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Tinnitus and Hearing Loss

Tinnitus and Hearing Loss

Tinnitus is the perception of sound when no external noise is present. It is most commonly described as ringing in the ears, but patients may also perceive hissing, whooshing, roaring, or buzzing. According to the American Tinnitus Association (ATA) and the U.S. Centers for Disease Control, over 50 million Americans experience some form of tinnitus.

Tinnitus itself is not a condition that can be directly diagnosed and treated, but rather it is a symptom of some other underlying condition. For example, hearing loss, ear injury or other trauma to the head/neck, and temporomandibular joint disorder (TMJ) are all associated with tinnitus. ATA reports that tinnitus is listed as a possible symptom of roughly 200 health conditions. Additionally, certain medications are known to generate tinnitus. Tinnitus may even be caused by a combination of different factors. Patients struggling with tinnitus should consult a physician or audiologist to help determine if a specific underlying condition can be identified. In some cases, tinnitus can be alleviated by resolving the underlying cause. Unfortunately, for the vast majority of patients, there is no definitive “cure” for tinnitus. There are, however, many proven treatment options to significantly reduce the perceived intensity and burden of tinnitus.

Tinnitus is often associated with stress and anxiety. Tinnitus itself can be quite distressing, and in turn, stress is known to exacerbate tinnitus. The ATA suggests that engaging in activities to improve one's general wellbeing, including exercise, social activities, and recreational hobbies, can help to ease the burden of tinnitus. Although there is insufficient evidence to suggest that certain alternative treatments such as acupuncture or herbal remedies are effective in managing tinnitus, any activity that lowers stress may help reduce its perceived intensity. This may include yoga, meditation, biofeedback, or hypnotherapy. Cognitive behavioral therapy (CBT) or mindfulness-based stress reduction (MBSR) can also be beneficial in reducing the negative emotional reactions often associated with tinnitus.

Patients with hearing loss may experience some improvement in their tinnitus by wearing hearing aids. By amplifying ambient environmental sounds, hearing aids can often provide enough background stimuli to mask, or “cover up,” the sound of tinnitus. Some hearing aids even generate additional low-level noise to mask tinnitus. Sound generators can also be used in patients without hearing loss. While any audio device (personal media players, radios, etc.) can be used to mask tinnitus, there are commercially available and medical-grade masking devices designed solely for this purpose. In addition to masking tinnitus, these devices can also assist with relaxation.

Since tinnitus is a complex symptom with a wide range of possible underlying causes and contributing factors, the American Academy of Audiology recommends a multifaceted approach to evaluation and treatment. Patients suffering from tinnitus should consult a healthcare provider to first attempt to diagnose a treatable underlying condition. If a cause for their tinnitus cannot be identified or resolved, it is recommended that they consider the many valuable, evidence-based tools for alleviating the negative effects of their tinnitus and improving their quality of life.

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