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Tinnitus

What is tinnitus?

Tinnitus is commonly described as a ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It may be soft or loud, high pitched or low pitched. You might hear it in either one or both ears. In the past year, experts estimate that 22.7 million adult Americans experienced tinnitus for more than three months, which is roughly 10 percent of the adult population of the United States.

What causes tinnitus?

Tinnitus (pronounced tin-NY-tus or TIN-u-tus) is not a disease. It is a symptom that something is wrong in the auditory system, which includes the ear, the auditory nerve that connects the inner ear to the brain, and 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 be the result of a number of health conditions, such as:

  • Noise-induced hearing loss
  • Ear and sinus infections
  • Diseases of the heart or blood vessels
  • Ménière’s disease
  • Brain tumors
  • Hormonal changes in women
  • Thyroid abnormalities

Tinnitus is sometimes the first sign of hearing loss in older people. It also can be a side effect of medications. More than 200 drugs are known to cause tinnitus when you start or stop taking them.

People who work in noisy environments—such as factory or construction workers, road crews, or even musicians—can develop tinnitus over time when ongoing exposure to noise damages tiny sensory hair cells in the inner ear that help transmit sound to the brain. This is called noise-induced hearing loss.

Soldiers exposed to bomb blasts can develop tinnitus if the shock wave of the explosion squeezes the skull and damages brain tissue in areas that help process sound. In fact, tinnitus is one of the most common service-related disabilities among veterans returning from Iraq and Afghanistan.

Pulsatile tinnitus is a rare type of tinnitus that sounds like a rhythmic pulsing in the ear, usually in time with your heartbeat. Doctors at The Hearing Center at Dallas Ear Institute 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.

Even with all of these associated conditions and causes, some people develop tinnitus for no obvious reason. Most of the time, tinnitus isn’t a sign of a serious health problem, although if it’s loud or doesn’t go away, it can cause fatigue, depression, anxiety, and problems with memory and concentration. For some, tinnitus can be a source of real mental and emotional anguish.

What should I do if I have tinnitus?

An evaluation by a Dallas Ear Institute audiologist or physician is the first step in your quest to find out more about your tinnitus. Your evaluation will include a full assessment as to the type of tinnitus you suffer from and possible factors that may be contributing to your tinnitus. Simple causes of tinnitus will be ruled out and your hearing will be assessed to check for this association with your tinnitus.

During your appointment, you will have a tailored evaluation to your symptoms. The Dallas Ear Institute professionals work together to give you a complete, coordinated approach to your problems. All possible causes of your tinnitus and all options for treatment will be considered during your evaluation.

Click here for information regarding The Hearing Center's Tinnitus and Hyperacusis Program

What if the sounds in my ear do not go away?

Some people find their tinnitus doesn’t go away or it gets worse. In some cases it may become so severe that you find it difficult to hear, concentrate, or even sleep. Your Dallas Ear Institute hearing professional will work with you to help find ways to reduce the severity of the noise and its impact on your life.

Are there treatments that can help me?

Tinnitus does not have a cure yet, but treatments that help many people cope better with the condition are available. The Dallas Ear Institute is a fully integrated center, with all possible treatment options considered and cutting edge technology offered.  Below are some of the treatments offered:

Devices Offered by The Hearing Center at The Dallas Ear Institute

Widex: Zen

Widex offers advanced hearing instruments that make use of fractal technology and offer a harmonic sound program called Zen.  Zen generates soothing sounds and is used as a sound therapy tool for relaxation and tinnitus treatment.  The fractal tones used in Zen sound therapy incorporate many useful characteristics of music while avoiding certain features that could be distracting to some individuals.  Zen is designed for relaxation and concentration and for making tinnitus less noticeable.  The Zen devices can also be used as hearing aids, and, if necessary, can simultaneously treat hearing loss as well as tinnitus.  This flexibility allows you to improve your quality of life from many angles.  Zen devices can be adjusted according to your specific needs and preferences. 

Widex: Zen

Neuromonics: Oasis

Neuromonics: Oasis, Haven, and Sanctuary

The Neuromonics tinnitus treatment is designed specifically to target the neurological processes of tinnitus by addressing auditory, attentional, and emotional aspects. Treatment is delivered via a compact, lightweight and uniquely-designed medical device and headphones. Stimulus is embedded within precisely-designed music and customized for each user’s profile. The treatment regimen is customized to each patient’s unique hearing and tinnitus profile.

These sounds, customized for each user’s audiological and tinnitus profile, stimulate the auditory pathway to promote neural plastic changes. Over time, new connections train the brain to filter out tinnitus disturbance, providing long-term relief from symptoms.
The device is worn for at least two hours per day (or longer, if preferred or needed) during daily activities like reading, preparing meals or at the office.

The Neuromonics Tinnitus Treatment:

  • Reduces symptoms quickly – Many patients enjoy some relief almost immediately
  • Treats the cause – Addresses underlying neurological causes of tinnitus
  • Provides significant long-term relief – Relief lasts, even long after the treatment ends
  • Convenient and non-invasive – No medication or surgery required. It supports your body’s own natural mechanisms to block out tinnitus symptoms
  • Clinically proven – Shown to be effective for 90% of suitable tinnitus cases as demonstrated by 15 years of clinical studies and in general clinical practice

Three levels of Neuromonics technology (Oasis, Haven, and Sanctuary) are offered. Your Dallas Ear Institute Audiologist will work with you to decide on the best option for your tinnitus treatment needs. The Neuromonics treatment may last anywhere from 2-12 months, depending on your specific needs and tinnitus disturbance level.

After the completion of your successful treatment program, your Dallas Ear Institute Audiologist will work with you to develop a maintenance program you can use to continue to control your tinnitus on your own.

Many people may not feel the need to use the device after treatment. Those who do typically use it for short periods of time (2-4 hours per week) to help them maintain the benefits achieved.

Hearing aids often are helpful for people who have hearing loss along with tinnitus. Using a hearing aid adjusted to carefully control outside sound levels may make it easier for you to hear. The better you hear, the less you may notice your tinnitus. The most advanced hearing aid technology is offered at The Hearing Center at Dallas Ear Institute, including new hearing aids that are specifically designed for patients with tinnitus.  This exciting new technology can be very useful in many patients suffering with tinnitus and hearing loss.

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. Professionals at The Dallas Ear Institute work closely with a neuropsychologist to treat patients with tinnitus in a coordinated, multi-pronged approach.  You will be evaluated by Dr. Sarah Nuche to explore the neuropsychological aspects of treating your tinnitus.

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.

Tabletop sound generators are used as an aid for relaxation or sleep. Placed near your bed, you can program a generator to play pleasant sounds such as waves, waterfalls, rain, or the sounds of a summer night. If your tinnitus is mild, this might be all you need to help you fall asleep.

Acoustic neural stimulation is a relatively new technique for people whose tinnitus is very loud or won’t go away. It uses a palm-sized device and headphones to deliver a broadband acoustic signal embedded in music. The treatment helps stimulate change in the neural circuits in the brain, which eventually desensitizes you to the tinnitus.

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.

Antidepressants and anti-anxiety drugs may be prescribed by your doctor to improve your mood and help you sleep. In some studies, these medications have been shown to decrease the effect of the tinnitus on your life and may be helpful in decreasing the effects tinnitus has on your quality of life.

Other medications may be available at drugstores and on the Internet as an alternative remedy for tinnitus, but none of these preparations has been proved effective in clinical trials.

Can I do anything to prevent tinnitus or keep it from getting worse?

Noise-induced hearing loss, the result of damage to the sensory hair cells of the inner ear, is one of the most common causes of tinnitus. Anything you can do to limit your exposure to loud noise—by moving away from the sound, turning down the volume, or wearing earplugs or earmuffs—will help prevent tinnitus or keep it from getting worse.

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