Are you tired of the constant ringing in your ears that seems to never fade away? At Penn Medicine Becker ENT and Allergy, we understand the frustration of tinnitus. As leading otolaryngologist specialists, we provide a comprehensive solution. Our skilled team combines advanced technology with personalized care to address the root causes of your tinnitus. Say goodbye to endless noise and hello to peace. Trust us to restore auditory harmony.
Tinnitus is the term for a sound that occurs in a person’s ear(s) or head but is not present in the environment. For most patients with tinnitus, the sound is only heard inside their head, and cannot be heard by others.
The onset may of tinnitus be gradual or sudden. Many people connect the origin of their tinnitus to a specific event or a health-related sickness. Descriptions of the perceived sound range from ringing, whistling, beeping, screeching, roaring, crickets, ocean, steam/ air, hissing, clicking, to a pulse or heartbeat. More than one sound may be heard simultaneously. Some people hear musical tinnitus.
Durations are highly variable. Some report their tinnitus as constant, while others experience the issue only intermittently. Episodes can last for seconds to hours or days. Some patients with tinnitus report a constant intensity throughout the day, while others report an increase in intensity first thing in the morning and late at night or when stressed or sleep-deprived. Some individuals report a correlation with the ingestion of certain foods or drinks, or when exposed to noisy environments.
Causes of Tinnitus
Tinnitus is a symptom, not a disease. There are many potential causes, and often the specific cause for the individual cannot be determined. The causes include noise or music exposure; the natural aging process; sudden impact noises, such as firearms, incendiary device, or an automobile accident; a reaction to a medication; injury to the neck or head; and stress/ emotional distress.
The current thinking is that tinnitus is the symptom most noticed when there has been a change to the auditory nervous system, most notably to the inner ear (a loss of hair cells or sensory cells) and brainstem areas responsible for changing sound into electricity and sending it up to the sound processing center of the brain. Some scientists feel that tinnitus is a form of auditory hallucination that arises in this auditory cortex.
If someone already has tinnitus but regularly engages in noisy activities or listens to music, it is still appropriate to choose the correct hearing protection to help prevent further hearing loss and tinnitus. An audiologist can help guide you to the correct device if you are uncertain.
Tinnitus evaluations typically begin with a visit to our audiology department for a hearing assessment with an audiologist. An ENT physician will also evaluate and treat relevant aspects of medical care for the person with tinnitus including any primary anatomical abnormalities that could be contributing.
The audiological assessment is integral to understanding the unique aspects of each patient’s auditory challenges and tinnitus. It includes pure tone audiometry to evaluate the integrity of perception of sound in the major frequencies necessary to hear and understand spoken language.
Speech audiometry is performed to document speech clarity and immittance measures check the middle ear health. Tinnitus evaluation is for assessing the tinnitus frequency, intensity, and ability to be masked.
The Tinnitus Handicap Inventory, a questionnaire, is also completed by the patient, at intervals to determine the degree of difficulty and later the effectiveness of the approach.
Treatment Options for Tinnitus
Some patients learn how to ignore their tinnitus so that it becomes a minor health issue. For others, tinnitus can be worrisome or even disabling.
In many patients, tinnitus is associated with anxiety and stress. These patients report their tinnitus as a major symptom often accompanied by sleep deprivation, anxiety, depression, concentration difficulties, mood swings, and distress.
Fortunately, treatment options for tinnitus have evolved over the past decade, and a variety of new treatments are now available for patients. Tinnitus is unique in each patient and requires a personalized treatment plan. There is no one-size-fits-all approach. The audiologists and ENTs at our New Jersey offices assess each patient’s symptoms and design a custom approach for improving the issues.
Options for treating tinnitus include:
Tinnitus Sound Therapy
For some patients, Tinnitus Sound Therapy (TST) treatments are quite effective. There are many varieties of TST; however, the most successful appear to be those that incorporate sound to gently help the brain to acclimate to the tinnitus. By presenting very gentle sound to the ears through tinnitus sound therapy, the brain can eventually learn to pay less attention to the tinnitus.
TST may also help to generate neural changes that reduce the awareness of tinnitus. Although the complete resolution of tinnitus is not always possible, an improvement over time is common.
In patients who have hearing loss as well as tinnitus, TST is easily incorporated in tiny digital hearing instruments. These hearing instruments are highly shapeable for style and sound. A barely-noticeable ocean sound can be presented through the instruments. Not only is it soothing for tinnitus patients to listen to gentle sounds during waking hours, but these sounds also target the tinnitus for after-use hours and gradually help the patient to take less notice of their tinnitus.
Most people find that keeping a steady quiet sound or music present in their listening environment will help mask their tinnitus while awake and make it less noticeable. Apps on smartphones, as well as dedicated sound generators, can present soothing music, nature sounds, or white noise through the air or via earphones. Some people find that audiobooks can provide a measure of sound relief and distraction.
Other supporting practices to help reduce the noticing of tinnitus include mindfulness exercises. These include yoga, other forms of physical exercise, wearing hearing protection in noisy settings, maintaining a healthy diet, and avoiding sound or food triggers.