Tinnitus refers to the sensation of hearing sounds in the ears or head in the absence of an external sound source, which often takes the form of a persistent ringing in the ears. It’s a very common phenomenon and is reported in all age groups, with an estimated 1 in every 8 adults in the UK experiencing persistent tinnitus.
Though most often perceived as a ringing noise, tinnitus can also take the form of a wide range of other sounds, including buzzing, whistling, humming, whooshing, clicking, and even musical notes. Tinnitus can come and go, be high or low pitched (or fluctuate between the two), and its loudness can vary too.
Everyone’s experience of tinnitus is different and unique to them. Some are unaffected by it, whereas others become severely distressed by their tinnitus, which can have a debilitating effect on their quality of life. However, understanding what causes tinnitus may help you to avoid the condition, while tinnitus therapy is available to provide support with the condition.
What Causes Tinnitus?
Knowing what causes tinnitus may help you to understand what to avoid to prevent the condition from developing in the first place. In fact, there are two subtypes of tinnitus: subjective tinnitus and objective tinnitus. Read on to find out more about each of these.
Subjective tinnitus is a phantom auditory sensation in the absence of a real sound. These sounds are only perceivable to the specific patient. This is the most common type of tinnitus, accounting for 99% of cases, and is predominantly linked to some degree of underlying change in the auditory system.
The potential tinnitus causes behind this may include:
Objective tinnitus are sounds that are produced by internal functions in the body’s circulatory (blood flow) and/or somatic (musculo-skeletal) systems. These sounds are audible to the patient and can also be detected during an examination. This type of tinnitus is uncommon, accounting for just 1% of cases, and is mainly caused by either spasms of small muscles in the middle ear or by a change in blood flow to the ear, typically resulting in pulsatile tinnitus (tinnitus that is synchronous to the heartbeat). Potential tinnitus causes for this subtype of the condition can include:
The first step in tinnitus treatment is appropriately diagnosing and measuring it using tinnitus diagnostic tests. At London Ear Centre, our tinnitus evaluations are comprehensive and are grounded on evidence-based clinical protocols to help assess and diagnose your tinnitus.
Our experts will initially obtain a detailed medical and audiological history and ask you to complete a set of tinnitus inventories to ascertain the degree of tinnitus burden and impact on your quality of life. They will then perform a number of tinnitus diagnostic tests aimed at assessing your tinnitus profile and identifying any underlying hearing loss that may be contributing to your tinnitus. Your results will be discussed following testing, before you begin your first tinnitus therapy session.
A tinnitus assessment may include the following where appropriate:
- Audiological / Medical history.
- Tinnitus Handicap Inventory.
- Tinnitus Functional Index.
- Clinical Otoscopy – Performed to inspect the condition of the outer ear and ear drum in order to detect any abnormalities or contra-indications.
- Pure Tone Audiometry – Test to identify hearing thresholds and the degree of any loss.
- Speech Audiometry – Used to determine the weakest intensity for word recognition.
- Speech in noise testing – Used to determine speech discrimination ability in the presence of background noise.
- Tympanometry – Test to examine the health of the middle ear and ear drum movement.
- Otoacoustic emissions – Test to determine the health of the inner ear by measuring its response to noise stimuli.
- Tinnitus pitch matching – Test to determine the specific pitch of tinnitus being perceived.
- Tinnitus loudness matching – Test to determine the specific loudness of tinnitus being perceived.
- Minimum masking level – Test to establish the volume at which an external narrowband noise masks the perception of tinnitus.
- Consultation and individual management plan.
- First session of Tinnitus Retraining Therapy.
- First session of Cognitive Behavioural Therapy, where appropriate.
- Onward referral to ENT/ other specialists for further medical evaluation as appropriate.
- Comprehensive audiological report or e-report provided to you and/ or your referring specialist.
Tinnitus treatment is more about managing the condition rather than curing it. Methods including hearing aids and various types of tinnitus therapy can be highly effective in managing persistent noises in the ears.
Whether you’ve recently developed tinnitus, or have a longstanding diagnosis, we understand that everyone’s perception of and reaction to tinnitus is different. Some people are able to carry on with their lives as normal, whereas others become severely distressed by it to the point it may feel like tinnitus is taking over their life. In our experience, most people that experience tinnitus fall somewhere in between, but there are things that can be done to help minimise its impact on your quality of life.
Our tinnitus treatment options are grounded on the best evidence-based protocols available, incorporating the latest in tinnitus research. We use a multidisciplinary approach, including clinical psychologists who can help manage the emotional triggers of tinnitus.
We can also recommend lifestyle changes like changing certain medications, adapting your diet, or removing obstructions like ear wax from your ears, to make sure you’re fully equipped to take control of your wellbeing. Find out more about microsuction ear wax removal.
Our tinnitus treatment options fall into three main categories:
Tinnitus Retraining Therapy (TRT) is a mixture of tinnitus-specific counselling, sound therapy, and relaxation techniques. TRT is a therapeutic approach based on the neurophysiological model that tinnitus is caused by abnormal processing of a signal generated in the auditory system.
TRT is aimed at redirecting your brain’s attention away from the tinnitus and thereby enabling a natural habituation process to occur. This type of tinnitus therapy typically includes the following:
- Tinnitus specific education and counselling
- Sound enrichment therapy
- Assistive technology
- Lifestyle modifications
- Sleep hygiene
- Relaxation training
- Advice on hearing conservation/ protective ear plugs
- Advice on alternative/ complementary therapies
Cognitive Behavioural Therapy (CBT) is a form of mindfulness-based treatment that is sometimes used as a form of tinnitus therapy. CBT explores how negative thought processes adversely affect behaviour and how you can change those thoughts. This type of therapy is a proven method for reducing depression and anxiety and is aimed at reducing the distress caused by tinnitus.
CBT as a form of tinnitus treatment uses a combination of relaxation, cognitive restructuring of thoughts, and different situations to help improve your feelings about tinnitus and is carried out by a Clinical Psychologist.
If you have underlying hearing loss, this may be causing your tinnitus to be more apparent. The use of hearing aids has long been recognised as one of the best and most effective means of managing tinnitus. This is because hearing aids lead to an increase in stimulation of the auditory system by speech and environmental sounds, subsequently reducing tinnitus awareness.
Using the latest technology and software, our experts will be able to advise on and fit you with the most suitable hearing aids for your specific hearing profile and lifestyle needs.
TINNITUS TREATMENT AT LONDON EAR CENTRE
Contact us today to undergo tinnitus diagnostic tests to see what type of tinnitus therapy could benefit you the most. From hearing aids to tinnitus retraining therapy, the experts at London Ear Centre are experienced in every area of tinnitus relief. Get in touch to book an appointment today.
* Please note, we always include the first session of TRT as part of your initial tinnitus assessment. We will also arrange for an additional session of CBT with a clinical psychologist following this depending on your degree of tinnitus severity and burden. Though we recommend a completing a minimum of 3 sessions of therapy, you will have the flexibility to choose which therapy you would like to continue with and for how many sessions depending on which you feel is providing the most benefit to your individual situation.