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What You Need to Know About Tinnitus: Ringing in the Ear Explained

Reviewed by Michal Luntz, M.D. and Kathryn D. Girardin, Au.D. on May 27, 2023



Woman holding her ears in pain, tinnitus

 

In this article

 

How to Pronounce Tinnitus?


The word 'tinnitus' has two common pronunciations. It can be pronounced either as "tin-NIGHT-us" or "TIN-a-tus". Both are correct and can be used interchangeably.


 

What is Tinnitus?

Tinnitus is the perception of noise or ringing in the ears, even when no external sounds are present. It's crucial to understand that tinnitus is not a disease in itself, but rather a symptom of an underlying health issue. There are two primary types of tinnitus:


  • Subjective Tinnitus: This is the most common form of tinnitus. With subjective tinnitus, only the individual themselves perceives these "phantom auditory" sounds. Most people who suffer from tinnitus experience this type. Subjective tinnitus is most often associated with hearing loss, as well as various other factors:


  • Hearing loss: Over 90% of tinnitus sufferers experience hearing loss

  • Exposure to excessively loud noise

  • Sudden impact noise

  • Neck or head injuries

  • Ototoxic medication (medication that can damage hearing)

  • Certain other medications

  • Anxiety

  • Underlying pathologies


Treating subjective tinnitus can be challenging because its causes are diverse and sometimes hard to pinpoint. Treatment may include hearing aids, sound therapy, cognitive-behavioral therapy, or medications to manage symptoms.


  • Objective Tinnitus: This is a rare form of tinnitus where the noise perceived by the individual can also be heard by someone standing close by. It is typically caused by an underlying condition such as a vascular, musculoskeletal, or respiratory disease. Treatment for objective tinnitus generally focuses on addressing this underlying condition.


Tinnitus can be a debilitating condition that negatively impacts a person’s overall health and social well-being. Even moderate cases can interfere with the ability to work and socialize. People with tinnitus often experience:


  • Distress

  • Depression

  • Anxiety

  • Frequent mood swings

  • Sleep disturbances

  • Irritability or frustration

  • Poor concentration

  • Pain (particularly when tinnitus is accompanied by hyperacusis, a heightened sensitivity to certain frequencies and volumes of sound)


If you are experiencing tinnitus, whether it's objective or subjective, it's crucial to consult with a healthcare professional. They can evaluate your symptoms, determine the underlying cause, and discuss the most appropriate treatment options with you.


 

How is Tinnitus Treated?


Our understanding of tinnitus, although extensive, remains incomplete. We do know that the condition involves not just our ears but also our brains. Experience has shown that while tinnitus may originate from damage to the hair cells in the cochlea (the inner ear), the brain is ultimately responsible for its perception. This theory is backed up by surprising cases where people have had the nerve that carries sound from the ear to the brain cut during surgery. Even after this procedure, which left them deaf, these individuals still reported 'hearing' the ringing in their ears.


While there's no definitive 'cure' for tinnitus, several treatment options can provide relief for those with chronic tinnitus:


What is well-known to work when it comes to tinnitus treatment options:

  • Medical Intervention: If your tinnitus has a specific, treatable cause, medical intervention may be an option. This could involve wax removal from the ear canal, adjusting or discontinuing a tinnitus-causing medication, treating arthritis in the jaw joint, or surgically treating vascular or musculoskeletal causes.


  • Hearing Aid Use: Over 90% of people with tinnitus have hearing loss. For these individuals, treating hearing loss with a suitable solution is a key part of effective tinnitus care. Hearing aid use significantly reduces the level and annoyance of tinnitus. Some models also include a tinnitus masker, a feature that produces a pleasant sound, white noise or pink noise to distract the brain from the internal noise caused by tinnitus, offering additional relief.


  • Sound Therapies: These therapies can include background music or noise, specialized ear-level maskers, or even downloadable smartphone apps.


  • Cognitive Behavioral Therapy (CBT): A series of weekly sessions led by a trained professional can improve the effects of tinnitus on quality of life.


  • Therapeutic Intervention: Tinnitus can be so bothersome that it may lead to depression or anxiety. Furthermore, if you are already suffering from depression and/or anxiety, the added burden of tinnitus could be especially challenging to cope with. In such instances, consultation with a psychiatrist or psychologist, with treatment directed to the underlying condition, can be beneficial.


  • Therapeutic Medication: Prescribing medications (antidepressants, anticonvulsants, anxiolytics) or administering intratympanic injections is not generally recommended for tinnitus, unless there's an underlying or associated medical problem that may benefit from such treatment.


  • Progressive Tinnitus Management: This is a step-by-step approach to help those with severe or hard-to-manage tinnitus. Individuals receive help that adjusts and increases according to their needs.

 

What may or may not work when it comes to tinnitus treatment options:

  • Acupuncture: Acupuncture may or may not be helpful in treating tinnitus; there are not enough quality studies of this treatment for tinnitus to make a recommendation.


  • Transcranial magnetic stimulation: This is a new modality, but it cannot be recommended for tinnitus treatment at this time, as long-term benefits have not been proven.

 

What does not work when it comes to tinnitus treatment options:

  • Dietary supplements: Despite the prevalence of advertisements, there is no evidence that any dietary supplement, including ginkgo biloba, melatonin, zinc, lipoflavinoids, and vitamins provides benefits for tinnitus.

 

If tinnitus affects your life, we hope that one or more of these solutions can help mitigate its impact. If you haven't done so already, take the first step and get your hearing tested. This may provide you with the information and solutions you need. If a hearing aid or tinnitus masker doesn't help, there are plenty of other strategies you can try.


 

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