Experts recommend that patients with severe tinnitus become educated about tinnitus and how they best deal with its symptoms. This can include learning about biofeedback in order to control stress and your reaction to tinnitus sounds, talking with a counselor, or joining a support group. Coping strategies are most useful for managing emotional side effects of tinnitus, such as anxiety, trouble sleeping, lack of focus and depression.
Superior semicircular canal dehiscence syndrome is another not uncommon cause of pulsatile tinnitus. The superior semicircular canal is one of three canals found in the vestibular apparatus of the inner ear. The vestibular apparatus helps to maintain equilibrium and balance. In this syndrome, a part of the temporal bone that overlies the superior semicircular canal is abnormally thin or absent. Superior semicircular canal dehiscence syndrome can affect both hearing and balance to different degrees.
The latest news about tinnitus treatment comes from a UK study showing that Mindfulness Based Cognitive Therapy (MBCT) significantly helps reduce the severity of the disorder. The researchers reported that, among the 75 patients being studied, both relaxation therapy and MBCT worked to alleviate symptoms as well as reducing psychological distress, anxiety and depression related to the disorder. MBCT led to greater reductions in tinnitus severity and the improvements lasted longer.
Loud noise is the leading cause of damage to the inner ear. Most patients with noise trauma describe a whistling tinnitus (Nicholas-Puel et al,. 2002). In a large study of tinnitus, avoidance of occupational noise was one of two factors most important in preventing tinnitus (Sindhusake et al. 2003). The other important factor was the rapidity of treating ear infections.
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 or into the middle ear to be effective. However, the benefits of lidocaine are almost always outweighed by the risks of the drug and it is therefore not recommended and not used for tinnitus.
Tinnitus is not a disease in and of itself, but rather a symptom of some other underlying health condition. In most cases, tinnitus is a sensorineural reaction in the brain to damage in the ear and auditory system. While tinnitus is often associated with hearing loss, there are roughly 200 different health disorders that can generate tinnitus as a symptom. Below is a list of some of the most commonly reported catalysts for tinnitus.
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.
Medications, Prescription Drugs and Food Additives. Other external irritants that can cause tinnitus are over the counter medications and prescriptions. Even something as simple as aspirin can generate tinnitus. I have experienced this throughout my lifetime. I take aspirin only when I absolutely need it. Certain antibiotics and other prescription drugs are also known to cause tinnitus. Two very common ones that have shown to cause tinnitus are quinine and chloroquine which are in malaria medications. Certain diuretics and cancer medications can also cause tinnitus. Although not a drug, NutraSweet has been linked to tinnitus and a whole host of side effects in clinical studies.
Changing Prescriptions, OTC Medications and Food Additives. Sometimes the cause of tinnitus is a prescription (such as an antibiotic), an over the counter medication or a food additive. As an example, two very common prescriptions that have been shown to cause tinnitus are quinine and chloroquine, which are both used to prevent malaria. Certain diuretics and cancer medications can also cause tinnitus. Even something as simple as OTC aspirin can generate tinnitus in some people. The food additives NutraSweet, Splenda and Aspartame have all been linked to tinnitus, and a whole host of other side effects, in clinical studies. These man-made food additives should be eliminated from your diet completely. If any of your medications are causing your tinnitus, your doctor may recommend stopping, reducing or switching them out for other medicines to see if that helps cure your tinnitus.
^ 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.
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.
You don’t need to enroll in an eight-week program to get started with mindfulness training. Participants in the MBTSR program all received a copy of the groundbreaking book “Full Catastrophe Living” by Jon Kabat-Zinn. Kabat-Zinn’s book is the premier manual for practicing mindfulness in daily life. You will learn about, and be encouraged to practice, meditation and breathing techniques that can help draw your focus away from tinnitus.
A brain tumor can be either non-cancerous (benign) or cancerous (malignant), primary, or secondary. Common symptoms of a primary brain tumor are headaches, seizures, memory problems, personality changes, and nausea and vomiting. Causes and risk factors include age, gender, family history, and exposure to chemicals. Treatment is depends upon the tumor type, grade, and location.
A wealth of research has gone into understanding the mechanisms of tinnitus due to the increased concern in our ageing and noise exposed society through the support of organizations such as the Tinnitus Research Institute, the American Tinnitus Association and even the US Department of Defense. This research has helped us to understand not only why and how this phantom percept can develop, but also sheds light on why it may sound like a hiss for one person and a high pitched tone for another.7 In addition, neuroscientists have shown connections between the limbic system (where emotions are processed) and the auditory system; it is not uncommon for tinnitus to increase during times of stress or negative emotions.5 As such, the effective tinnitus treatment strategies should be enjoyable and positive, and should account for the variability in what tinnitus sounds like for each patient.

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]
ABR (ABR) testing may show some subtle abnormalities in otherwise normal persons with tinnitus (Kehrle et al, 2008). The main use of ABR (ABR test) is to assist in diagnosing tinnitus due to a tumor of the 8th nerve or tinnitus due to a central process. A brain MRI is used for the same general purpose and covers far more territory, but is roughly 3 times more expensive. ABRs are generally not different between patients with tinnitus with or without hyperacusis (Shim et al, 2017).
Removing Excess Earwax. There is a small chance that your tinnitus is being caused by an excess build up of ear wax that is blocking the ear canal. This is especially common in older patients who have a lot of ear hair that ear wax has been building up on over the years. By removing both the excess hair and ear wax, especially if it’s in contact with your ear drum, your tinnitus can improve.
Homeopathy, hypnosis, meditation and acupuncture are also thought to suppress tinnitus conditions. Studies have shown acupuncture can help relieve symptoms of tinnitus, but relief may not be seen until you have completed 10 to 15 sessions. Homeopathy, which uses plant, mineral and animal material in doses to help relieve ailments, can also be used as a treatment.  Some remedies can be used to suppress loud roaring noises, echoing, dull humming and other tinnitus symptoms.

A large, 2014 study of almost 14,000 people found obstructive sleep apnea was linked to significantly higher rates of hearing impairment and hearing loss. Scientists think one reason for this is changes to blood flow to the ear that result in inflammation. (We know that sleep apnea causes changes to circulation and weakens blood flow to some areas of the body, including the brain.) A related factor? People with sleep apnea are at greater risk for high blood pressure, and high blood pressure can exacerbate hearing loss, according to research.


But one of the awesome powers of the human brain is its adaptability. “It can learn and reorganize itself every time you practice something new,” Kilgard says. His research, including a study published in February 2014 in the journal Neuromodulation, has shown this adaptability may be key to helping the brain “turn down” the hyperactivity that can lead to tinnitus, he says. (4)
At Sound Relief Hearing Center, we utilize a variety of evidence-based tinnitus treatment options. Most audiologists only offer one solution, hearing aids, which are ineffective in many cases. To treat each unique case of tinnitus, we utilize a variety of innovative technologies and therapies, including Tinnitus Retraining Therapy (TRT). For more information about your tinnitus treatment options, visit our page Tinnitus Treatment. If you’re worried that you won’t ever escape the ringing in your ears, check out our page Tinnitus Success Stories. Finally, follow our Tips from Tinnitus Experts to avoid exacerbating the problem.
Treatment of the underlying primary disorder may help to improve or cure rhythmic tinnitus. For example, the treatment of blood vessel disorders (e.g. dural arteriovenous shunts) can include certain medications or surgery. A surgical procedure known as sinus wall reconstruction can successfully treat pulsatile tinnitus due to sigmoid sinus diverticulum and dehiscence. In fact, most individuals have experienced complete resolution of their tinnitus following this surgery. Surgery may also be necessary for rare cases of pulsatile tinnitus caused by a tumor.
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]
In the advance online edition of Nature on January 12, 2011, the researchers reported that the number of neurons tuned to the high frequency had jumped by 79% compared to control rats. The scientist then tested 2 different tones in a second group of rats but stimulated the vagus nerve only for the higher one. The neurons tuned to the higher tone increased by 70%, while those tuned to the lower one decreased in number. This showed that the tone alone wasn’t enough to initiate the change; it had to be accompanied by VNS.
The majority of cases of tinnitus are subjective. Objective tinnitus is far less common. However, a diagnosis of objective tinnitus is tied to how hard and well the objective (outside) listener tries to hear the sound in question. Because of this problem, some clinicians now simply refer to tinnitus as either rhythmic or non-rhythmic. Generally, rhythmic tinnitus correlates with objective tinnitus and non-rhythmic tinnitus correlates with subjective tinnitus. Specific forms of tinnitus such as pulsatile tinnitus and muscular tinnitus, which are forms of rhythmic tinnitus, are relatively rare. Pulsatile tinnitus may also be known as pulse-synchronous tinnitus. Properly identifying and distinguishing these less common forms of tinnitus is important because the underlying cause of pulsatile or muscular tinnitus can often be identified and treated.

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.
Dr. Julie Prutsman’s team of audiologists offer a higher standard of expertise. She has been deeply involved with tinnitus for more than 15 years, long before effective treatments had been developed beyond hearing aids and maskers. Dr. Julie also studied under one of the industry’s most respected and leading medical experts, Dr. Pawel Jastreboff, and she has personally trained each and every one of her doctors.
Before long, you’re both mentally and physically stimulated in ways that make it even harder to relax and fall asleep. Like any other form of anxiety, stress about falling asleep creates mental arousal, bringing your brain to alertness. And it also creates physical arousal, raising heart rate and body temperature. This kind of anxiety can lead to behaviors that further undermine sleep, including:

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.


Tinnitus is usually described as a ringing in the ears, but it can also sound like clicking, hissing, roaring, or buzzing. Tinnitus involves perceiving sound when no external noise is present. The sound can be very soft or very loud, and high-pitched or low-pitched. Some people hear it in one ear and others hear it in both. People with severe tinnitus may have problems hearing, working, or sleeping.
Cochlear implants are sometimes used in people who have tinnitus along with severe hearing loss. A cochlear implant bypasses the damaged portion of the inner ear and sends electrical signals that directly stimulate the auditory nerve. The device brings in outside sounds that help mask tinnitus and stimulate change in the neural circuits. Read the NIDCD fact sheet Cochlear Implants for more information.
None of these treatment options are supported by science. Many people are convinced that the herb gingko biloba is helpful, however large-scale studies have been unable to prove this. There are many nutritional supplements claiming to be tinnitus remedies. These are usually a combination of herbs and vitamins, often including zinc, ginkgo, and vitamin B-12.
Earwax (ear wax) is a natural substance secreted by special glands in the skin on the outer part of the ear canal. It repels water, and traps dust and sand particles. Usually a small amount of wax accumulates, dries up, and then falls out of the ear canal carrying with it unwanted particles. Under ideal circumstances, you should never have to clean your ear canals. The absence of ear wax may result in dry, itchy ears, and even infection. Ear wax may accumulate in the ear for a variety of reasons including; narrowing of the ear canal, production of less ear wax due to aging, or an overproduction of ear wax in response to trauma or blockage within the ear canal.
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.
The use of sound therapy by either hearing aids or tinnitus maskers helps the brain ignore the specific tinnitus frequency. Although these methods are poorly supported by evidence, there are no negative effects.[3][90][91][92] There is some tentative evidence supporting tinnitus retraining therapy.[3][93] There is little evidence supporting the use of transcranial magnetic stimulation.[3][94] It is thus not recommended.[73] As of 2017 there was limited evidence as to whether neurofeedback is or is not helpful.[95]
A brain tumor can be either non-cancerous (benign) or cancerous (malignant), primary, or secondary. Common symptoms of a primary brain tumor are headaches, seizures, memory problems, personality changes, and nausea and vomiting. Causes and risk factors include age, gender, family history, and exposure to chemicals. Treatment is depends upon the tumor type, grade, and location.
None of these treatment options are supported by science. Many people are convinced that the herb gingko biloba is helpful, however large-scale studies have been unable to prove this. There are many nutritional supplements claiming to be tinnitus remedies. These are usually a combination of herbs and vitamins, often including zinc, ginkgo, and vitamin B-12.
Research regarding using cognitive behavioral therapy for tinnitus shows that tolerance to tinnitus can be facilitated by “reducing levels of autonomic nervous system arousal, changing the emotional meaning of the tinnitus, and reducing other stresses.” (6) It’s been found that there’s some overlap in anxiety and tinnitus due to an association between subcortical brain networks involved in hearing sounds, attention, distress and memory functions.
If you're not sure of what is causing your tinnitus, a hearing care professional can help pinpoint the issue through a series of tests. It can be helpful to take notes of the sounds you are regularly or irregularly experience to help your hearing healthcare professional put together the clues to what may be causing it. Be sure to alert your practitioner of any pertinent medical history, medications or excessive noise exposure that could be playing a role in your tinnitus.
Muscle spasms: Tinnitus that is described as clicking may be due to abnormalities that cause the muscle in the roof of the mouth (palate) to go into spasm. This causes the Eustachian tube, which helps equalize pressure in the ears, to repeatedly open and close. Multiple sclerosis and other neurologic diseases that are associated with muscle spasms may also be a cause of tinnitus, as they may lead to spasms of certain muscles in the middle ear that can cause the repetitive clicking.
Earwax (ear wax) is a natural substance secreted by special glands in the skin on the outer part of the ear canal. It repels water, and traps dust and sand particles. Usually a small amount of wax accumulates, dries up, and then falls out of the ear canal carrying with it unwanted particles. Under ideal circumstances, you should never have to clean your ear canals. The absence of ear wax may result in dry, itchy ears, and even infection. Ear wax may accumulate in the ear for a variety of reasons including; narrowing of the ear canal, production of less ear wax due to aging, or an overproduction of ear wax in response to trauma or blockage within the ear canal.
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.

Before long, you’re both mentally and physically stimulated in ways that make it even harder to relax and fall asleep. Like any other form of anxiety, stress about falling asleep creates mental arousal, bringing your brain to alertness. And it also creates physical arousal, raising heart rate and body temperature. This kind of anxiety can lead to behaviors that further undermine sleep, including:
While there is currently no cure for tinnitus, treatment options like Tinnitus Control at least provide patients with the ability to successfully manage the ringing they hear by suppressing the cause of it. This is achieved through their proprietary blend of the following active ingredients: arnica, chininum sulphuricum, ferrum metallicum, kali phosphoricum, natrum sulphuricum, pulsatilla, silicea, thiosinaminum, garlic and gingko biloba.

One group of 247 patients received standard (usual) care for tinnitus. This included audiological checks, counselling, prescription of a hearing aid if indicated, prescription of a “masker” if requested by the patient (a device that generates neutral sounds to distract from the noise of the tinnitus), and counselling from social workers when required.


The physician may also request an OAE test (which is very sensitive to noise induced hearing damage), an ECochG (looking for Meniere's disease and hydrops, an MRI/MRA test (scan of the brain), a VEMP (looking for damage to other parts of the ear) and several blood tests (ANA, B12, FTA, ESR, SMA-24, HBA-IC, fasting glucose, TSH, anti-microsomal antibodies).


One group of 247 patients received standard (usual) care for tinnitus. This included audiological checks, counselling, prescription of a hearing aid if indicated, prescription of a “masker” if requested by the patient (a device that generates neutral sounds to distract from the noise of the tinnitus), and counselling from social workers when required.

Hearing loss often accompanies tinnitus, so a hearing aid can hit two birds with one stone. In addition to amplifying sound, the device can camouflage the ringing in your ears by boosting other soft sounds in your environment. If you experience hearing loss in addition to your tinnitus, discuss the potential benefits of a hearing aid that may assist with both conditions at the same time.

To understand what causes tinnitus, you first need to understand what tinnitus is. Tinnitus is, very simply, unexplainable noises you hear in your head when there is no actual sound present. A person with tinnitus will often hear a whistling, humming, buzzing, whooshing, clicking or ringing in their ears, even when there is nothing in the area that is emitting that particular sound. It may be intermittent or last only a short time or never seem to stop.

Meniere’s disease isn’t directly connected to tinnitus, but people with Meniere’s often experience it, at least temporarily. Meniere's disease is an inner ear disease that typically only affects one ear. This disease can cause pressure or pain in the ear, severe cases of dizziness or vertigo and a ringing or roaring tinnitus. While Meniere’s isn’t fully understood, it appears that several relief options for tinnitus can also help with this disease. Patients are often advised to reduce stress and lower their consumption of caffeine and sodium.
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