That Ringing In My Ear — That Hissing, Whistling, Pulsating Tone …

It’s called tinnitus, and for some, it’s a debilitating experience.

What Is Tinnitus?

Though the common misconception about tinnitus is that it’s a disease, tinnitus is actually a medical condition characterized by persistent ringing in one or both ears that can only be heard by the affected individual.

Many who suffer from tinnitus describe the annoying sound as ringing in the ear, but a whistling, hissing, buzzing, or pulsing sound is also possible. For some, these sounds come and go. But most are not that lucky, and will experience symptoms 24 hours a day, seven days a week.

These phantom sounds may cause only a slight annoyance, or they may severely disrupt everyday life. The American Tinnitus Association estimates more than 50 million Americans suffer from at least occasional bouts of tinnitus.

What Causes Tinnitus?

There are a number of causes, with the most common being exposure to loud noise for a prolonged period of time. In this case, your hearing may be temporarily or permanently damaged, depending upon the severity of the sound.

We can’t always tell whether your temporary damage will become permanent, but tinnitus is usually representative of an inner-ear problem. Tinnitus research is ongoing, and the mechanisms that cause tinnitus in the brain and inner ear are being more closely studied. Some possible causes are:

Loud noises can be a cause of tinnitus

Exposure to loud noise

Some medications can be a cause of tinnitus

Certain medications

Diet can be a cause of tinnitus

Diet

Head Trauma can be a cause of tinnitus

Head Trauma

Stress can be a cause of tinnitus

Stress

Blockage can be a cause of tinnitus

Eardrum blockage

Jaw joint disorders can be a cause of tinnitus

Jaw joint disorders

Hearing Loss can be a cause of tinnitus

Hearing loss

In rare cases, tinnitus may be caused by a blood vessel disorder, resulting in pulsatile tinnitus. This type of tinnitus may be caused by a head or neck tumor, a buildup of cholesterol in the circulatory system, high blood pressure, turbulent blood flow, or malformation of the capillaries surrounding the ear. The result is a tinnitus that sends out pulsing signals in conjunction with the flow of your heartbeat.

Is There a Cure?

There is currently no scientifically validated cure for most types of tinnitus. However, a comprehensive audiologic and tinnitus evaluation in our office is vital, which will determine if possible medical factors could be causing or contributing to the patient’s tinnitus. If our audiologists find an underlying cause, such as high blood pressure or temporomandibular joint dysfunction, we may be able to treat that problem – which, in turn, may reduce or eliminate the tinnitus. This is why a comprehensive tinnitus evaluation is vital to the differential diagnosis of each patient. Using best-practice objective testing and protocols, our skilled audiologists identify potential causes for your specific symptoms. Our clinic fully supports the American Tinnitus Association (ATA) as it leads the charge in the ongoing search for definitive cures for tinnitus and better treatments.

What Are the Treatment Options for Tinnitus?

Because each patient’s tinnitus symptoms are personal and unique in nature, an in-depth evaluation will help us create a customized treatment plan. There are more treatment options than ever before that can reduce the perceived loudness, awareness, and burden of tinnitus, allowing patients to live more comfortable, relaxed, and productive lives.

Tinnitus retraining therapy

Progressive Tinnitus Management (PTM)

Tinnitus is a psycho-physiological phenomenon that affects various parts of the brain in different ways. This is why a multi-factor, progressive method is very effective for tinnitus patients. PTM was developed at the National Center for Rehabilitative Auditory Research (NCRAR) at the Portland VA Medical Center where Dr. Shannon formerly worked with pioneers in the field of tinnitus. This method is “progressive” because not everyone needs the same level of assistance. Some patients with tinnitus need personalized information (e.g. diagnosis, underlying cause(s), how the patient’s auditory system and brain is reacting and responding, etc). Other patients need more professional intervention, and still other patients need personalized treatment and management. This evidenced-based incremental approach is the foundational roadmap for each patient’s treatment plan.

AGX Hearing Technology

Ear-level Technology with Sound Therapy

Our office provides all styles, brands, technology levels to assure our patients have full-access to optimize outcomes. This technology has proven to be effective because as they reduce the contrast between perceived tinnitus and the patient’s auditory environment, as well as increasing brain activity and stimulation, and diverting attention from the perception of tinnitus. People often mistake that loud tinnitus, rather than hearing loss, interferes with their hearing. It is therefore critical to have one’s hearing evaluated since as many as 90 percent of people who experience chronic tinnitus also have hearing loss. However, research clearly indicates that maximum effectiveness is only achieved when these devices are programmed and verified using evidence-based, best-practice procedures, including real-ear measurements, to assess the sound levels being delivered to the eardrum and auditory system.

Masking

Supplemental Sound Therapies

Most newer ear-level technology includes supplemental sound functionality that further mitigates the perception of tinnitus. There are various features that can be used, including:
 
Notched Sound: Removing (“notching”) sound around the tinnitus center frequency produces lateral inhibition, thereby reducing hyperactivity. This feature is most effective for patients with tonal tinnitus.

A graphic depicting notched sound on a chart

Matched Noise: Narrow-band noise is presented at tinnitus center frequency and at an intensity that is near the threshold of the tinnitus (“mixing point”). This feature increases neural input to areas of hyperactivity to restore normal spontaneous activity.

A graphic depicting matched noise on a chart

Residual Inhibition: Temporary suppression or elimination of tinnitus following appropriate auditory stimulation. Using the standard clinical protocol, residual inhibition occurs in 80-90% of patients.

A graphic depicting residual inhibition on a chart

Cognitive behavioral therapy

Bimodal Stimulation

Bimodal stimulation is a new technology that pairs sounds with touch, which reduces the volume and annoyance of tinnitus. This program typically requires 10 minute at-home daily sessions. Most patients participate in our program for 2 months, some find it useful to continue the sessions as needed.

We are now offering the Lenire treatment device which is proven to reduce the severity of tinnitus. In fact, Lenire is the first medical device of its kind granted approval for the treatment of tinnitus by the FDA.
Learn More About Lenire