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Key Facts About Tinnitus

Crooks, Tennille; Eintracht, Beverley

doi: 10.1097/01.HJ.0000549527.02003.16
Special Section on Tinnitus Management: Patient Handout

Tennille Crooks and Beverley Eintracht are clinical audiologists and tinnitus specialists who are members of Audiology Australia and Independent Audiologists Australia. They are co-owners of Perth Hearing and Tinnitus Clinic, which is committed to providing evidence-based, ethical, and comprehensive services within a comfortable and relaxed atmosphere.

Tinnitus is the perception of sound when there is no external sound present, often described as a ringing, buzzing, humming, clicking, or cicada-like sound. Less commonly, tinnitus can be heard as a musical tune or a pulsing sound in time with a person's heartbeat. It may be one or multiple sounds, and it may be constant or intermittent. It can be heard as coming from one or both ears or from within the head. Research shows that most people hear tinnitus when they are asked to listen in a very quiet environment (i.e., when sitting in a sound-proof booth). Tinnitus is common and reported in all age groups.

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CAUSE AND HABITUATION

The exact cause of tinnitus is hard to pinpoint, but it is generally understood that it results from some type of change, either mental or physical, but not necessarily related to the ear. Tinnitus can be associated with noise exposure, hearing loss, middle ear pathology or dysfunction, impacted wax, head or neck injuries, some medications, or a period of high stress. In many instances, the cause or the trigger is unknown.

Tinnitus may dissipate over time or a person may habituate to it such that even though it may be audible, it is of little consequence. In some people, the tinnitus can be intrusively bothersome and significantly affect their general well-being.

Seek assistance if the tinnitus:

  • is associated with hearing difficulties.
  • presents or changes suddenly.
  • becomes intrusive and bothersome.
  • interferes with sleep and/or your ability to concentrate.
  • impacts general well-being.
  • is in one ear only.

Individuals with tinnitus are often told that “there is nothing that can be done” or that “you will have to learn to live with it,” but this is not the case. While there is no cure, treatment options are available, and patients can successfully manage the tinnitus to the point where it is no longer a concern.

Consult a general practitioner to address any underlying medical factor that may be contributing to the tinnitus.

Some people require a more involved intervention, and those with distressing tinnitus often benefit from a multidisciplinary approach. In addition to a general practitioner, an ENT specialist, and an audiologist/a tinnitus specialist, others who may be involved in the rehabilitation process include physiotherapists, counsellors, sleep specialists, and/or temporomandibular joint dental specialists.

Factors influencing your ability to get used to the tinnitus include current stress levels and coping abilities, emotional and physical support systems, and insight into the mechanisms of the tinnitus.

Plus, understanding how all of the above interact.

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FINDING SUPPORT

Your experience of tinnitus and its impact on your life are unique, so it's important to seek the assistance of a tinnitus specialist who can offer a holistic, evidence-based tinnitus program designed specifically for your personal situation.

A tinnitus management program should provide you with a deeper understanding of tinnitus and strategies you can use to manage and reduce the symptoms.

These strategies may include a combination of:

  • sound enrichment
  • hearing devices
  • neuromonics treatment
  • behavioral techniques such as cognitive behavioral therapy and acceptance commitment therapy
  • stress reduction and relaxation strategies
  • sleep solutions
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TINNITUS AND HEARING

If the tinnitus is accompanied by any hearing loss, the use of hearing aids can be helpful on a number of levels. Well-fitted hearing aids assist with communication, help reduce the stress and fatigue associated with intensive listening, and amplify low-level background sound. This can result in a reduction in tinnitus awareness. There are also devices that combine a hearing aid and a noise generator in a single unit, and these can provide the benefits of both.

The timing and sequence of different types of intervention can play an important role in how individuals respond to treatment. A person with chronic tinnitus may be grieving for the perceived loss of silence and how this is affecting his or her life. This person may not be ready for certain types of intervention (e.g., hearing aids, maskers), and may even reject any early intervention. Before the rehabilitation process begins, it is helpful for the individual to be in a place of acceptance and to start coping emotionally.

For additional resources, check out the following: American Tinnitus Association (www.ata.org), British Tinnitus Association (www.tinnitus.org.uk), https://www.nidcd.nih.gov/health/tinnitus, and https://hearinghealthfoundation.org/what-is-tinnitus.

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