Most people with tinnitus and no warning signs have had tinnitus for a long time but should see their doctor about it if they have not already done so. In people with tinnitus, doctors first ask questions about the person's symptoms and medical history. Doctors then do a physical examination. What they find during the history and physical examination may suggest a cause of the tinnitus and the tests that may need to be done see table Some Causes and Features of Tinnitus Some Causes and Features of Tinnitus Ringing in the ears tinnitus is noise originating in the ear rather than in the environment.
The nature of the tinnitus, including whether it is in one or both ears and whether it is constant or pulsatile. During the physical examination, doctors focus on examining the ears including hearing and the neurologic system. They also listen with a stethoscope over and near the person's ear and on the neck for sounds of objective tinnitus. Most people should have a formal hearing test done by either the doctor or a hearing specialist audiologist.
People with tinnitus in only one ear and hearing loss should have gadolinium-enhanced magnetic resonance imaging MRI. People with pulsatile tinnitus often require magnetic resonance angiography MRA Magnetic resonance angiography MRA In magnetic resonance imaging MRI , a strong magnetic field and very high frequency radio waves are used to produce highly detailed images.
MRI does not use x-rays and is usually very safe Attempts to identify and treat the disorder causing tinnitus are often unsuccessful. However, correcting any hearing loss for example, with a hearing aid Hearing Aids Many causes of hearing loss have no cure. In these cases, treatment involves compensating for the hearing loss as much as possible. Most people with moderate to severe loss use hearing aids Treatment of stress and other mental conditions such as depression may help.
Many people are reassured if they learn that their tinnitus is not caused by a serious disorder. Caffeine and other stimulants can worsen tinnitus, so people should try to avoid these. Various techniques can help make tinnitus tolerable, although the ability to tolerate it varies from person to person.
Many people find that background sound helps mask the tinnitus and helps them fall asleep. Some people play background music. Other people use a tinnitus masker, which is a device worn like a hearing aid that produces a constant level of neutral sounds. For the profoundly deaf, an implant in the cochlea Cochlear Implants Many causes of hearing loss have no cure. If these standard techniques are not helpful, people may want to seek treatment in clinics that specialize in the treatment of tinnitus.
In many cases, tinnitus is the result of something that can't be prevented. However, some precautions can help prevent certain kinds of tinnitus. Mayo Clinic does not endorse companies or products.
Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Tinnitus Open pop-up dialog box Close. Tinnitus Tinnitus can be caused by a number of things, including broken or damaged hair cells in the part of the ear that receives sound cochlea ; changes in how blood moves through nearby blood vessels carotid artery ; problems with the joint of the jaw bone temporomandibular joint ; and problems with how the brain processes sound.
Request an Appointment at Mayo Clinic. More Information Tinnitus and antidepressants. Share on: Facebook Twitter. Show references AskMayoExpert. Non-pulsatile tinnitus. Mayo Clinic; Kellerman RD, et al. In: Conn's Current Therapy Elsevier; Accessed Dec.
American Academy of Audiology www. American Tinnitus Association www. In addition to treating associated problems such as depression or insomnia , there are several strategies that can help make tinnitus less bothersome. No single approach works for everyone, and you may need to try various combinations of techniques before you find what works for you.
If you have age-related hearing loss, a hearing aid can often make tinnitus less noticeable by amplifying outside sounds. There is no FDA-approved drug treatment for tinnitus, and controlled trials have not found any drug, supplement, or herb to be any more effective than a placebo. That includes ginkgo biloba, which is sometimes promoted for this purpose. Some patients believe that acupuncture helps, but it too has been found to be no better than a placebo. The most effective approaches are behavioral strategies and sound-generating devices, often used in combination.
They include the following:. Cognitive behavioral therapy CBT. CBT uses techniques such as cognitive restructuring and relaxation to change the way patients think about and respond to tinnitus.
Patients usually keep a diary and perform "homework" to help build their coping skills. Therapy is generally short-term — for example, weekly sessions for two to six months. CBT may not make the sound less loud, but it can make it significantly less bothersome and improve quality of life. Tinnitus retraining therapy TRT. This technique is based on the assumption that tinnitus results from abnormal neuronal activity see "What's going on?
The aim is to habituate the auditory system to the tinnitus signals, making them less noticeable or less bothersome. The main components of TRT are individual counseling to explain the auditory system, how tinnitus develops, and how TRT can help and sound therapy. A device is inserted in the ear to generate low-level noise and environmental sounds that match the pitch, volume, and quality of the patient's tinnitus. Depending on the severity of the symptoms, treatment may last one to two years.
When TRT was developed in the s by neuroscientist Dr. Pawel Jastreboff, it was designed to be administered according to a strict protocol. Today, the term TRT is being used to describe modified versions of this therapy, and the variations make accurate assessment of its effectiveness difficult.
Masking devices, worn like hearing aids, generate low-level white noise a high-pitched hiss, for example that can reduce the perception of tinnitus and sometimes also produce residual inhibition — less noticeable tinnitus for a short time after the masker is turned off. A specialized device isn't always necessary for masking; often, playing music or having a radio, fan, or white-noise machine on in the background is enough.
Although there's not enough evidence from randomized trials to draw any conclusions about the effectiveness of masking, hearing experts often recommend a trial of simple masking strategies such as setting a radio at low volume between stations before they turn to more expensive options.
Biofeedback and stress management. Tinnitus is stressful, and stress can worsen tinnitus. Biofeedback is a relaxation technique that helps control stress by changing bodily responses. Electrodes attached to the skin feed information about physiological processes such as pulse, skin temperature, and muscle tension into a computer, which displays the output on a monitor.
Sometimes, the sounds you hear can interfere with hearing real sounds around you. Tinnitus can occur with depression , anxiety , and stress. You may experience tinnitus in one or both ears. Tinnitus can be either objective or subjective. Objective tinnitus means that both you and other people can hear certain noises in your ears. This is commonly due to abnormal blood vessels in and around your ears.
When your heart beats, you and others can hear a distinct pulsing sound. Objective tinnitus is rare. Subjective tinnitus is much more common. Only you can hear the roaring, ringing, and other sounds of subjective tinnitus. Damage to the middle or inner ear is a common cause of tinnitus. Your middle ear picks up sound waves, and their conduction prompts your inner ear to transmit electrical impulses to your brain.
Only after your brain accepts these signals and translates them into sounds are you able to hear them. Sometimes, your inner ear sustains damage, altering the way your brain processes sound. Damage to your eardrums or the tiny bones in your middle ear can also interfere with the proper conduction of sound. Tumors in the ear or on the auditory nerve may also cause ringing in the ears. Those who use jackhammers, chainsaws, or other heavy equipment are more likely to have tinnitus.
Listening to loud music through headphones or at a concert may also produce temporary symptoms of tinnitus. Medication use can also cause tinnitus and hearing damage, called ototoxicity, in some people. Drugs that may cause tinnitus include:.
0コメント