Tinnitus treatment


Tinnitus treatment-various aspects-

Tinnitus treatment
Tinnitus treatment

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 anr 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-

Tinnitus with Ear Infection

Is it possible for tinnitus to develop in a patient with conductive hearing loss ?

Yes, it is possible for a patient with conductive hearing loss to also experience tinnitus. Tinnitus is the perception of sound in the ears or head when no external sound is present. It can arise from various underlying conditions, including issues with the inner ear, middle ear, or auditory nerve pathways.

Conductive hearing loss affects the outer or middle ear and can be caused by conditions such as ear infections, earwax buildup, or abnormalities in the ear structure. Despite being related to problems in conducting sound waves to the inner ear, conductive hearing loss does not necessarily prevent the perception of tinnitus.

Tinnitus can occur independently of the type of hearing loss a person experiences. In the case of conductive hearing loss, tinnitus may be caused by the same underlying conditions or may be a separate issue altogether, such as related to changes in nerve activity in the auditory system.

Therefore, if a patient with conductive hearing loss develops tinnitus, he should be evaluated by ENT specialist doctor by Ear microscopy  ,Pure Tone Audiometry to determine the specific cause and appropriate management.

What is line of treatment for tinnitus caused due to conductive hearing loss ?

The treatment for tinnitus caused by conductive hearing loss typically involves addressing the underlying cause of the hearing loss itself. Here are some potential approaches:

  1. Medical Management: If the conductive hearing loss is due to conditions like ear infections, middle ear fluid, or earwax buildup, medical treatment can often resolve these issues. This may involve antibiotics for infections, earwax removal, or procedures to drain fluid from the middle ear.
  2. Surgical Intervention: In some cases, surgical procedures may be necessary to correct structural abnormalities in the ear that are causing the conductive hearing loss. For example, surgery might be needed to repair a perforated eardrum or to address malformations of the middle ear bones (ossicles).
  3. Hearing Aids: If the conductive hearing loss cannot be completely corrected through medical or surgical means, hearing aids can be very effective. Hearing aids amplify sounds and can help compensate for the loss of hearing sensitivity. In many cases, the amplification provided by hearing aids can also help reduce the perception of tinnitus by providing more external sound to distract from the tinnitus sound.
  4. Sound Therapy: This approach involves using external noise to make the tinnitus less noticeable. This can be done through devices that generate low-level background noise (like white noise machines or sound generators) or through hearing aids that have built-in sound therapy features.
  5. Counseling and Cognitive Behavioral Therapy (CBT): Tinnitus can be distressing, and counseling or CBT techniques can help patients manage their emotional reaction to tinnitus and develop coping strategies.
  6. Medications: In some cases, medications might be prescribed to help manage tinnitus symptoms, although there are no specific medications approved solely for treating tinnitus. Medications might be prescribed to address underlying conditions contributing to tinnitus, such as anxiety or depression.

It’s important to note that the effectiveness of these treatments can vary depending on individual circumstances and the underlying cause of the tinnitus. A otolaryngologist (ENT specialist) or an audiologist, can evaluate the specific situation and recommend appropriate treatment options tailored to the patient’s needs.

Should I see a neurologist about my tinnitus?

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. 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.

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 .

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.
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..

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.
Personal care. 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 !

Tinnitus with Ear Infection

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