Tinnitus

Patient information on Tinnitus

Who is this information for?

This information is for patients, families and carers regarding tinnitus.

What is Tinnitus?

Tinnitus is the experience of hearing a sound from within one or both of your ears, or your head, in the absence of an actual sound. Tinnitus is often described as a ringing, buzzing or whistling, but can be any noise.

This noise is usually due to a minor disorder of the hearing system and it may be associated with a hearing loss or exposure to loud noise. It is often worse in quiet environments, such as when going to sleep at night.

Although tinnitus can be distressing, it is not life threatening and your quality of life can be improved. Strategies can be implemented to manage tinnitus.

Click here for a Tinnitus Reaction Questionnaire

More information about Hearing Loss.

How does my hearing affect tinnitus?

When you hear, outside sounds travel in waves in the air and are converted by your inner ear (cochlea) into nerve signals that are like tiny electrical currents. These signals pass along your hearing nerve to your brain. Your brain then sorts out what information is important. This usually means ignoring meaningless sounds. Unfortunately many people with tinnitus tend to pay attention to this unfamiliar sound in their ear/ears, which can cause distress.

Your hearing system has the ability to select out certain important, strange or worrying sounds such as tinnitus for special attention, and filter out other sounds. With hearing loss, your ability to hear external sounds reduces, and with this lack of contrasting sound, you become more aware of internal tinnitus noises. Any other form of hearing disorder or damage can add to this natural hearing loss and make tinnitus even more noticeable. However, tinnitus can also happen with completely normal hearing levels as well.

Hearing aids may improve tinnitus symptoms in people with age-related hearing loss. Hearing aids work by making outside sounds clearer and louder, which may cause the tinnitus noise to be less noticeable. People with other causes of hearing loss may benefit from surgery to the outer or middle ear. Cochlear implants may help relieve tinnitus in some cases of severe hearing loss.

In patients with auditory system damage due to use of medication, stopping the medication may improve tinnitus and prevent hearing loss from worsening. Patients should consult with a health care provider before starting or stropping any medications.

How can I reduce the tension and anxiety associated with tinnitus?

Patients often worry about tinnitus and this can cause tension. Understanding the cycle of tinnitus and tension, and learning how to relax, can assist in reducing anxiety and the tinnitus itself. The cycle of tinnitus and tension is as follows:

Depression is common in people with tinnitus. Safe and effective treatments for depression may improve the symptoms of tinnitus in some people. Anti-depressants can also improve a person’s ability to cope with the problem.

How do relaxation exercises assist with tinnitus management?

Relieving tension in your body assists in breaking the cycle of tension and tinnitus. Simple relaxation exercises can be used to help your body to relax.

More formal Cognitive behavioural therapy (CBT) is also used to teach patients to manage their psychological responses to tinnitus. It involves using coping strategies, distraction skills, and relaxation techniques.

What is sound therapy and how can it assist in the management of tinnitus?

The natural history of tinnitus is for it to gradually recede into the background so that you become hardly aware of it. This is known as the habituation process. You can speed up the habituation process by increasing the amount of background sound near you. This is known as sound therapy. Sound therapy reduces the contrast between the level of your tinnitus and the level of background sound. This results in a reduction of intrusiveness of your tinnitus and the tensionit causes, which disrupts the tinnitus tension cycle. Background sounds may come from the following:

• Pleasant low sound from television, radio or a fan
• Sound conditioner,such as a device that plays natural sound
• White noise generator
• Wearable noise generator, a device which looks like and is worn like a hearing aid, but makes its own “shhh’ sound – often referred to as a masking device.
• Wearing and using a hearing aid, even if you only have slight difficulty in hearing

The level of the background sound needs to be just below that of the tinnitus. By removing a quiet environment, your brain does not to try and hear the tinnitus noise more clearly. Sound therapy is usually required when you are awake and asleep, but some people find they only need it in quiet environments.

What is tinnitus retraining therapy (TRT)?

TRT in performed by experts in a tinnitus centre. It includes counselling as well as the use of a wearable device that emits low-level noise and environmental sounds. Although TRT has demonstrated short-term success in many tinnitus sufferers, it requires a commitment to the program; the noise-generating device may need to be worn for 1-2 years. Studies show up to 80% of patients find some relief of their tinnitus with TRT.

Are there other therapies for tinnitus?

A number of other types of treatments for tinnitus have been studies, although none have been found to reliably be more effective than placebo:

• Electrical Stimulation: of certain parts of the inner ear can be accomplished by placing electrodes on the skin or using acupuncture needles
• Acupuncture: Acupuncture has shown some benefit in tinnitus sufferers. It may be used alone or in combination with electrical stimulation.
• Repetitive Trans-cranial magnetic stimulation (rTMS): in rTMS, a powerful magnetic field is used to stimulate the brain. This treatment shows promise for some tinnitus sufferers but is still experimental.
• Herbal Remedies: Gingko biloba and melatonin have both been studies for use in treating tinnitus. While some patients report benefit from these types of treatment, there are no studies with high rates of improvement in tinnitus from herbal remedies.
• Vitamins and minerals: Vitamins and minerals that have been studies for treatment of tinnitus and inner-ear health include niacin (a B vitamin), zinc, and copper. While some patients report benefit from these types of treatment, there are no studies with high rates of improvement in tinnitus from vitamin or mineral remedies.

Should I use earplugs to manage tinnitus?

If you have tinnitus, you should not wear any kind of earplugs that make it more difficult to hear, except when you are exposed to very loud noise (e.g. concerts, machinery). Earplugs will not help your tinnitus and will probably make the tinnitus sound louder when you are wearing them.

Can I have temporary deafness and tinnitus?

If you have been exposed to a particularly loud sound or working environment, you may experience dullness of hearing and/or tinnitus immediately afterwards. This tinnitus will usually disappear within a few minutes to hours. If your ears are repeatedly exposed to loud sounds there is a risk of permanent damage to your hearing.

Can my general health affect tinnitus?

Some diets, activities and situations may aggravate your tinnitus. By adjusting your lifestyle, tinnitus may be improved. Aggravating factors may include:

• Very loud noise
• Some medications
• Stress and fatigue
• Coffee, tea, cola drinks or chocolate (caffeine)
• Alcohol
• Smoking

Concerns or questions?
You can contact your ENT Specialist at the Melbourne ENT Group (MEG):

• Phone: 1300- 952-808
• Email: admin@melbentgroup.com.au
• Website: www.melbentgroup.com.au

You can contact your ENT specialist at the Melbourne ENT Group (MEG)

Further information

Thee Tinnitus Association of Victoria has published further information about tinnitus on their website:

Download PDF

Can my general health affect tinnitus?

Some diets, activities and situations may aggravate your tinnitus. By adjusting your lifestyle, tinnitus may be improved. Aggravating factors may include:

• Very loud noise
• Some medications
• Stress and fatigue
• Coffee, tea, cola drinks or chocolate (caffeine)
• Alcohol
• Smoking

Concerns or questions?

You can contact your ENT Specialist at the Melbourne ENT Group (MEG):

• Phone: 1300- 952-808
• Email: admin@melbentgroup.com.au
• Website: www.melbentgroup.com.au

Your GP is also the best contact for ongoing care and concerns.

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