Other potential sources of the sounds normally associated with tinnitus should be ruled out. For instance, two recognized sources of high-pitched sounds might be electromagnetic fields common in modern wiring and various sound signal transmissions. A common and often misdiagnosed condition that mimics tinnitus is radio frequency (RF) hearing, in which subjects have been tested and found to hear high-pitched transmission frequencies that sound similar to tinnitus.
Tinnitus can vary a lot between individuals; therefore you can find many different types of tinnitus. Tinnitus varies considerably in intensity and type. Some people describe tinnitus as high-frequency whistling sounds while others perceive tinnitus as a buzzing noise or a sound similar to butter sizzling in a frying pan. But some experience, instead, a thumping sound in the same rhythm as their heartbeat. This is called pulsatile tinnitus. Read more about the types of tinnitus.
The most common noise is the sound of rapid or turbulent blood flow in major vessels of the neck. This abnormal blood flow may occur because of a reduced red blood cell count (anemia) or a blockage of the arteries (atherosclerosis) and may be worsened in people with poorly controlled high blood pressure (hypertension). Some small tumors of the middle ear called glomus tumors are rich in blood vessels. Although the tumors are small, they are very near the sound-receiving structures of the ear, and blood flow through them can sometimes be heard (only in one ear). Sometimes, blood vessel malformations that involve abnormal connections between arteries and veins (arteriovenous malformations) develop in the membrane covering the brain (the dura). If these malformations are near the ear, the person sometimes can hear blood flowing through them.
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.
It is important to note that existing hearing loss is sometimes not directly observable by the patient, who may not perceive any lost frequencies. But this this does not mean that hearing damage has not been done. A trained audiologist or other hearing health professional can perform sensitive audiometric tests to precisely measure the true extent of hearing loss.
The best supported treatment for tinnitus is a type of counseling called cognitive behavioral therapy (CBT) which can be delivered via the internet or in person. It decreases the amount of stress those with tinnitus feel. These benefits appear to be independent of any effect on depression or anxiety in an individual. Acceptance and commitment therapy (ACT) also shows promise in the treatment of tinnitus. Relaxation techniques may also be useful. A clinical protocol called Progressive Tinnitus Management for treatment of tinnitus has been developed by the United States Department of Veterans Affairs.
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.
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.
Shore says her therapy isn’t for everyone — at least not yet. So far, she’s only treated patients who have a specific form of tinnitus that changes in intensity or pitch when a person moves certain parts of her body. For example, some tinnitus sufferers find the sound in their ears lessens when they clench their teeth or open their mouths wide. This suggests that some touch inputs can influence the tinnitus, Shore says. (Roughly two-thirds of tinnitus patients have this form of the condition, she adds.)
This study has several strengths. It included a relatively large number of patients, reducing the possibility of bias by “masking” which treatment patients received, classifying participants according to the severity of their tinnitus and using highly standardised interventions. Also, the researchers used established scales to measure the severity of tinnitus and its impact on quality of life.
The treatment group (245 patients) received some elements of standard care (such as a masking device and hearing aid if needed), but also received CBT. The CBT included an extensive educational session, sessions with a clinical psychologist and group treatments involving “psychological education” explaining their condition, cognitive restructuring, exposure techniques, stress relief, applied relaxation and movement therapy.
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Tinnitus habituation therapies, such as tinnitus retraining therapy (TRT), involve using low level sounds in a graduated fashion to decrease the perception of tinnitus. This differs from use of masking devices such as described earlier. TRT involves a wearable device that an affected individual can adjust so that the level of sound emitting from the device is about equal to or matches the tinnitus sound. This may be called the “mixing point” because the sound from the device and the tinnitus sound begin to mix together. An affected individual must repeatedly adjust the device so that the sound is at or just below the mixing point. TRT is supported by counseling with a trained professional who can teach the individual the proper techniques to maximize the effectiveness of TRT. Eventually, by following this method, affected individuals no longer need the external sound generating device. Affected individuals will become accustomed to the tinnitus sound (habituation), except when they choose to focus on it. Even then the sound will not be bothersome or troubling. The theory is akin to a person’s ability to ignore sounds such as the hum of air conditioner, the refrigerator motor turning on, or raindrops falling on the roof when driving a car in the rain.
From amongst the many treatments for tinnitus, you’re certain to find a solution that helps you live a more comfortable life, free of the frustration of tinnitus. Although a definitive cure is not currently available, these tools can help you manage your tinnitus and minimize its influence on your life. If you work closely with an experienced tinnitus specialist, they can help you determine which course of action is best for you.
Tinnitus usually comes in the form of a high-pitched tone in one or both ears, but can also sound like a clicking, roaring or whooshing sound. While tinnitus isn't fully understood, it is known to be a sign that something is wrong in the auditory system: the ear, the auditory nerve that connects the inner ear to the brain, or the parts of the brain that process sound. Something as simple as a piece of earwax blocking the ear canal can cause tinnitus, but it can also arise from a number of health conditions. For example, when sensory cells in the inner ear are damaged from loud noise, the resulting hearing loss changes some of the signals in the brain to cause tinnitus.
Demographic variables (age, sex, type of tinnitus) and baseline THI scores of placebo (n = 16) and treatment (n = 11) groups did not significantly differ from one another at the start of the study. At 3 months, participants in the treatment group reported significantly lower scores on the THI when compared to the placebo group (p < .05). The treatment group also showed an 11-point drop in THI scores when comparing baseline and 3 months (p < .05; please see Figure 2). THI scores for the placebo group comparing both time points were non-significant. Past studies have indicated that the minimum change in the THI score to be considered clinically significant is a drop of 6 to 7 points.9 As such, the results of our clinical study suggest that tinnitus and its related symptoms can produce a clinically significant reduction in tinnitus within the first 3 months using the personalized music-based therapy.
Tinnitus affects every layer of society, and there has been increasing support for awareness. Recently, musicians who are affected by tinnitus have come together to create awareness for the disorder. Artists including Chris Martin of Coldplay and Black Eyed Peas have created a compilation album to help raise funds towards finding a cure for tinnitus. In the United States, the Department of Defense has invested millions of dollars into investigations of tinnitus sound therapies. In addition, the American Tinnitus Association makes efforts to lobby the US government to provide support for tinnitus sufferers.
Some instances of tinnitus are caused by infections or blockages in the ear, and the tinnitus can disappear once the underlying cause is treated. Frequently, however, tinnitus continues after the underlying condition is treated. In such a case, other therapies -- both conventional and alternative -- may bring significant relief by either decreasing or covering up the unwanted sound.