Until recently, most tinnitus patients had little reason to believe doctors would ever be able to completely cure or reverse the affliction. Drug therapies had consistently failed, and so had more invasive procedures — including some surgeries to remove the auditory nerve that transmits sound from the ear to the brain, according to past research. (1,2)
Tinnitus is commonly thought of as a symptom of adulthood, and is often overlooked in children. Children with hearing loss have a high incidence of tinnitus, even though they do not express the condition or its effect on their lives.[100] Children do not generally report tinnitus spontaneously and their complaints may not be taken seriously.[101] Among those children who do complain of tinnitus, there is an increased likelihood of associated otological or neurological pathology such as migraine, juvenile Meniere’s disease or chronic suppurative otitis media.[102] Its reported prevalence varies from 12% to 36% in children with normal hearing thresholds and up to 66% in children with a hearing loss and approximately 3–10% of children have been reported to be troubled by tinnitus.[103]

The similarities between chronic pain and tinnitus have led researchers to develop a mindfulness-based tinnitus stress reduction (MBTSR) program. The results of a pilot study, which were published in The Hearing Journal, found that participants of an eight-week MBTSR program experienced significantly altered perceptions of their tinnitus. This included a reduction in depression and anxiety.


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.
Tinnitus is commonly thought of as a symptom of adulthood, and is often overlooked in children. Children with hearing loss have a high incidence of tinnitus, even though they do not express the condition or its effect on their lives.[100] Children do not generally report tinnitus spontaneously and their complaints may not be taken seriously.[101] Among those children who do complain of tinnitus, there is an increased likelihood of associated otological or neurological pathology such as migraine, juvenile Meniere’s disease or chronic suppurative otitis media.[102] Its reported prevalence varies from 12% to 36% in children with normal hearing thresholds and up to 66% in children with a hearing loss and approximately 3–10% of children have been reported to be troubled by tinnitus.[103]
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.
Subjective tinnitus is the most common type and accounts for 95 percent of cases. Only you can hear it and it’s usually caused by exposure to excessive noise. It can appear suddenly and may last three months (acute) to 12 months (subacute), or longer. Subjective tinnitus is often accompanied by hearing loss due to hair cell nerve damage. The severity of symptoms varies from patient to patient, and largely depends on your reaction to the noise.
In persons with pulsatile tinnitus, additional tests maybe proposed to study the blood vessels and to check the pressure inside the head. Gentle pressure on the neck can be performed to block the jugular vein but not the carotid artery. The Valsalva maneuver reduces venous return by increasing intrathoracic pressure. If there is a venous hum, this usually abates or improves markedly. If the pulsation is arterial, these tests have no effect.
Inspection of the eardrum may sometimes demonstrate subtle movements due to contraction of the tensor tympani (Cohen and Perez, 2003). Tensor tympani myoclonus causes a thumping. Another muscle, the stapedius, can also make higher pitched sounds. See this page for more. Opening or closing of the eustachian tube causes a clicking.    The best way to hear "objective tinnitus" from the middle ear is simply to have an examiner with normal hearing put their ear up next to the patient.  Stethoscopes favor low frequency sounds and may not be very helpful.
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.

Individuals with tinnitus describe perceiving a wide variety of sounds including ringing, clicking, hissing, humming, chirping, buzzing, whistling, whooshing, roaring, and/or whirling. These sounds may be present at all times, or they may come and go. The volume, pitch or quality of tinnitus sounds can fluctuate as well. Some people report that their tinnitus is most obvious when outside sounds are low (i.e. during the night). Other individuals describe their tinnitus as loud even in the presence of external sounds or noise, and some describe it as exacerbated by sounds. Tinnitus can affect one ear or both ears. It can also sound like it is inside the head and not in the ears at all.
Other causes of tinnitus include middle ear infections, disorders that block the ear canal (such as an external ear infection [external otitis], excessive ear wax, or foreign bodies), problems with the eustachian tube (which connects the middle ear and the back of the nose) due to allergies or other causes of obstruction, otosclerosis (a disorder of excess bone growth in the middle ear), and temporomandibular disorders. An uncommon but serious cause is an acoustic neuroma, a noncancerous (benign) tumor of part of the nerve leading from the inner ear.
As an initial test of our treatment, we first conducted a small pilot study to see if there were measurable benefits within 3 to 6 months of using this therapy. While we did not inform participants of whether they would receive a treatment or unaltered music, every participant in fact received a treatment. Participants reported a drop in scores on the Tinnitus Handicap Inventory (THI) within 3 months of using their personalized sound therapy for about 2 hours a day. THI is a psychometrically robust and validated questionnaire that assesses the impact of tinnitus on daily living and the degree of distress suffered by the tinnitus patient. Furthermore, we saw increased benefits after 6 months of treatment use (Figure 1). This data suggested that our treatment may be engaging brain plasticity in a positive manner, thereby gradually reducing tinnitus over time. Armed with this information, we designed a more rigorous trial that is very uncommon among research in tinnitus therapies.
Pulsatile tinnitus is a rare type of tinnitus that sounds like a rhythmic pulsing in the ear, usually in time with your heartbeat. A doctor may be able to hear it by pressing a stethoscope against your neck or by placing a tiny microphone inside the ear canal. This kind of tinnitus is most often caused by problems with blood flow in the head or neck. Pulsatile tinnitus also may be caused by brain tumors or abnormalities in brain structure.
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
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
Unfortunately that means tinnitus is a very complicated condition that involves several systems of the body. The good news, though, is that as doctors and researchers have developed a better understanding of the mechanisms behind tinnitus, they’ve also been able to develop new and promising treatments that target the brain rather than the ear — and have more of a chance of actually reversing the problem.
Tinnitus sufferers most often cite stress as the cause of their condition. While it’s true noises are perceived more acutely when you are tense, there is no scientific basis for saying stress causes tinnitus. But the reverse is definitely true — hearing a constant noise in your ears can certainly cause stress and anxiety, and even lead to depression in some cases.

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.

Participants were contacted to complete questionnaires (including THI) for the three-month assessment. A 30-minute individual phone interview with each participant was also conducted to explore their experiences with using the music package on a daily basis, and to further understand how the music package was affecting their tinnitus. At present, 27 participants have been interviewed to obtain the results presented here.

Other therapies. Other treatments that have been studied for tinnitus include transcutaneous electrical stimulation of parts of the inner ear by way of electrodes placed on the skin or acupuncture needles, and stimulation of the brain using a powerful magnetic field (a technique called repetitive transcranial magnetic stimulation, or rTMS). Transcutaneous electrical stimulation has been shown to be no more effective than a placebo. In two small trials, rTMS compared with a sham procedure helped improve the perception of tinnitus in a few patients.


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.


Almost every ENT, audiology practice, and hearing aid dispenser who claims to offer tinnitus treatment only offers one solution: hearing aids. While amplification may help some, only 50% of people living with tinnitus experience hearing loss that affects their understanding of speech, which means hearing aids are ineffective. At Sound Relief, we offer only evidence-based options like sound therapy and have seen countless patients experience life-changing results.
Participants were contacted to complete questionnaires (including THI) for the three-month assessment. A 30-minute individual phone interview with each participant was also conducted to explore their experiences with using the music package on a daily basis, and to further understand how the music package was affecting their tinnitus. At present, 27 participants have been interviewed to obtain the results presented here.
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.

Tinnitus sufferers have tried many alternative therapies but often to no avail. Some have heard of success stories involving the use of certain vitamins, minerals, herbal preparations, or even a change in diet, but often did not experience personal success in treating tinnitus using such options. Unfortunately, no studies to date have been able to associate such treatments to any real benefits. While much of the existing research have been dedicated to helping us understand tinnitus and its etiological underpinnings, there are currently very few treatments that are clinically validated. Of the few that conducted clinical studies to evaluate the effectiveness, most did not use rigorous clinical methods such as controlling for placebo effects or double-blinding to ensure the integrity of the data and to eliminate any sources of bias. Tinnitus sufferers who access such treatments often do not experience relief from their tinnitus. As a result, tinnitus sufferers often experience confusion, frustration, a loss of hope, and skepticism after having invested time and money on available treatment options.

One of the big problems associated with curing tinnitus, experts say, is that it’s really a symptom of multiple conditions, as opposed to being a single condition with a predictable trigger. In fact, more than 200 different conditions — problems ranging from hearing loss to head or neck trauma — have been linked with tinnitus, which makes it a real bear to try to stop. (3)
There seems to be a two-way-street relationship between tinnitus and sleep problems. The symptoms of tinnitus can interfere with sleeping well—and poor sleep can make tinnitus more aggravating and difficult to manage effectively. In the same study that found a majority of people with tinnitus had a sleep disorder, the scientists also found that the presence of sleep disorders made tinnitus more disruptive.
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.
 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.
In Canada, the level of funding or engagement towards tackling the problem of tinnitus is comparably minimal. But with recent headlines about the effects of tinnitus on those in police forces2 and frustration among veterans, this may change. Because of the progress made in tinnitus treatment and management research – including work done right here in Canada – the time is right to offer tinnitus sufferers effective options and the support they need. While many with tinnitus are not yet aware that there are ways to reduce or manage the constant ringing, hissing or buzzing in their ears, as more health care professionals make effective options available, word will spread. In time, tinnitus and its impact on quality of life can be reduced.
^ 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.
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.
Limit use of earplugs. Earplugs are important to use to protect your hearing when you’re likely to be exposed to loud noises. (Remember, exposure to loud sounds, and noise-induced hearing loss, are common causes of tinnitus, and may make tinnitus worse if you already have the condition.) But otherwise, people with tinnitus are advised not to wear earplugs, including for sleep. Earplugs reduce your ability to hear external noise and can make tinnitus more noticeable.

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.

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.
Most tinnitus is "sensorineural," meaning that it's due to hearing loss at the cochlea or cochlear nerve level. But tinnitus may originate in other places. Our bodies normally produce sounds (called somatic sounds) that we usually don't notice because we are listening to external sounds. Anything that blocks normal hearing can bring somatic sounds to our attention. For example, you may get head noise when earwax blocks the outer ear.
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