Tinnitus Treatments
Tinnitus: Is There a Cure for It?
Ali A. Danesh, Ph.D.
Associate Professor and Director of Audiology
Florida Atlantic University
Boca Raton, FL
Tinnitus is a common symptom of a series of pathologies that involve organ of hearing. Whatever the cause of tinnitus is, it is considered as a challenging and difficult to cure condition by the majority of medical community. It is estimated that more than two million people visit a physician for their tinnitus every year. Therefore, if you are one of those practitioners who tell to their tinnitus patients to go and live with their tinnitus you might want to re-consider your approach. There are many tinnitus management protocols and algorithms now available that can help individuals with tinnitus. It could have been nice if there was a panacea or a “magic pill” for all kind of diseases but realistically speaking there is nothing like that and tinnitus is no exception. During the last several hundred years scientists and physicians have come up with some methods to study and control exasperating tinnitus.
Underlying Etiologies: The underlying etiology of tinnitus is very broad which will be briefly discussed in here. Tinnitus origination has been reported form abnormalities in the external auditory canal that include the presence of impacted cerumen and foreign objects. Some of the underlying middle ear pathologies that can cause tinnitus include otosclerosis, Eustachian tube malfunction, and middle ear tumors such as glomus jugulare. The inner ear and eighth cranial nerve disorders such as labyrinthitis, Meniere’s disease, vestibular schwanoma, and degenerative cochlear and retrocochlear pathologies due to presbycusis and noise exposure are just a few examples that can result in tinnitus. Tinnitus is not necessarily an ear-related symptom. It can be present in many of metabolic and systemic illnesses and conditions such as diabetes mellitus, anemia, hyperthyroidism, and hypertension. Tinnitus can be perceived in one ear, two ears, or within the head. One of the most common reasons for tinnitus is exposure to loud noises in the industrial world and exposure to loud music especially in teenagers. Ototoxic medications such as certain types of aminoglycosides can result in tinnitus and cancer treatment medications such as cisplatinum is another agent that can result in tinnitus.
Treatment Options: Tinnitus treatment is a multidisciplinary approach and includes a variety of tactics, which is logically anticipated, as there is no single etiology for tinnitus as discussed earlier. Some of the tinnitus management approaches include medical and surgical management, transmitter antagonist therapy, masking therapy and habituation, amplification, tinnitus retraining therapy, biofeedback, cognitive behavioral modification, electrical suppression, low level laser therapy, and counseling. The drug therapy seems to be one of the promising methods of tinnitus management, which includes the administration of medications that range from antidepressants and benzodiazepines, to vitamins and antihistamines. Surgical approaches comprise procedures such as stapedectomy and middle ear reconstructive surgery that can improve both hearing and tinnitus, and microvascular decompression of the eighth cranial nerve and trigeminpharyngoplasty to alleviate tinnitus. One of the methods that have been very successful in the management of tinnitus is the use of masking sounds to mask out tinnitus which consequently results in habituation to tinnitus. With the use of small noise generators or amplification devices combined with counseling and retraining techniques we have been able to relieve tinnitus in a large number of individuals with tinnitus. In addition to the use of masking devices or noise generators that are used with individuals with normal hearing, the use of digital hearing aids has been enormously helpful in cases of unilateral sudden hearing loss that are associated with intractable tinnitus.
In summary, tinnitus patients need to be evaluated on a case by case basis. A thorough audiological evaluation is necessary following medical examination. Finding the appropriate treatment for tinnitus depends on its underlying etiology. Additionally, treatment of the accompanying symptoms of tinnitus such as stress, anxiety, depression, fear, and insomnia will help in the alleviation of tinnitus and effectiveness of its management.
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