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Hearing & Balance Doctors is currently open. We are taking special measures to prevent the spread of COVID-19 including offering a curbside service for hearing aids. Please call 435-688-8991 for more information. Utah: 435-688-8991 | Nevada: 702-896-0031
Hearing & Balance Doctors is currently open. We are taking special measures to prevent the spread of COVID-19 including offering a curbside service for hearing aids. Please call 435-688-8991 for more information. Utah: 435-688-8991 | Nevada: 702-896-0031

Tinnitus Evaluations, Treatment, & Management

What Is Tinnitus?

Tinnitus (pronounced either ti-NIGH-tus or TIN-uh-tis) is a phantom sound that an individual perceives, but is not really present in the environment. The most common forms of tinnitus include a ringing, buzzing, hissing, or chirping sound. In more rare cases, people describe hearing music, voices, or singing. Most of us have experienced brief episodes of tinnitus – perhaps after a rock concert – but the sound usually subsides and disappears. Some people experience chronic tinnitus that can interfere with their daily routine. Approximately 10-15% of the population experiences bothersome persistent tinnitus.

What Causes Tinnitus?

Tinnitus is typically a side effect of hearing loss. In general terms, when hearing loss is present, the signal being sent from the auditory nerve to the brain is diminished. To compensate for this, the auditory centers of the brain may generate a phantom sound. This phantom sound is tinnitus and it often corresponds closely to the very frequency where hearing loss is greatest. In other words, if an individual does not hear high-pitched sounds well, the tinnitus often takes the form of a high-pitched ringing sound. Tinnitus is often compared to phantom limb syndrome, a condition in which an amputee will continue to experience sensations – often pain or itching – in a missing limb. Similarly, this condition is a phantom signal being generated by the brain due to a lack of input.

Less frequently, tinnitus may be caused by other issues. These other issues may include a wax blockage in the ear canal, a middle ear infection, allergies, sinus congestion, concussions, head trauma, chronic pain, metabolic issues, certain medications, and neurologic conditions. These sources of tinnitus can often be treated medically and in some cases the tinnitus can be eliminated.

Exacerbating Factors of Tinnitus

While tinnitus is usually caused by hearing loss, other factors can cause tinnitus to intensify or worsen. These are sometimes referred to as exacerbating factors. Exacerbating factors can include stress, fatigue, depression, diet, illness, and overall well-being. Identifying and controlling these factors can often help to mitigate the effects of tinnitus.

Evaluating Tinnitus

A tinnitus evaluation with one of our audiologists at Hearing & Balance Doctors will typically include the following:

  • Thorough case history (emphasizing the onset and severity of the tinnitus)
  • Comprehensive hearing evaluation (hearing test to rule out hearing loss as a contributing factor)
  • Otoscopy (a visual inspection of the ear canal and ear drum)
  • Tympanometry (evaluation of the mobility of the ear drum to rule out middle ear congestion)
  • Otoacoustic emissions (a test of the hair cell function of the inner ear)
  • Pitch and Loudness matching (a test designed specifically to match the pitch and loudness of an individual’s tinnitus)
  • Discussion of test results
  • Creation of a treatment plan

A complete tinnitus evaluation allows a doctor of audiology to determine the underlying cause of the tinnitus. Once a cause is determined, a customized treatment plan can then be created to help treat or manage the problem. A tinnitus evaluation and subsequent consultation at our clinic often takes between 60 and 90 minutes.

Medical Treatment of Tinnitus

Some causes of tinnitus can be medically treated. These include:

  • Excessive ear wax blocking the ear canal
  • Congestion behind the ear drum
  • Middle ear infections
  • Sinus congestion
  • Allergies
  • Some metabolic issues

Some of these issues can be treated by our audiologists. Others may require treatment from your primary care physician or an otolaryngologist. Our audiologists will oversee your individual treatment plan.

Hearing Aids as Treatment for Tinnitus

The most common cause of tinnitus is hearing loss. The best treatment, therefore, is usually to treat the underlying hearing loss with hearing aids. By correcting for the hearing loss, the tinnitus – the phantom sound being generated by the brain – is usually reduced. Using hearing aids is the only treatment approved by the Food and Drug Administration (FDA). Some people experience a complete cessation of their tinnitus while wearing their hearing aids. Others experience a significant reduction in tinnitus while wearing their hearing aids. A smaller percentage of people do not experience relief from wearing hearing aids. Many studies report a success rate of approximately 66% in using hearing aids as treatment.

Many hearing aids also have built-in tinnitus treatment capabilities beyond correcting for the underlying hearing loss. For example, many hearing aids have the capability of producing a special filtered noise that can be effective in soothing tinnitus. Apps, such as the ReSound Tinnitus Relief app, also provide customized “soundscapes,” relaxation therapies, and educational materials that can be very useful. Many hearing aid manufacturers have tinnitus therapy options available:

  • ReSound – the ReSound Tinnitus Sound Generator is one of the original, and most effective, built-in hearing aid tinnitus solutions. Additionally, the ReSound Tinnitus Relief app (mentioned above) is the best tinnitus app on the market. It works in conjunction with an individual’s hearing aids, but can also be used to some degree without hearing aids. The app is available through the Apple App Store and on Google Play
  • Widex – The Widex Zen Therapy was the first tinnitus treatment solution built into a hearing aid. Widex utilizes “fractal tones” to help break negative emotional associations people have with their tinnitus. When these associations are broken, the tinnitus can be relieved. Widex also has an app available, The Widex Zen Therapy app, to work with smartphones (both Apple and Android).
  • Oticon – new hearing aids from Oticon also have sound generators built-in to help manage tinnitus. Peaceful background sounds include white noise, ocean sounds, and other options.
  • Phonak – The Phonak Tinnitus Treatment Portfolio is similar to that provided by Oticon. Soothing sounds are generated by the hearing aids helping to reduce tinnitus. Accessories, like the ComPilot, can also help stream other sounds to the hearing aids. Phonak provides the Tinnitus Balance app, free through the iOS App Store and on Google Play, to help control some features of the streamed sound.

Using hearing aids to treat tinnitus, by both correcting for the underlying hearing loss as well as using built-in sound generators, is a form of Sound Therapy. The use of sound therapy in conjunction with hearing aids is the preferred treatment strategy at our clinic.

Other Treatment Therapies

In addition to hearing aids and Sound Therapy, other therapies have been used to treat tinnitus. These include:

  • Tinnitus Retraining Therapy (TRT) – this form of therapy-based treatment involves Sound Therapy in conjunction with counseling. The focus of TRT is to gain knowledge and understanding of the tinnitus and to empower the patient to have greater control over his or her emotional response to the tinnitus.
  • Mindfulness-Based Stress Reduction (MBSR) – MBSR emphasizes “mindfulness” and teaches patients to embrace and control the tinnitus. It can help change the negative emotional responses that people often have to tinnitus.
  • Progressive Tinnitus Management (PTM) – PTM is similar to TRT in that it emphasizes knowledge and education. It employs a tiered treatment approach that is customized to each individual patient.

Alternative Therapies For Tinnitus

There are many alternative treatments for tinnitus. An internet search will quickly reveal drops, pills, supplements, and exercises all purporting to help relieve tinnitus. When studied, none of these treatments have proven to be any more effective than a placebo. In other words, there is no legitimate scientific research to support the use of these treatments.

The Hearing & Balance Doctors Can Help You

Tinnitus is a very prevalent problem. It can range in severity from mild to catastrophic. If you or a family member is struggling with tinnitus, there is help available. We have great success in our clinics treating tinnitus. Our doctors of audiology specialize in evaluating, diagnosing, and treating tinnitus. Contact us today to schedule your appointment.