Tinnitus treatment

Tinnitus treatment-various aspects-

Tinnitus treatment should be done by ENT specialist doctor or a Neurologist .

Before starting treatment of Tinnitus it is necessary to diagnose the cause of Tinnitus .

First the patient of Tinnitius should be examined by ENT specialist doctor .

He will first examine the tympanic membrane under ear microscope or endoscope .

If any ear wax or fungus is there he will clean it under ear microscope  by suction irrigation system.

If tinnitus is persisting after this also then he will advise to get done Pure Tone Audiometry .

If the Audiometry report is showing pure sensorineural hearing loss or a mixed hearing loss then the diagnosis of Tinnitus is confirmed , but tinnitus can also occur in a patient with ear infection ,-for details of Tinnitus caused due to ear infection pl click on the link given below-

First, you should only see an otolaryngologist- ENT specialist doctor  if you have tinnitus .
Using an ear microscope, he cleans the external ear canal, and using the microscope’s camera system, his eardrum can be seen on the screen by patient and his relatives .
He prescribes antibiotics and other anti-inflammatory medications.

Audiometry needs to be done
Audiometry must be done by an audiologist in a soundproof room.
In audiometry, if there is conductive hearing loss then the treatment is provided by ENT specialist doctor as mentioned above in this article ,for tinnitus due to sensorineural hearing loss also treatment is given by ENT specialist doctor only and details for this are mentioned in this article .

In which cases of Tinnitus is consultation with Neurologist compulsory ?

Visiting a neurologist: – The patient should consult a neurologist in the following cases –

Neurological symptoms: If tinnitus is accompanied by other neurological symptoms such as headache, numbness, weakness or visual disturbances.
Unilateral tinnitus: If the tinnitus is only in one ear, especially if it is a new symptom.
Pulsatile tinnitus: When the tinnitus sounds like a heartbeat or pulse.
Head trauma: If the tinnitus started after a head injury or trauma.
Associated diseases: If the patient has a known neurological disease, such as multiple sclerosis or other central nervous system disease.
Dizziness and cognitive changes: If there are changes in cognitive function, memory or mental state.
A neurologist is a doctor who specializes in the diagnosis and treatment of diseases related to the brain, spinal cord and nerves.

 If your tinnitus causes headaches or if you are sensitive to sounds, you may want to see a neurologist and an otolaryngologist..

How is tinnitus diagnosed?
If you have tinnitus, first contact your ENT specialist doctor to check for ear wax or fluid from an ear infection that may be blocking your ear canal. Your doctor will also ask about your medical history to determine if a medical condition or medication may be causing tinnitus.

The ENT doctor will ask you to describe the tinnitus sounds and how they start, and will examine your head, neck, and ears.

When did you start having symptoms?
What does the audible noise sound like?
Do you hear it in one or both ears?
Was the sound you heard constant or did it come and go?
How loud is the noise?
How much noise bothers you?
What, if anything, seems to improve your symptoms?
What can make your symptoms worse?
Exposed to loud sounds?
Have you had an ear infection or a head injury?.

You may also be referred to an audiologist who will measure your hearing and evaluate your tinnitus.

An otolaryngologist may order imaging tests, especially if the tinnitus is pounding. Imaging tests such as magnetic resonance imaging (MRI), computed tomography (CT), or ultrasound can help determine whether tinnitus is caused by a structural problem or an underlying disease..

What treatments can help tinnitus?
If the tinnitus has a physiological cause, such as wax in the ear or jaw joint problems, treating the cause-ear wax in this case can eliminate or significantly reduce the symptoms. However, many people may have symptoms for months or even years. There are several ways to reduce the effects of tinnitus. Below are some treatments your doctor may recommend.

Blood investigations are necessary to rule out cardiac cause of tinnitus .

You may also need a dental evaluation to determine if your tinnitus is a symptom of temporomandibular joint disease (TMD)..

Sound therapies.–

Sound therapies are based in part on the idea that tinnitus is caused by changes in the brain’s neural circuits caused by hearing loss. Some evidence suggests that exposure to sound can reverse some of these neural changes and help soothe tinnitus or relief from tinnitus can last only till this sound therapy is given ,as soon as you stop sound therapy tinnitus can occur again .Sound therapy can also work by masking the tinnitus sounds, helping you get used to them, or distracting patient from tinnitus can help him .

Cochlear implants-

These devices implanted in the ear are mostly used to treat severe deafness. They also seem to help some people with significant hearing loss related to tinnitus. The device works by sending electrical signals from the ear to the brain. But this surgery is not only done for tinnitus, it is used only for hearing problems.

Alternative Therapies

Although no vitamin supplement or other alternative treatment has been proven to help with tinnitus, some people try herbal preparations such as ginkgo biloba or minerals such as zinc or magnesium with varying results. Others have experienced relief with acupuncture, magnets or hypnosis.

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There are several types of equipment used in sound therapy. These include:

Desktop or smart sound generators are commonly used as relaxation or sleep aids. Near your bed, you can program a generator or set your smart app to play soothing sounds like waves, waterfalls, rain or summer night sounds. You can also use other sound generators, such as a radio or a household fan.

 If your tinnitus is mild, this may be all you need to help you fall asleep.
Hearing aids are one of the most important treatment options for people with tinnitus and hearing loss. They amplify outside sounds, allowing you to better interact with the world while making tinnitus less noticeable.
Portable sound generators are small electronic devices that fit in the ear just like hearing aids and produce soft, pleasant sounds. Because they are portable, these devices can provide continuous tinnitus relief throughout the day. Smartphone apps can also be used to generate these sounds.
Combination devices that fit in the ear, such as hearing aids, amplify sound and produce sound in one device. These devices are another option for treating tinnitus in people with hearing loss.

Education about tinnitus can reduce anxiety by helping you understand that in most cases the condition is probably not related to a serious illness. Counseling can help you learn coping techniques and strategies to prevent your symptoms from getting worse, such as limiting your exposure to loud noises..
Behavior therapy. Counseling can improve your well-being by helping you reduce the impact of tinnitus on your life.
Education about tinnitus can reduce anxiety by helping you understand that in most cases the condition is probably not related to a serious illness. Counseling can help you learn coping techniques and strategies to prevent your symptoms from getting worse, such as limiting your exposure to loud noises.
Cognitive behavioral therapy teaches you to identify negative thoughts that cause anxiety. Your counselor will teach you how to change your reaction to negative thoughts and focus on positive changes you can make to reduce the impact of tinnitus on your life. Research has shown that this type of therapy can help improve the well-being of people with the disease.
Tinnitus retraining therapy uses counseling and sound therapy to “retrain” the brain both emotionally and physiologically so that you no longer notice your tinnitus. The goal of the treatment is to help you reclassify the tinnitus sounds as neutral, while the constant low sound of the hearing aid helps you get used to the tinnitus.

 Medicines. There is no specific medication to treat tinnitus, but your doctor may prescribe antidepressants or anti-anxiety medications to improve your mood or help you sleep. Although certain vitamins, plant extracts and dietary supplements are often touted as cures for the disease, none have been proven to be effective.

Many medications have been studied to treat tinnitus. For some, treatment with low-dose anti-anxiety medications (such as Valium) or antidepressants (such as Elavil) may help reduce tinnitus. Using a steroid inserted into the middle ear and an anti-anxiety medication called alprazolam has been shown to be effective for some people. Some small studies have shown that a hormone called misoprostol can help in some cases.

Lidocaine, a drug used to treat certain types of heart arrhythmias, relieves tinnitus in some people, but it must be given intravenously or into the middle ear to be effective. However, the benefits of lidocaine almost always outweigh the risks associated with the drug, so it is not recommended or used for tinnitus..

• Limit alcohol, caffeine and nicotine. These substances, especially when used in excess, can affect blood flow and contribute to tinnitus.
• Other modalities of tinnitus treatment include-
• Acupuncture
• Ginkgo biloba
• Melatonin
• Zinc supplements-regarding these things a patient of tinnitus needs to take treatment only under supervision of his ENT specialist doctor only .
• What should I avoid?
  If you have tinnitus, try to avoid:Complete silence (this can make symptoms worse because the ringing is more visible).
  Exposure to loud noise.
  Common tinnitus triggers are poor sleep quality and extreme stress.
  Some experts believe that diet plays a role in whether people develop tinnitus. There is little research on the subject, but recent research suggests that these foods and drinks may increase the risk of tinnitus:Caffeine.
  Salt
  Saturated fats.
• Bimodal therapy-
• As the name suggests, bimodal therapy treats tinnitus by training the brain to think differently about sound using two forms of sensory stimulation – sound and touch. By using non-invasive external devices for a few minutes each day, you can change the way your brain perceives sound. One option produces both sound to the ears and electrical stimulation to the tongue, while the other includes a bracelet and a phone app. You will hear sounds in the application and the wrist will vibrate to confirm the presence of external sound..

What kinds of tinnitus research are researchers doing?
Researchers at the National Institutes of Health (NIH) and other research centers across the country, many supported by the NIDCD, are working to better understand the causes of tinnitus and develop new treatment strategies. Evidence suggests that tinnitus is caused by changes in neural networks in the brain, so many studies have focused on testing the benefits of magnetic or electrical stimulation of the brain.

Here are examples of current research topics:

Electrical stimulation. Cochlear implants have been shown to reduce tinnitus in addition to restoring functional hearing in patients with severe or profound hearing loss, but are not suitable for most tinnitus patients with significant acoustic hearing. Researchers use noninvasive electrical stimulation of parts of the inner ear to suppress tinnitus without harming acoustic hearing.
Bimodal stimulation. Acoustic stimulation can be combined with other types of tongue, head or neck, or electrical stimulation of the vagus nerve to provide long-term tinnitus relief.
Repetitive transcranial magnetic stimulation (rTMS). In this painless and non-invasive procedure, short magnetic pulses are delivered to the brain using a device called an electromagnet. Initial rTMS studies produced mixed results, so researchers are now investigating the ideal coil placement and frequency of patient visits.
Deep brain stimulation (DBS). This procedure is usually used to treat people with certain types of movement disorders or neuropsychiatric disorders. Some people treated with DBS have found that the procedure suddenly reduced their tinnitus symptoms. Unlike rTMS, DBS is invasive and involves surgery to implant electrodes deep into the brain. Although early results of the use of DBS to treat tinnitus have been encouraging, more research is needed to determine if the procedure is warranted for the treatment of tinnitus alone. Medicines. Although there are currently no drugs approved by the US Food and Drug Administration to treat tinnitus, researchers are testing several options.
Researchers have found a drug that reduces tinnitus in mice and are working to develop second-generation versions that may one day be effective in humans.
Researchers are investigating how tinnitus is related to central nervous system overactivity caused by damage to the sound-sensitive structure of the inner ear. Researchers are working to understand the cellular mechanisms that cause the increased activity and to find drugs that can control it and relieve the symptoms of tinnitus.
Genetic risk factors. Tinnitus and hearing loss affect many seniors. Researchers are examining a large genetic database of people with tinnitus and age-related hearing loss to identify genetic risk factors for both conditions. Determining genetic associations between age-related hearing loss and tinnitus could have far-reaching implications for risk prediction, prevention, screening, and therapy.
Personalised treatment. Tinnitus symptoms vary and different people hear different sounds in different patterns. Also, the results of brain imaging studies of people with tinnitus vary from person to person. Using data collected from study participants who track their tinnitus with a smartphone app and brain imaging data, researchers are trying to characterize the many forms of the condition. They aim to describe the different profiles of tinnitus and determine the most effective treatments for them.

This above article is for Treatment of Tinnitus due to general causes , for specific treatment of Tinnitus caused due to ear infection pl click on the link given below as it is a MUST READ FOR EVERYONE !