Treating Tinnitus

It isn't unusual to occasionally hear a slight ringing or humming in your ears. But if the ringing or humming is constant for an extended period of time, you might have a condition known as tinnitus. "Tinnitus is not a disease, but a symptom typically associated with nerve damage to the inner ear," said David R. Friedland, MD, PhD, Assistant Professor of Otolaryngology and Communication Sciences at the Medical College of Wisconsin. Dr. Friedland, a neuro-otologist, practices at the Froedtert & The Medical College Otolaryngology and Communication Sciences Clinic.

The American Tinnitus Association estimates that at least 50 million Americans have experienced tinnitus, either short term or long term, at some point in their lives. "Most people just get used to it, but for about ten percent of those people, it becomes intrusive and affects their quality of life," Dr. Friedland said.

Origin of the Problem
The noise connected with tinnitus may be heard in one ear, both ears or in the middle of the head - or it may be difficult to pinpoint its exact location. The noise might be low, medium or high-pitched. There may be a single noise or two or more components. The noise may be continuous or it may come and go.

A variety of problems can cause the condition, according to Dr. Friedland. "Trauma to the head and neck, a hearing loss, continued exposure to loud noise, and disorders of the temporomandibular joint (TMJ) located in the jaw are all associated with ear problems including tinnitus. Allergies are another common reason for the problem," he said. In addition, more than 200 medicines can cause tinnitus, including over-the-counter medications like aspirin.

On the other hand, tinnitus might rarely originate from a much more serious cause. "If the tinnitus is localized directly in only one ear, I am more concerned that there may be another problem, such as a tumor," Dr. Friedland said.

What to Do
"The most important thing you can do if you suspect you have tinnitus is go see your doctor. He or she can check to see if it is related to blood pressure, allergies, diet, or any medicine you are taking," Dr. Friedland said. "Your doctor may also refer you to a specialist who will examine your ears and your hearing to try to find out why you have tinnitus," he said.

Most tinnitus is a continuous sound, but there is another type of tinnitus. "The other kind of tinnitus is called "pulsatile" tinnitus, where a person can hear their pulse in their ears. This could be related to high blood pressure or vascular disease or tumors. It's also fairly common in people with allergies," Dr. Friedland said. "This kind of tinnitus definitely should be evaluated, as we often have treatments available."

Treatments
Dr. Friedland points out that there is no cure for tinnitus, but there are treatments that give patients some relief.

"There are a lot of different things people can try that may work for them," Dr. Friedland said. Not every treatment works for every person, however, so you may need to try several to find the ones that help you. Treatments might include:

Hearing aids. Many people with tinnitus also have a hearing loss. Wearing a hearing aid improves your ability to hear the outside world and can mask the internal sound of tinnitus. The better you hear other people talking or the music you like, the less you notice your tinnitus.

Maskers. Maskers are small electronic devices that emit a "white noise" to make tinnitus less noticeable. Maskers do not make tinnitus go away, but they make the ringing or roaring seem softer. For some people, maskers hide their tinnitus so well that they can barely hear it. "For people with a hearing loss, we can also fit their hearing aids with a masker," Dr. Friedland said.

Medicine or drug therapy. Some medicines ease tinnitus. If your doctor prescribes medicine to treat your tinnitus, he or she can tell you whether the medicine has any side effects.

"There have been a number of over-the-counter herbs and treatments such as gingko biloba that have been touted as being useful. None of them has been proven effective in clinical trials," Dr. Friedland said.

Tinnitus retraining therapy. This treatment uses a combination of counseling and maskers. Physicians and therapists can help you learn how to deal with your tinnitus better, and the maskers can make the tinnitus less noticeable. After a time, some people learn how to avoid thinking about their tinnitus. It takes time for this treatment to work, but it can be very helpful.

Counseling/Stress Education. Some people with tinnitus become depressed. Talking with a counselor or people in tinnitus support groups can be helpful. Learning how to relax is very helpful if the noise in your ears frustrates you. Stress makes tinnitus seem worse and by relaxing, you have a chance to rest and better deal with the sound.

"I have prescribed biofeedback, acupuncture, massage therapy, Tai Chi, stress reduction classes - all to help patients with tinnitus," Dr. Friedland said. "Education is very important. Once people know what their problem is, they are not as stressed and anxious about it."

You can also help yourself in the battle against tinnitus by steering clear of certain stimuli. "Avoid caffeine, alcohol and smoking. Avoid noisy environments if you can," Dr. Friedland advised. If you are regularly exposed to loud noise at work, wear earplugs to protect your hearing.

Tinnitus Research
Physicians continue to study tinnitus in the hope of finding better treatment. Dr. Friedland is currently conducting a clinical trial through the Medical College to find out more about treating tinnitus. "This is an initial feasibility study of an implant. We have started the test here with two patients, whom we will follow for one year. We hope to enroll several more people in this study," he said. After a year, the group will release the results of the study. Dr. Friedland has also begun research to localize and identify the genes associated with tinnitus.

JoAnn Petaschnick
HealthLink Contributing Writer

This article includes information from National Institutes of Health.

MCW Health News presents up-to-date information on patient care and medical research by the physicians of the Medical College of Wisconsin.