tinnitus EVALUATION & Treatment / Management
What is TINNITUS?
Tinnitus is often described as the perception of sound, such as: ringing, buzzing, or hissing, without an external source.
Tinnitus can also sound like many other sounds, such as: crickets, cicadas, frogs, and more. The key component to tinnitus, is a sound that is only heard by the individual experiencing it, not created by something in the room, and is inaudible to others.
what causes tinnitus / ringing in the ears?
#1 Tinnitus is most often a symptom of hearing loss.
Tinnitus is often a symptom of #2 Noise Exposure without adequate hearing protection (earplugs/earmuffs).
Other risk factors include: high blood pressure/cardiovascular disease, drugs and medications, diabetes, kidney disease, and many others. There are even supplements (not FDA approved) which “claim” to treat tinnitus, that can actually cause tinnitus! Please do NOT take these!
IMPORTANT: Do not Start or Stop any medications without consulting your primary care provider first! Many medications and supplements can have drug interactions, which can be life threatening.
Is there a cure for tinnitus? / will my tinnitus go away? / Is my tinnitus permanent?
While there isn't a "cure" per se, there are many different treatments and management strategies for Tinnitus or "Ringing in the Ears".
Many of our patients are able to successfully treat and manage their tinnitus, reducing the impact of tinnitus on their day to day living and overall quality of life. Unfortunately, we know many individuals are told “learn to live with it”. But, that’s NOT the end of the story!
There is HOPE for tinnitus sufferers! There are solutions to treat and manage tinnitus!
Tinnitus treatment and management is unique to each individual, their hearing, listening and lifestyle needs. Not everyone benefits from the same treatment options, and not all options are appropriate and/or realistic for every individual. For instance: Dr. Lamb has primary, constant, high-pitched, ringing tinnitus in both ears. One of the recommended management strategies for tinnitus is to reduce stress...but she own the practice. That's not likely to happen in the foreseeable future!
The first step to treating and managing tinnitus is a diagnostic hearing evaluation. Tinnitus is often, but not always, a symptom of hearing loss. Many patients benefit from treating the underlying cause of their tinnitus, their hearing loss, with hearing aid(s).
The most powerful treatment for tinnitus is KNOWLEDGE.
What kind of tinnitus do i have?
Tinnitus can be “Primary” - of unknown cause which may or may not be related to hearing loss; or “Secondary” - associated with an identifiable underlying cause other than hearing loss, which may benefit from medical intervention.
Tinnitus can also be “Non-Bothersome” - present but not interfering with day-to-day activities or quality of life; or “Bothersome” - having a significant impact on daily living and quality of life, requiring diagnostic audiologic testing and management.
Tinnitus can be “Recent Onset” - within less than 6 months; or “Persistent” - present for more than 6 months.
“Spontaneous Tinnitus”, otherwise know as “Transient Tinnitus”, is a sudden, loud tone in one ear, which is often accompanied by the ear feeling “stuffed up” and difficulty hearing while the tone is present. It lasts 1-2 minutes and then resolves. While disconcerting, intermittent spontaneous tinnitus is NORMAL in the general population. If you experience spontaneous tinnitus and find it bothersome, a diagnostic hearing evaluation is recommended.
Tinnitus can also be classified as “Temporary” - often caused by noise exposure or exposure to medication with the known side effect of hearing ringing in the ears; “Occasional” - experienced every now and then over a period of weeks or months; “Intermittent” - experienced weekly or daily for short duration; or “Constant” - experienced throughout the day and often more noticeable in quiet situations, like first thing after waking up or when tryin to fall asleep at night,
does my tinnitus mean i’m going to die?
It is HIGHLY UNLIKELY your tinnitus means you are going to die. Tinnitus is most often a symptom of hearing loss (primary tinnitus). It can also be a symptom related to another medical condition (secondary tinnitus). However, as a symptom, tinnitus cannot be the “cause” of death. It is important to talk to your Primary Care Provider about any tinnitus and/or health symptoms you may be having.
does my tinnitus mean i have cancer?
Tinnitus can be a symptom of a benign (non-cancerous) tumor on the auditory nerve, called an Acoustic Neuroma. However, your chances of having an acoustic neuroma is 1 in 100,000. Even then acoustic neuromas are BENIGN and extremely slow growing. The most common treatment for an acoustic neuroma is to monitor it.
does my tinnitus cause hearing loss?
No. Tinnitus does NOT cause hearing loss.
Tinnitus has no “mechanism” to cause damage to the organ of hearing, the cochlea, the auditory nerve, or the brain. Therefore, tinnitus cannot cause hearing loss. However, tinnitus IS a symptom of hearing loss. Approximately 90% of chronic tinnitus sufferers also have hearing loss. Some individuals have extended ultra-high-frequency hearing loss, which doesn’t impact speech or quality of life, but does result in the symptom of tinnitus. Fewer individuals experience tinnitus without having any hearing loss, they just have it.
Does my tinnitus mean i’m going deaf?
While tinnitus is most commonly associated with hearing loss, tinnitus doesn’t mean you are going deaf. The most common (but not all encompassing) causes of “deafness” include: prolonged, repeated exposure to loud noise without use of hearing protective devices (earplugs/earmuffs), genetic predisposition, viral or bacterial infection in the inner ear, the cochlea (such as meningitis), and severe trauma to the ear resulting in temporal bone fracture.
what is a tinnitus EVALUTION?
At Lake Medical Hearing Center, we pack a LOT of components into one 2 hour appointment. We do this, to ensure we have enough information to determine the best treatment and management options for your tinnitus and/or hearing needs.
Hearing Impact Assessment - part 1: Review of how your tinnitus and/or hearing is impacting your day to day life, including multiple questionnaires, and a thorough case history to identify any other underlying medical conditions.
Otoscopy: Visualization of the outer ear (ear canal leading up to the tympanic membrane aka eardrum) to determine if there is any wax buildup and/or visible medical condition of the outer ear.
Tympanometry: A pressure test of the eardrum/tympanic membrane to assess middle ear function. This checks for fluid in the middle ear behind the eardrum and for a perforation or hole in the eardrum.
Acoustic Reflex Testing: Presentation of short and loud tones, at varying pitches to trigger the ear’s reflex to loud sounds. Presence or absence of the acoustic reflex can aide in a differential diagnosis of the auditory system.
Diagnostic Hearing Evaluation: Puretone air and bone conduction testing - to determine severity and type of hearing loss; Speech Reception Thresholds (SRT) - how soft we can make words that you can still hear and understand; Word Recognition Scores (WRS) - how many singular words you can understand when presented at a loud enough volume to best hear them.
Hearing Impact Assessment - part 2 (in the booth): Testing for Most Comfortable Levels (MCLs) - determines how loud you like speech to be, Uncomfortable Levels (UCLs) - the point at which the tones become too loud/uncomfortable, and Speech-In-Noise testing - determines how you process information in the presence of noise/competing signal.
Tinnitus Assessment: Extended High-Frequency Puretone testing - to determine if you have ultra high-frequency hearing loss (hearing loss above the standard thresholds for speech perception), Pitch Matching - determining at what pitch you hear your tinnitus, Loudness Matching - determining how loud your tinnitus seems to you, Minimum Masking Level (MML) - at what volume does a broadband noise “mask” or cover up your perception of your tinnitus, Masking Effectiveness - determining if masking is partially or fully effective, and Residual Inhibition - determining how long it takes for your tinnitus to return after prolonged masking presentation.
Review of Results & Counseling: We review test results and the associated recommendations, as well as, tinnitus counseling on the most common tinnitus treatment options (often hearing aids, but not always) and management strategies (lifestyle changes).
As you can see, we pack a LOT of testing and information into one 2-hour appointment. For the majority of our tinnitus patients, this process is sufficient to get them on the path of successful Tinnitus Treatment & Management.
However, some patients need more one-on-one care and/or advance treatment options; which are offered on an as needed basis.
how do you “treat” or “Manage” tinnitus?
There is no “One Size Fits All” tinnitus treatment or management option.
Successful treatment and management of tinnitus can vary WIDELY from patient to patient. Which is why we recommend our comprehensive and extensive Tinnitus Evaluation. We need to learn about YOUR specific needs, hearing, and lifestyle in order to recommend the best treatment and management options for YOUR tinnitus.
For individuals who have hearing loss, the #1 treatment of tinnitus is the treatment of hearing loss with hearing aids.
The #1 Management Strategy of tinnitus is KNOWLEDGE. Learning more about your tinnitus can significantly help you to be successful in changing your tinnitus from “bothersome” to “non-bothersome”.
Other treatment and management options, vary depending on each individual’s needs, may include but are not limited to: reduction of stress, reduction of caffeine intake, reduction of sodium/salt intake, adding low level music/TV/sound to your environment (aka Sound Enrichment), increasing physical activity (please consult your primary care provider to determine if this is safe for YOU before increasing your activity level), and others.
Advanced treatment options, such as: Tinnitus Retraining Therapy, Progressive Tinnitus Management, Cognitive Behavioral Therapy, and/or Mental Health Counseling may also be needed to find success in treating tinnitus.
Interested in getting help? Ready to talk to an expert?
Call (352) 483-4327 to schedule a tinnitus evaluation with Dr. Lamb.
She has tinnitus, she gets it. Her personal and profession experience with tinnitus helps her to help you.
