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Tinnitus Evaluation and Management

What is Tinnitus?

Tinnitus is the perception of sound when no actual external noise is present; it can occur in one or both ears. While it is commonly referred to as “ringing in the ears,” tinnitus can be reported as many different perceptions of sound, including buzzing, hissing, whistling, swooshing, and clicking. The duration of tinnitus varies from person to person.

What Causes Tinnitus?

Tinnitus is not a disease but rather a symptom of some other underlying health condition. In most cases, tinnitus is a symptom of damage to the auditory system (hearing loss). While tinnitus is most often triggered by hearing loss, there are around 200 different health disorders that can generate tinnitus as a symptom. 

Those with persistent tinnitus are advised to have an audiological evaluation as a first step in the management and treatment of their condition. An audiologist or otolaryngologist may be able to provide a more precise diagnosis for your tinnitus symptom and identify the specific cause of your tinnitus, which informs the best treatment option for your condition. Depending on your specific case, a hearing health professional may refer you to another specialist for further diagnosis and/or subsequent management.

How Can You Help Me with My Tinnitus?

There is presently no known cure for tinnitus. However, there are well-established tools and management strategies that can significantly reduce the perceived burden of tinnitus, including hearing aids and sound therapy treatments. To learn more on how to better manage your tinnitus you should consult with a UI Health audiologist who can discuss an array of evidence-based tinnitus management options and help identify the best tinnitus management strategy for your specific situation.

What Can I Expect During a Tinnitus Evaluation?

An audiologist who specializes in the area of tinnitus will conduct a comprehensive evaluation; the appointment typically lasts about 2 hours.

A tinnitus evaluation starts with an in-depth interview followed by a comprehensive audiology evaluation that includes standard pure tone audiometry and ultra-high frequency audiometry up to 14 kHz (a procedure typically not part of a standard hearing test). Speech testing includes speech reception thresholds, word recognition scores, MCL (most comfortable level), UCL (uncomfortable listening level), and ANL (acceptable noise levels). Otoacoustic emission testing also is conducted which evaluates the presence and function of outer hair cells in the cochlea. Tinnitus studies include pitch and loudness matching, masking studies, LDLs (loudness discomfort levels), and tests for residual inhibition.

The hyperacusis evaluation includes some of the same tests depending on the LDLs of the individual.

Following completion of the evaluation, the audiologist will review the findings with you and discuss the variety of treatment and therapy options available for management of tinnitus. Below is a list of sound therapy options and counseling services offered at our clinic.

  • Educating patients on hearing loss and/or tinnitus
  • Providing realistic expectations
  • Facilitating treatment and adaptation using a combination of sound therapy and counseling/education
  • Referral to other specialists when necessary

Acoustic Sound Therapies

A range of treatments for tinnitus use various forms of external sounds or noise to change how a patient perceives or reacts to the condition. These sounds are not a cure but a tool for managing the symptoms and strain of tinnitus.

Sound therapies have different levels of intensity and effect based on each patient’s needs, with the goal in each case to mask or distract the ringing sounds in the ear, or to help the brain respond differently to ringing or in some cases minimize brain activity at the root of tinnitus.

UI Health Audiology uses various sound therapies, customizing them to each patient’s unique condition and needs.  These include:

  • Hearing aids/amplification devices: These can change external noise to divert the patient’s attention from the perception of tinnitus.
  • Neuromonics: Neuromonics are customized sounds that remove low-end frequency bias, helping patients gradually accommodate and manage their tinnitus.
  • SoundCure: SoundCure are customized sounds matched to the specific nature of the patient’s tinnitus to stimulate the affected parts of the brain.
  • Custom Musician’s Plugs: These are earplugs specifically designed to reduce sound levels of ambient noise while retaining maximum quality of sound.