Nov 17

What are the Various Treatment Options for Tinnitus?

As with any other medical issue, a tinnitus treatment is most successful when it addresses the cause directly. Since tinnitus is considered a symptom of a disease rather than its own disorder, treatment for tinnitus focuses on the underlying illness. Unfortunately, in many cases it is very difficult to determine the precise cause of tinnitus, which makes targeted treatment equally challenging.

Key Points About Treating Tinnitus:

Prevention

The phrase “prevention is the best medicine” could have been coined specifically for tinnitus. That is because tinnitus can be difficult to treat. It is better to avoid tinnitus than to correct it. The best way to prevent tinnitus are to avoid those things that assault the ears namely prolonged exposure to loud noise, short exposures to extremely loud noise, and drugs that can hurt the ears. Maintaining good health, in general, helps prevent tinnitus. Regular checkups can catch hormonal and metabolic problems in the early stages before they result in tinnitus.

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Medical (pharmacological) tinnitus treatments

When poor physical health is to blame for tinnitus, correct the underlying medical issue(s) are sometimes all it takes to get rid of the ringing in the ears. Balancing thyroid hormone, correcting anemia, and controlling cholesterol might be all that is required to reverse tinnitus. Perhaps a good earwax removal is all that is needed. A full medical checkup is a good place to start because a great number of potential causes will be checked and addressed if needed.

While it is not clear exactly why they work, certain antidepressant medications can correct or reduce tinnitus. While some have argued that tinnitus and depression are linked, it is not so simple to think that depression alone leads to tinnitus. Sure having tinnitus can be depressing, but only certain types of antidepressants work on tinnitus, specifically tricyclic antidepressants. If depression was the sole cause, one would expect that better depression medicines like selective serotonin reuptake inhibitors (SSRIs) would also be the better tinnitus medicines. The area is certainly murky, scientifically, but antidepressant medications may be a tool to treat tinnitus in certain patients.

Benzodiazepines (most famously, Valium and Ativan) have been tried in tinnitus with mixed results. These medicines quiet electrical activity in the brain and can be helpful in quieting some of the signals that cause tinnitus. Unfortunately benzodiazepines cause drowsiness and slow thinking at higher doses. Also, this class of drugs can be habit-forming, which is why they are used with caution and weighed against their usefulness.
Surgical tinnitus treatments

While it may sound extreme, surgery has a place in tinnitus treatment for some people. If there is a physical problem that is causing tinnitus and it can be reached and corrected surgically, surgery becomes the treatment of choice. Take for example, the case of acoustic neuroma. An acoustic neuroma is a benign growth around the nerve that carries electrical signals from the inner ear to the brain. This growth can have a negative impact on hearing as well as create unusual sounds. A neurosurgeon may be able to remove the benign tumor and correct the problem. Similar tissue growths at various places in and around the ear can cause tinnitus and can be cured surgically.

Tissue growth is not the only surgically correctable cause of tinnitus. Derangements of the blood vessels could also be a surgical target. Sometimes these arteriovenous malformations, as they are called, are present at birth but more often they develop later in life. Traditionally these blood vessel abnormalities would be directly cut out by a surgeon. Newer strategies for treating abnormal blood vessels include burning them or injecting them with sclerosing agents which causes the vessel to shrink and to die. If the blood vessel that is causing the problem is an important one (like the jugular vein) destroying it is not a viable option. In this case other treatment options should be considered.

When tinnitus is a symptom on Meniere’s disease, surgical therapy might be able to correct the dizziness and ear fullness while at the same time eradicating tinnitus. In Meniere’s disease there is an excess of endolymph (fluid) in the vestibular system (the inner ear organ that helps us walk upright and maintain balance). Surgeons can place a tube (shunt) in the vestibular system to drain excess fluid. More aggressively, they can cut away part of the vestibular system itself. Meniere’s surgery is not 100% effective at treating the primary disease or tinnitus, but it may be an option for some people.

Stimulation and suppression

While they have not yet been perfected, there are various types of electrical and mechanical devices that have been used to treat tinnitus. Since once of the root causes (or pathways, really) of tinnitus is abnormal electrical activity in the nerves going from the cochlea to the auditory cortex, scientists and doctors have tried to use electrical stimulation to override those signals. In fact, the earliest reports of electrical stimulation of the ears for the treatment of tinnitus date back over a hundred years. While directly stimulating the auditory system has been reported to help 4 out of 5 patients, the tinnitus returns soon after the stimulation has stopped. It is not practical to use current methods of stimulation constantly—there would be no time for living life. However, one area of research is in people with cochlear implants. While these devices are primarily used to give the sense of hearing to the deaf, they do so by directly stimulating the cochlea. While it would be considered a rather bold clinical move, cochlear implants may be used to treat tinnitus in the future.

A longer lasting form of stimulation therapy is transcranial magnetic stimulation. Instead of stimulating the cochlea, a device is applied to the outside of the skull and stimulates brain tissue using strong magnetic oscillations. The technology has been used to improve drug delivery and reduce auditory hallucinations, but may also be effective in treating tinnitus. Early research indicates that transcranial magnetic stimulation may reduce the symptom of tinnitus for up to six months at a time.

Sound-producing devices have been one of the main treatments of tinnitus for decades. These tinnitus treatments include hearing aids, masking devices, and tinnitus feedback retraining. Since hearing and tinnitus are intimately related, it makes sense that treating deafness also helps treat tinnitus. Improving hearing with a hearing aid does not always correct tinnitus, but it can be quite helpful to a number of patients with both hearing loss and tinnitus (about half).

A tinnitus masking device is quite similar to a hearing aid in form but not necessarily in function. While a hearing aid amplifies sounds that enter the ear, a tinnitus masking device creates noise of its own.

Psychological treatment and support

Biofeedback is a process in which a patient is trained to identify a bodily process or symptom that is not routinely considered to be under their control and attempt to control it. Heart rate is a good example. Patients are taught by a psychologist or other clinician skilled in biofeedback therapy to think about the rate of their heart, focus on it, isolate it in the mind, and attempt to change its rate. Since heart rate is easily measured by monitoring the pulse, the patient’s efforts are immediately recognized, which fuels an even further reduction in heart rate.

When biofeedback is used to treat tinnitus, it is a little less clearly defined. The sound is most likely only audible to the patient, so there is no objective means of quantifying the patient’s success. Nevertheless, by isolating and exerting mental control over the sound, many patients have learned to control the symptom. Four out of five people notice an improvement of symptoms and one in five reports a complete resolution of the tinnitus.

Psychological treatment may be useful apart from its role in biofeedback. In these cases, the mental health professional provides the patient with a way to cope with the troubling sound and methods to manage situations where tinnitus interferes with life. There is also great power in the reassurance that comes from knowing that tinnitus is not a symptom of a deadly or otherwise severe disease. Reassurance can also come from group therapy and group support. The premier tinnitus support organization in the United States is the American Tinnitus Association. The ATA is involved in support, advocacy, research, and in the organization of treatment resources.

Alternative tinnitus therapy

Because medical, psychological, and surgical therapy does not help every patient, some of the treatments prescribed by the medical establishment are associated with their own side effects and complications, and because people with illnesses that are not life threatening like to treat themselves, alternative tinnitus therapy thrives.

Tinnitus sufferers turn to homeopathy more than most other illnesses. While practitioners of homeopathy are often at odds with practitioners of traditional Western medicine, it is curious to note that some of the treatments overlap. For example, zinc deficiency is one of the many causes of tinnitus. If your doctor finds you to have zinc deficiency or even if zinc deficiency is suspected, you would likely be given zinc supplements as treatment. While the philosophy behind the treatment is completely different, Zincum Metallicum is one of the homeopathic treatments used for tinnitus. If you choose to use homeopathic remedies for tinnitus, it is important to seek the services of a professional since many of the treatments (at high concentrations) are harmful and even deadly. In other words, use with caution and under the direction of a professional.

Acupuncture has been used with success in patients with tinnitus. Acupuncture is the system of Traditional Chinese Medicine in which practitioners improve the flow of Qi (pronounced chi) along channels or meridians in the body. Needles are used in various acupuncture points most famously, but there are a number of ways that acupuncturists go about treatment. Anecdotal evidence supports the use of acupuncture in the treatment of tinnitus. In other words, it has been very helpful for some and reported in the scientific literature as helpful to small groups of patients. When large studies were performed to examine the effective of acupuncture on tinnitus, acupuncture treatment was no better than a sham procedure (placebo). However, the placebo effect should not be dismissed; those that achieved a benefit from acupuncture—even a placebo effect—still got relief from their symptoms.

A number of herbal and “natural” preparations are available that have been used to treat tinnitus. The most commonly used agents are Ginkgo biloba, niacin, and high-dose antioxidants. The way that these drugs work is not known (assuming that they do, in fact, work). Ginkgo biloba may help tinnitus sufferers by increasing blood flow in the brain and near the ears. In addition to being a vitamin, high dose niacin is a cholesterol medicine and may reduce the contribution of high cholesterol on the symptom of tinnitus.

Also, high-dose antioxidants are believed to protect against age-related tissue destruction, in this case, the breakdown of hair cells and related auditory system structures.

Finally, hypnosis has been helpful for some in the treatment of tinnitus. Just like other alternative therapies (and many traditional medical therapies) it is not always clear which treatments work in which patients. While some self-hypnosis programs are available, if this is your first exposure to hypnosis you are better off having a professional show you how to perform the steps necessary to do it properly.

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6 Comments

  1. Tinnitus Help says:

    Why do so many people suffer from Tinnitus but little is known about it? I liked the information on your site and will be sending people who ask me Tinnitus questions here. Keep up the good work.

  2. george waite says:

    I have severe tinnitus in my ear due to a cochlea insult my cochlea was badlyDamaged

  3. george waite says:

    I have a cochlea damage just real bad tiinitus all day long and night long if you are ent surgeon oran otolgyI I Iiii

  4. Stephen Waterstram says:

    Has anyone considered B-12′ing their tinnitus? In my experience trying to use distracting noises to therepize one that’s stuck in your ear is pointless to Me. Taming it with supplements seem to be a better persuit.

  5. mike says:

    Im surprised they have no cure for this. I have it bad in my right ear… Some days it drives me crazy. The good news is that I have not loss any sleep to it but I will say its almost unbarable to be in a quite room… Oh what I would do to not hear the ringing… It really sucks to know that I will have to hear this crap for the rest of my life.

  6. Chris M. Ferguson says:

    I was truck in the back of the head in a car accident. I have a tennitus so bad I ask to have my right eardrum popped. They told me my ear will still ring. It’s harming the way I live so bad it makes you think evil wicked thoughts. Good luck all, may we pray for medicine to help us.

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