Treatment of Tinnitus

What impact does it have and what can be done to help patients?

Patients with tinnitus may be severely affected, developing even mental problems such as depression, anxiety, and suicidal tendencies. Fortunately, most patients are not affected to such an extent, but in any case, a visit to an Otolaryngologist is recommended.

The otolaryngologist will ask questions to determine the nature of the problem and accompanying symptoms. If the symptoms indicate that there may be problems originating from the ears, nose, throat, central nervous system or large cervical vessels, a detailed examination will ensue.
A tonal audiogram will most probably take place and, depending on the results, further checks will be advised. In this way, the rare causes of tinnitus can be diagnosed and the patient can be offered appropriate treatment.

The objective, when dealing with tinnitus, is to relieve the disorder of the cerebral stem that is caused by sounds. The cerebral stem can be helped to “learn” that these noises are not a form of threat and can ultimately be ignored (acclimatization) so that they do not become perceived and do not activate the early alarm system. In many patients, a careful examination, appropriate laboratory tests, and a well-documented diagnosis of what is happening is enough to initiate the process of acclimatization. Of course, the interactions between the brain stem and the upper cerebral echelon are complicated and poorly understood. Some patients may need additional help, depending on the severity and degree of discomfort that tinnitus causes to them.

Hearing aid-assisted restoration often helps the patient to counteract tinnitus by allowing the auditory threshold to be reset so that tinnitus is not perceived. In some cases, hearing restoration may not be immediately effective, but the intensity of tinnitus decreases significantly, so internal sounds become less important than new external sounds.

Most forms of acoustic treatment of tinnitus now follow this way: the intensity of external sounds is increased in order to reduce the importance of the internal sound, so the brain stem learns to place the tinnitus in the background, thus considering them to be of no importance. Another way of dealing with tinnitus is to employ loud sounds, a method known as complete masking or acoustic concealment, but this is no longer considered as effective, because when the concealment ceases, tinnitus may persist at the same level.