February 18, 2015

Tinnitus Management

What is Tinnitus?

Tinnitus, more commonly known as “ringing in the ears”, is the presence of sound in the ears or head where no external sound source is present. It can also be described as a buzzing, hissing, or roaring noise depending on the patient’s perception.  According to the American Tinnitus Association, 50 million people in the United States suffer from some degree of tinnitus. Of those 50 million, 16 million people experience symptoms severe enough to seek medical attention. Tinnitus may or may not accompany hearing loss, but should always be classified as a symptom, not as a disease by itself. It can be intermittent or constant, with symptoms ranging in severity amongst patients.

The reference link below provides in depth information on the different types of tinnitus (subjective vs. objective tinnitus) and possible causes of tinnitus.


 Treatment Options

In most cases, there is no medical or surgical treatment which will eliminate tinnitus. While there is no cure for tinnitus, listed below are common treatment options to help with the management of tinnitus.

  • Hearing aids: When a patient presents with both tinnitus and hearing loss, one of the most successful management strategies is the use of a hearing aid. Patients receive benefit from amplification for their hearing loss, which frequently is also very effective in “masking out” their perceived tinnitus. Many newer hearing aid models have built-in tinnitus maskers, which use sounds such as white noise and music for masking purposes.
  • Tinnitus maskers:  For patients with normal hearing who suffer from tinnitus, the use of a tinnitus masker may be effective. A tinnitus masker looks much like a traditional behind-the-ear style hearing aid. This device does not offer any amplification, just a tinnitus masking noise, which is used to distract the wearer from his/her perceived tinnitus.
  • Sound generators: For many, the presence of an external sound source can be useful to mask out the tinnitus. Commonly used devices can include running fans, radios at low volumes or soft background music. There are many types of tabletop sound generators, and also pillows with built-in speakers for those who have trouble sleeping because of their tinnitus. Most generators enable users to choose from a variety of sound options, such as rainfall, ocean waves and nature sounds, to best mask out their tinnitus.
  • Neuromonics Tinnitus Treatment:  There are currently three different treatment options offered by Neuromonics:


    • Oasis:  The Oasis is a medical device that is FDA approved for the long-term, significant relief of tinnitus. Designed as a lightweight, hand-held device, the Oasis is customized to the patient’s unique tinnitus profile. The protocol is clinically administered by an audiologist or physician. The device uses relaxing music that is embedded with a neural stimulus, which stimulates the auditory pathway to promote neural change. Over time, new connections are able to train the brain to filter out tinnitus disturbance, providing long-term relief. The Oasis works with Neuromonics Tinnitus Treatment (NTT) and uses a two step process for long-term relief.

Step 1: Relieving the Symptoms (~2 months)

The device is worn for at least 2 hours a day during daily activities. This enables users to begin to feel in control of their tinnitus

Step 2: Breaking the Cycle (~ 4months)

The device is initially worn for at least 2 hours a day. As training continues, treatment times are reduced as tinnitus disturbance decreases.


After completion of the tinnitus program, your audiologist will work with you to set up a maintenance cycle. Many patients find they no longer need the device after the program, though some users continue to use the device 2-4 hours per week to help maintain perceived benefits.


    • Haven: The Haven is a customizable device for on demand tinnitus relief that is clinically administered by an audiologist or physician. The Haven combines a high frequency signal with relaxing music for tinnitus relief while wearing the device.


    • Sanctuary: The Sanctuary is a semi-customizable device used by patients for tinnitus relief when they need it. While the Sanctuary also uses relaxing music combined with a neural stimulus, the device comes with three pre-programmed profiles for the users to choose between for optimal tinnitus relief.  Unlike the Oasis, the Sanctuary is not a long-term treatment program. This device can be beneficially to those patients who find their tinnitus to be bothersome in certain situations, rather than a constant problem.


  • Tinnitus Retraining Therapy (TRT)
    • There are two components to TRT: sound therapy and direct counseling & education on effective coping techniques. The thought is that with proper counseling, education and understanding the brain is able to get used to a sound pattern in order to distract one’s attention away from the tinnitus and reduce anxiety. With intervention, it is thought that the negative reaction to tinnitus can be conditioned and altered.  Counseling techniques should be taught by an audiologist or professional who received specialized training in tinnitus management.
      • For sound therapy, a patient would wear an ear-level tinnitus masker that presents soft sounds to the ear that is barely audible.
      • During counseling, adaptation techniques are taught, which allows the brain to de-emphasize the importance of the tinnitus.

If you or someone you know is affected by tinnitus, schedule an appointment with your Audiologist to discuss appropriate management options.



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