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.

^ McCombe A, Baguley D, Coles R, McKenna L, McKinney C, Windle-Taylor P (2001). "Guidelines for the grading of tinnitus severity: the results of a working group commissioned by the British Association of Otolaryngologists, Head and Neck Surgeons, 1999". Clinical Otolaryngology and Allied Sciences. 26 (5): 388–93. doi:10.1046/j.1365-2273.2001.00490.x. PMID 11678946. Archived (PDF) from the original on 2017-09-24.

^ Jump up to: a b c Han BI, Lee HW, Kim TY, Lim JS, Shin KS (March 2009). "Tinnitus: characteristics, causes, mechanisms, and treatments". Journal of Clinical Neurology. 5 (1): 11–19. doi:10.3988/jcn.2009.5.1.11. PMC 2686891. PMID 19513328. About 75% of new cases are related to emotional stress as the trigger factor rather than to precipitants involving cochlear lesions.
Don’t ignore ear pain. Pain or discomfort in your ear can be a sign of conditions associated with tinnitus, including ear infections and earwax buildup. These conditions, and the discomfort they cause, can also interfere with sleep. Whether your ear pain is sharp or dull, constant or intermittent, accompanied by itching or not, take these symptoms to your doctor.
Cognitive behavioral therapy (CBT). CBT uses techniques such as cognitive restructuring and relaxation to change the way patients think about and respond to tinnitus. Patients usually keep a diary and perform "homework" to help build their coping skills. Therapy is generally short-term — for example, weekly sessions for two to six months. A 2010 review of six studies by the Cochrane Collaboration (an international group of health authorities who evaluate randomized trials) found that after CBT, the sound was no less loud, but it was significantly less bothersome, and patients' quality of life improved.
Your doctor will try to determine what is causing the condition. If it is not due to a medication side effect or a general medical condition (such as high blood pressure), he or she may refer you to an otolaryngologist (an ear, nose, and throat doctor) or an audiologist (hearing specialist). It is especially important to see an otolaryngologist if you experience tinnitus in only one ear, tinnitus that sounds like your heartbeat or pulse (pulsatile tinnitus), tinnitus with sudden or fluctuating hearing loss, pressure or fullness in one or both ears, and/or dizziness or balance problems. Unless the cause of the tinnitus is obvious on physical examination, a hearing test is usually required.
It’s the same mechanism that’s happening in people who feel a phantom limb sensation after losing a limb, explains Susan Shore, PhD, a professor of otolaryngology, molecular physiology, and biomedical engineering at the University of Michigan in Ann Arbor. With tinnitus the loss of hearing causes specific brain neurons to increase their activity as a way of compensating, she explains. “These neurons also synchronize their activity as they would if there were a sound there, but there is no external sound,” she adds.
Tinnitus is believed to be caused by inner ear cell damage. Cilia in your inner ear move in relation to the pressure of sound waves. This triggers these cells to release an electrical signal through a nerve from your ear (auditory nerve) to your brain. Your brain interprets these signals as sound. If the hairs inside your inner ear are bent or broken, they can "leak" random electrical impulses to your brain, causing tinnitus.
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.
 Sound therapy can be effective in treating tinnitus because it may make the tinnitus less noticeable or mask the tinnitus or fade tinnitus. Hearing aids are included as a critical component of a sound therapy program. Modern hearing aids come with a special tinnitus managing sounds along with digital amplification. They are much evolved over the older technology. Different products work in different ways, although most hearing aids can alleviate tinnitus, certain hearing aids have built-in technology specifically for tinnitus relief. At amplifon, we have a clearly defined way to measure and quantify chronic tinnitus. As per the severity of the problem, an appropriate combination of treatment methods is selected to deal with your tinnitus. Amplifon audiologists are specially trained in counselling procedures as well which is another critical element of sound therapy. Consult your Amplifon audiologist to find more details about what suits you to deal with your tinnitus problem.
White noise machines. These devices, which produce simulated environmental sounds such as falling rain or ocean waves, are often an effective treatment for tinnitus. You may want to try a white noise machine with pillow speakers to help you sleep. Fans, humidifiers, dehumidifiers and air conditioners in the bedroom also may help cover the internal noise at night.
As with the first exercise, make sure you’re comfortable and unlikely to be disturbed. Now imagine yourself leaving this room. You walk out of the door and follow a path… at the end of the path is another door. You open that door and inside you see a beautiful garden – you can hear birds singing, children playing somewhere in the distance. You feel a cool breeze on your skin and hear the rustle of leaves through the trees. The colours of the leaves, green, gold, red, all dance across a beautiful pond in the middle… as you walk over to the pond, you feel the soft grass under your bare feet… you dip your toes into the calm, clear pond and stop for a moment – just experiencing the beauty of everything around you…
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.

Schecklmann et al (2014) suggested that tinnitus is associated with alterations in motor cortex excitability, by pooling several studies, and reported that there are differences in intracortical inhibition, intra-cortical facilitation, and cortical silent period. We doubt that this means that motor cortex excitability causes tinnitus, but rather we suspect that these findings reflect features of brain organization that may predispose certain persons to develop tinnitus over someone else.


Pulsatile tinnitus is generally caused by abnormalities or disorders affecting the blood vessels (vascular disorders), especially the blood vessels near or around the ears. Such abnormalities or disorders can cause a change in the blood flow through the affected blood vessels. The blood vessels could be weakened from damage caused by hardening of the arteries (atherosclerosis). For example, abnormalities affecting the carotid artery, the main artery serving the brain, can be associated with pulsatile tinnitus. A rare cause of pulsatile tinnitus is a disorder known as fibromuscular dysplasia (FMD), a condition characterized by abnormal development of the arterial wall. When the carotid artery is affected by FMD, pulsatile tinnitus can develop.

In some cases, a special audiologic device, which is worn like a hearing aid, may be prescribed. These devices, called masking agents, emit continuous, low-level white noises that suppress the tinnitus sounds. In some cases, a hearing aid may be recommended to help to suppress or diminish the sounds associated with tinnitus. A combination device (masker plus hearing aid) may also be used. Masking devices provide immediate relief by reducing or completely drowning out the tinnitus sound. However, when the masking device is removed, the tinnitus sound remains.
Muscular tinnitus can be caused by several degenerative diseases that affect the head and neck including amyotrophic lateral sclerosis or multiple sclerosis. Myoclonus can also cause muscular tinnitus, especially palatal myoclonus, which is characterized by abnormal contractions of the muscles of the roof of the mouth. Spasms of the stapedial muscle (which attaches to the stapes bone or stirrup), which is the smallest muscle in the body, and tensor tympani muscle, both of which are located in the middle ear, have also been associated with objective tinnitus. Myoclonus or muscle spasms may be caused by an underlying disorder such as a tumor, tissue death caused by lack of oxygen (infarction), or degenerative disease, but it is most commonly a benign and self-limiting problem.
There are two types of tinnitus: subjective tinnitus and objective tinnitus.[3] Tinnitus is usually subjective, meaning that there is no sound detectable by other means.[3] Subjective tinnitus has also been called "tinnitus aurium", "non-auditory" or "non-vibratory" tinnitus. In very rare cases tinnitus can be heard by someone else using a stethoscope, and in less rare – but still uncommon – cases it can be measured as a spontaneous otoacoustic emission (SOAE) in the ear canal. In such cases it is objective tinnitus,[3] also called "pseudo-tinnitus" or "vibratory" tinnitus.
Don’t ignore ear pain. Pain or discomfort in your ear can be a sign of conditions associated with tinnitus, including ear infections and earwax buildup. These conditions, and the discomfort they cause, can also interfere with sleep. Whether your ear pain is sharp or dull, constant or intermittent, accompanied by itching or not, take these symptoms to your doctor.
Although there’s no proven cure for tinnitus, there are treatments that help make it easier to ignore. For example, you can wear devices in your ear(s) that produce soothing therapeutic noises to shift your focus away from the tinnitus. Other devices produce constant, soft noise to mask the tinnitus. Tinnitus sufferers who also have hearing loss sometimes find relief simply by wearing properly fitted hearing aids.
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