Tinnitus Management

Tinnitus Management

For those tinnitus sufferers who also have hearing loss, the use of hearing aids may have a two-fold benefit. As many as 1 in 5 individuals suffer from tinnitus (“tin-a-tis”). Tinnitus is defined as noise or ringing in your ears or head. Some people describe crickets while others experience a ringing, hissing, roaring, or whistling. Age is a common factor associated with the prevalence of tinnitus, as males report tinnitus more often than females.

There is still much to be learned about tinnitus and its origin. While tinnitus is not usually a sign of a serious medical problem, you should see an audiologist or ENT (Ear, Nose & Throat) physician if you are experiencing tinnitus. Tinnitus often occurs secondary to sensorineural hearing loss, which is a type of hearing loss that arises due to inner ear nerve damage. While there currently is not a cure, there are numerous treatments and rehabilitative strategies available that can improve the amount of annoyance and discomfort experienced by the patient.

Prevalence of chronic tinnitus by age
Figure 1 – Prevalence of chronic tinnitus by age.1

For those tinnitus sufferers who also have hearing loss, the use of hearing aids may have a two-fold benefit. First, hearing instruments will provide amplification to aid in overcoming the volume deficits caused by hearing loss. Second, tinnitus becomes less perceptible as the brain has other stimuli to listen to, rather than internally generated tinnitus. A recent study indicated that 69% of patients with severe tinnitus and hearing loss noted a significant decrease in the prevalence of their tinnitus when fitted with bilateral hearing aids.Tinnitus reduction of this type is likely due to the masking of the tinnitus by ambient noises now amplified through the hearing instruments.

One of the most exciting areas of improvement that has been recognized in tinnitus treatment is the development of tinnitus maskers. These small, discrete devices can produce both tinnitus masking and amplification (hearing aid and masker combined), so, therefore, can be used by tinnitus sufferers who have hearing loss, but also those who do not. Tinnitus maskers generate a low-level noise that masks the tinnitus. This masking noise is fed to the ear using a small, behind the ear hearing aid. The instrument is discrete and effective and does not interfere with natural communication. Combined with education about tinnitus, tinnitus maskers are very effective. To set the parameters of a tinnitus masker, the instrument is adjusted by an Audiologist using wireless connectivity. The tone of the masking signal, level, and other various properties can be set so to best mask a person’s individual tinnitus quality.

Siemens Hearing aid with tinnitus masker
Figure 2 – Siemens Hearing aid with tinnitus masker.

The use of white-noise generators, fan noise, or low-level music can also be very effective at reducing the affect of tinnitus. Specifically, patients with tinnitus almost always report that their tinnitus is most severe when in quiet. To reduce the perception of tinnitus, avoid complete quiet. Use sound machines or low-level music when trying to go to sleep or when working at a computer. Introduce a box fan or calming environmental sounds into your environment. These simple steps can introduce noise into otherwise quiet environments, which allows the brain to listen, rather than produce, sound.

Lastly, a number of factors have also been shown to increase tinnitus; specifically, exposure to loud noise, caffeine, aspirin, and stress.3 Additionally, many medications may cause tinnitus as a side effect. The presence of tinnitus can become a debilitating issue if left untreated; therefore, it is recommended that if you are experiencing tinnitus, with or without any other symptoms, that you seek an audiological evaluation and/or consultation with an ENT so that options for successful management of your tinnitus may be explored.

1. Hoffman HJ, Reed GW. Epidemiology of tinnitus. In: Snow JB Jr, ed: Tinnitus: Theory and Management. Hamilton, Ontario: B.C. Decker, Inc. 2004; 16-41.
2. Trotter, M.I; & Donaldson, I (2008) ‘Hearing aids and tinnitus therapy: a 25-year experience.’ The Journal of Larnygology and Otology, 122: 1052- 1056.
3. Chung DY, Gannon RP and Mason K (1984) ‘Factors affecting the prevalence of tinnitus.’ Audiology, 23(5) 441-452.

Lynn High, AuD
About the Author
Audiologist at CornerStone Ear, Nose & Throat, PA
Lynn High, Au.D., is a doctor of audiology with CornerStone Ear, Nose & Throat and offers complete hearing evaluations and hearing loss care, including hearing aid dispensing and fitting services.

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