No Cure for Tinnitus – But Several Treatments to Provide ReliefIt is unlikely that anyone old enough to read and understand this article has not, at least on one occasion, experienced the annoying sensation of ringing in their ears. The phenomenon is termed tinnitus and it is equally unlikely that many of those affected readers required treatment, as the ringing sounds would have persisted, at worst, for no more than a day or two. That said, there are literally millions of people worldwide for whom these phantom noises are something they are required to cope with every day of their lives.
These intrusive noises, which are not confined to ringing, but include buzzing, hissing, whooshing, and other sounds, do not constitute an illness per se. They are merely a symptom that, only on rare occasions, may be indicative of some underlying pathology and in more than 50% of those affected, is accompanied by some degree of hearing loss. Often, a hearing aid will not only improve the wearer’s audition. The sonic enrichment that a hearing aid provides can also act rather like a treatment by effectively masking the sounds of tinnitus.
These phantoms sounds fall into one of two classes. They can be objective, in which case an examining physician will also be able to hear them and they are probably the result of calcification of the ossicles in the middle ear or anomalies in local blood flow. More commonly, it is the subjective variety that is seen. The sounds originate within the areas of the brain known as the auditory cortices and cannot be perceived by other individuals. It is well known that the reversible symptoms referred to earlier are most often the result of exposure to a sudden loud noise which temporarily incapacitates the sensory hair cells in the cochlea. When these cells are still able to recover, no tinnitus treatment will be needed. Both the phantom sounds and the muffled hearing that accompany them are just a temporary phenomenon.
Where exposure to loud noise is prolonged and repeated, however, those sensory cells may be injured beyond their capacity to recover, or even destroyed, resulting in irreversible hearing loss. There are also indications that damage to these cells results in the release of free radicals that, in turn, could be responsible for triggering the anomalous responses by the sound centres in the brain that present as the phantom ringing and other sounds typical of subjective tinnitus. If severe and prolonged, treatment will not reverse the symptoms, but will definitely provide sufferers with some welcome relief from those incessant phantom noises.
There is some evidence to support the effectiveness of certain supplements containing vitamins, minerals, and other micronutrients as a protective mechanism and perhaps to alleviate symptoms. Anti-anxiety medication and anti-depressants can also reduce the severity of the symptoms. However, the two approaches that have gained more widespread acceptance and have proved to be most effective focus on promoting attitudinal changes and attempts to mask the sounds to a degree that makes it possible for patients to cope with them.
The first of these tinnitus treatments involves counselling by a professional, such as a psychologist or psychotherapist, and may include the use of cognitive behavioural therapy. The goal of counselling, which may be conducted either as group therapy or on a one-on-one basis, is to teach techniques that help patients to deal with the anxiety and stress that are common responses to the phantom noises. It helps patients to adopt a more positive mental attitude and, with practice, to become far less conscious of those noises.
Counselling can be made more effective by supplementing it with sound therapy. The combined effect is to retrain the ear, enabling it to ignore these subjective sounds and providing a tinnitus treatment that can work for anyone who is willing to persevere. The sound therapy is provided by some form of white noise generator and employs the same principle used to mask the background noise that might otherwise distract those who are required to work in an open-plan office environment.
For anyone with a hearing impairment, the white noise generator can either be built-in or an add-on accessory, and for those with no hearing problems, a device that resembles a hearing aid can be worn behind the ear. Other possible options are special CDs and a downloadable app that can be accessed with a smartphone. Either way, the mix of counselling and sound therapy offers patients the most effective tinnitus treatment to date.