Herbal home remedies (ginkgo biloba, melatonin), and the vitamin zinc are not recommended by the American Academy of Otolaryngology. Lipo-flavonoid is a supplement being marketed as a way to relieve tinnitus, but there is no current evidence it is effective for most cases of the condition; however, it may be helpful for symptoms of Meniere's disease. Check with your doctor or other health care professional before taking any herbal or over-the-counter (OTC) natural remedies.
While tinnitus is as varied as its causes, it can be grouped into two categories: tonal and non-tonal. Tonal tinnitus is more common and describes the perception of a near-continuous sound or overlapping sounds with a well-defined frequency (e.g., whistling, ringing, buzzing). Non-tonal forms of tinnitus include humming, clicking, crackling, and rumbling.
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.
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.
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.
The researchers paired electrical stimulation of the vagus nerve — a large nerve that runs from the head to the abdomen — with the playing of a tone. Vagus nerve stimulation (VNS) is known to release chemicals that encourage changes in the brain. This technique, the scientists reasoned, might induce brain cells (neurons) to tune to frequencies other than the tinnitus one. For 20 days, 300 times a day, they played a high-pitched tone to 8 rats during VNS.
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. These questionnaires measure the degree of psychological distress and handicap associated with tinnitus, including effects on hearing, lifestyle, health and emotional functioning. 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. 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. Developed to guide diagnosis or classify severity, most tinnitus questionnaires have been shown to be treatment-sensitive outcome measures.
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. There is some tentative evidence supporting tinnitus retraining therapy. There is little evidence supporting the use of transcranial magnetic stimulation. It is thus not recommended. As of 2017 there was limited evidence as to whether neurofeedback is or is not helpful.
FACT: Many people with tinnitus will also have a hearing loss. In fact, a recent French study showed that of 123 people with tinnitus surveyed only one did not have hearing loss. The British Tinnitus Association estimates that 90 percent of people with tinnitus also have a hearing loss. Moreover, research says that those who don’t may have a “hidden hearing loss.”
The multidisciplinary approach required input from many different professionals including audiologists, psychologists, speech therapists and physical therapists. Which particular care elements of the intervention had the greatest effect is unknown. A multidisciplinary approach such as the intervention trialled here may have resource implications if it were introduced into standard clinical practice.
Another way of splitting up tinnitus is into objective and subjective. Objective tinnitus can be heard by the examiner. Subjective cannot. Practically, as there is only a tiny proportion of the population with objective tinnitus, this method of categorizing tinnitus is rarely of any help. It seems to us that it should be possible to separate out tinnitus into inner ear vs everything else using some of the large array of audiologic testing available today. For example, it would seem to us that tinnitus should intrinsically "mask" sounds of the same pitch, and that this could be quantified using procedures that are "tuned" to the tinnitus.
Over the last 40 years of treating patients suffering from tinnitus, there’s been one over the counter medication that has shown the greatest promise. While it doesn’t provide relief for everyone, I continue to see an 87% efficacy rate in my patients. The treatment, which does not require a prescription, is known as Tinnitus Control and is available online at http://www.tinnituscontrol.com
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.
Avoid a too-quiet bedroom. People with tinnitus may find it easier to sleep in a less quiet bedroom, and may benefit from white noise or other sleep-friendly sounds that help mask and minimize their tinnitus. To my patients who are looking to introduce soothing sounds to their sleep environment, I recommend the iHome Zenergy Sleep System, which combines relaxing sounds with aromatherapy and sleep-promoting light therapy.
Hyperacusis is a different, but related condition to tinnitus. People with hyperacusis have a high sensitivity to common, everyday environmental noise. In particular, sharp and high-pitched sounds are very difficult for people with hyperacusis to tolerate—sounds like the screeching of brakes, a baby crying or a dog barking, a sink full of dishes and silverware clanging. Many people with tinnitus also experience hyperacusis—but the two conditions don’t always go together.
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.
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.
Ear canal obstructions, infections, injuries or surgeries. This can include ossicle dislocation within the ear that affects hearing or recurring ear infections (like swimmer’s ear) either in the outside or inside of the ear canal (otitis media or otitis externa). Other ear disorders tied to tinnitus include otosclerosis (causes changes to the bones inside the ears), tympanic membrane perforation or labrynthitis (chronic infections or viruses that attack tissue in the ears).
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.
Antidepressants. Antidepressants, such as nortriptyline and amitriptyline, have been used as mood enhancers to help someone with tinnitus cope with the life changing implications and complications it brings. However, they are often only prescribed in the most severe of tinnitus cases as they carry some serious side effects that might not make them worth taking for everyone. These include blurred vision, heart problems, dry mouth and constipation.
Tinnitus (pronounced tih-NITE-us or TIN-ih-tus) is sound in the head with no external source. For many, it's a ringing sound, while for others, it's whistling, buzzing, chirping, hissing, humming, roaring, or even shrieking. The sound may seem to come from one ear or both, from inside the head, or from a distance. It may be constant or intermittent, steady or pulsating.