The word tinnitus is derived from the Latin word “tinnire” which means to ring. It is the perception of sound despite the absence of external sounds. Tinnitus can be generally categorized into:
- Subjective tinnitus (audible only to the affected individual, most common)
- Objective tinnitus (the sound can be heard by others as well as the patient, relatively rare)
It affects approximately 10-15% of the population with as many as 50 million Americans being affected. In patients who present with ear related issues, 85% reported that they experienced tinnitus as well. Although more common in individuals over the age of 50 years (increased age), the rate of children and adolescents affected have been reported to be as high as 13%. There are many who experience tinnitus after exposure to loud noises such as attending concerts, going to clubs, or being near to a gun being fired. Other risk factors of tinnitus include:
- Sleep deprivation
- Noise exposure from earphones or surrounding environment (construction work etcetera)
- Tympanic membrane issues
- Rheumatoid arthritis
- Thyroid disease
- Taking ototoxic medication
- And more
It is important to bear in mind that tinnitus is a symptom of an underlying abnormality and is not a disease on its own. Individuals who suffer from tinnitus may also experience:
- Poor concentration
- Disrupted work or school performance
- Sleeping problems such as insomnia
While many of those afflicted are able to adapt to the symptoms, thee are also a portion of affected individuals who find it debilitating and unbearable. This specific group would have sought help from various professionals. Unfortunately, therapy that is effective and beneficial to one patient does not mean that it always works for the next. Since there are so few who are cured, the treatment and management of tinnitus focuses on helping each person cope with their symptoms as it is likely to be a chronic problem.
The Cure for Tinnitus
Since tinnitus is a symptom for a range of diseases, there is no one cure for tinnitus. The cure for tinnitus depends on the underlying issue that causes it. Here are some of the treatment options available:
Most tinnitus patients would not have to undergo surgery but for those who have tinnitus due to a lesion in the ear, surgery is a potential cure. For example:
- glomus tumors
- arteriovenous malformation
- conductive hearing loss
- sigmoid sinus diverticulum
These are all issues that can cause tinnitus but can be cured through surgery. In acoustic tumors, as many as 50% of patients find that their tinnitus improved while the other 50% find no change. In a study that analyzed the effectiveness of surgical correction in patients with sigmoid sinus diverticulum, 17 out of 25 patients had completely resolved tinnitus and 3 others found it to be partially resolved. In Meniere’s syndrome (a common disorder of the inner ear that causes vertigo, tinnitus, and hearing loss), surgical intervention can provide relief for 40-80% of patients.
Medical Therapy Examples
The suppression of tinnitus through electrical stimulation of the inner ear has mixed success rated. There are many variations of electrical stimulation such as:
- Cutaneous stimulation
- Brain stimulation
- Promontory stimulation
- And more.
While the authors of these published studies have often reported a tinnitus resolution rate as high as 80%, the effects are usually transient and is therefore not considered as one of the primary therapies for tinnitus.
Biofeedback is used to help lower stress and anxiety levels in patients that may be contributing towards or aggravating their tinnitus. To ensure that this method is a success, the patient involved must be committed and cooperative throughout therapy. The patient is encouraged to relax and relate his relaxation to their stress levels being lowered and hence, the gradual reduction of their tinnitus. Biofeedback sessions may be required weekly over a course of several months before any improvement can be seen. For maximum benefit from the therapy, it is best for a psychologist and otologist to conduct this therapy together. Biofeedback has been able to provide total relief to 20% and partial relief to 80% of patients.
Repetitive transcranial magnetic stimulation
Transcranial magnetic stimulation is a minimally invasive method that is used to stimulate the brain without causing pain on the surface. Repetitive transcranial magnetic stimulation refers to the rhythmic application of a series of stimuli and is being researched as a potential therapeutic tool for other disorders such as depression, schizophrenia, and stroke. Since tinnitus has been considered by some professionals to be an excitability of the cerebral cortex, specifically the auditory cortex, this method is being studied as a treatment option for those for tinnitus. A study conducted have concluded that this technique can provide short-term relief of tinnitus thorough the modulation of neuron excitability in the auditory cortex. Another study reported that this method resulted reduced severity of tinnitus after 6 months of follow up.
When patients first start experiencing tinnitus, they tend to get anxious and depressed. In most cases, these patients simply want the reassurance that their tinnitus is not due to cancer or any other malignancy such as a brain tumor. In these patients, once potentially serious disorders are eliminated, they can move on to assessment if a hearing aid or any other devices that may improve their symptoms or quality of life. Improvements can be seen in 50% of patients with subjective tinnitus. Studies have found that patients without intervention experience a small but significant improvement over time.
Support groups can be especially useful for individuals who feel alone due to their condition. This provides an opportunity to share experiences and learn from one another. Support groups can be conducted with or without a counselor present as it is still beneficial to those involved. You can look for support groups online or through your local library or newspaper. If there is none available locally, you can also join an online community that also acts as a support group. One of the most famous organizations in the United States is the American Tinnitus Association that is based in Portland, Oregon. It is an organization that conducts research and aims to educate those interested in learning more about tinnitus.
Pharmacologic therapy or medication is beneficial in the treatment of tinnitus in 80% of patients especially those who also suffer from depression. Nortriptyline is found to be the most effective treatment but can take 3-4 weeks of therapy before any signs of improvement can be observed. Selective serotonin reuptake inhibitors (SSRIs) such as Paroxetine and Sertraline can also be helpful.
Conclusion on Cure for Tinnitus
There are many other types of treatment such as tinnitus maskers, hearing aids, tinnitus feedback retraining and alternative therapies (gingko biloba, niacin, combination supplements, acupuncture, etcetera) that are available for tinnitus, but they may or may not work for you. Tinnitus is a symptom of an underlying problem. Depending on the underlying issue, the treatment for tinnitus may vary from person to person. Make an appointment with your doctor today to get started!