Tinnitus, described as a ringing or buzzing sound in the ear, is a symptom that can be related to almost every known hearing problem. It is not a disease, but can be caused by exposure to loud sounds, middle ear infections, tumors on the hearing nerve and even wax on the eardrum.

Sometimes tinnitus can be medically or surgically treated. All patients with tinnitus should consult an ear, nose and throat physician (otolaryngologist) before seeking any other form of treatment.

It is not always possible for your physician to determine the cause of your tinnitus; each case is different. The same cause will not necessarily produce the same set of symptoms in each patient.

Does Cutting the Hearing Nerve Cure Tinnitus?

Unfortunately, cutting the nerve does not relieve tinnitus often enough to recommend it as a treatment. It does, however, produce total deafness in the operated ear and may cause balance problems, and in some cases, can make the tinnitus worse.

Will Tinnitus Cause Me to Lose My Hearing?

No, but tinnitus may be worse with a loss of hearing. Ninety percent of patients with severe tinnitus also experience some hearing loss, usually in the high frequencies, which may be produced by exposure to loud sounds. The accompanying symptom is usually a high-pitched noise, often called "ringing tinnitus." Tinnitus patients should do everything possible to protect their hearing.

Is Tinnitus Interfering with My Hearing?

No, tinnitus does not interfere with hearing, although it may affect your attention span. On the other hand, it will seem worse if your hearing loss increases because outside sounds will not cover up the tinnitus.

Although psychological or emotional problems may be associated with tinnitus, it is a real problem -- not imagined. Almost all patients indicate that stress or tension makes their tinnitus worse. Tinnitus is difficult to describe because there is no standard terminology related to it. Family and friends have trouble understanding the problems tinnitus patients face since they cannot see or hear it themselves. Because tinnitus is so hard to describe and treat, patients may fall victim to self-pity--often hurting their friends, family and themselves.

There are, as yet, no cures for tinnitus but there are several treatments currently used to produce relief. One treatment is the use of masking which is available in several forms and, when properly administered, relieves from 58 to 65 percent of patients so treated. Another relief procedure involves drugs such as Xanax which, in a properly controlled study, relieved 76 percent of those tested. For some patients, stress management is recommended. Research for relief procedures continues, and hope is very much alive.

Masking

Masking is simply the addition of an outside sound that serves as a substitute for the tinnitus (inside sound). The sound is produced by a device that looks, and is worn, like a hearing aid. Frequently, it is necessary to use two masking units when the tinnitus is in both ears or perceived to be in the head.

Patients find masking to be a welcome relief from tinnitus because at equal loudness, the high-pitched tinnitus is much more unpleasant than the masking noise. It is easier for patients to ignore the masking noise than tinnitus. Experts list masking as the preferred treatment for tinnitus, but it is not appropriate in all cases. We can only determine whether masking works for an individual by thorough testing of a variety of masking options.

One problem with masking is the difficulty in arriving at the proper sound level: loud enough to mask the tinnitus, but not too loud for the patient. One major complication may be that the patient has a hearing loss. In such cases, we usually need to compensate for the hearing loss before masking can work.

Hearing Aids

For a small percentage of patients, a hearing aid alone will provide relief because the tinnitus is usually at a low pitch. In these cases, the use of a hearing aid that amplifies low-pitched environmental sounds covers up the tinnitus.

Tinnitus Instruments

A combination unit, called a tinnitus instrument, consisting of a hearing aid and a masker, is often used to relieve tinnitus in patients who experience both hearing loss and tinnitus. The unit has been successful for many patients who do not find relief from the masker or hearing aid alone.

Drug Therapy

The drug Xanax has been tested using a double-blind, placebo controlled study method. The subjects in the Xanax group who obtained tinnitus relief had a before-treatment average measured tinnitus loudness of 7.5 dB SL (sensation level; the apparent sound level at which the tinnitus is heard), which was reduced to an average of 2.3 dB SL after treatment. The reduction in the measured loudness of the tinnitus was not only significant but it provided a more objective indicator than does the patient's perception although, in this case, each patient's perception supported the measured loudness of his or her tinnitus.

Between the use of masking and the drug Xanax it is possible to provide relief of tinnitus to a number of patients so that the plight of the patient with severe tinnitus is not as bleak as it once was. Continued research will undoubtedly provide new and better treatment procedures for the future.

Finding the Best Treatment Method

It takes time to find the correct method of treatment and to properly fit and adjust hearing or tinnitus instruments. The first fitting is seldom the final one. Please remember that even at best, masking or drugs only provide relief, not a cure.

The faucet test can help you understand more about your tinnitus. Open a water faucet to full force. Can you hear your tinnitus? The sound of running water contains many different tones or frequencies . If it covers your tinnitus, masking may relieve your condition. If water sounds do not cover your tinnitus, your hearing may be reduced in the tin latter is the case, treatment of your hearing loss will be required before masking can work.

Tuning a radio to "between stations", so that only the sound of static can be heard, is a similar test. If the static covers up your tinnitus, masking may be a good treatment for you. Note: some radios, such as those with digital tuning, suppress the static and cannot be used for this test.

Things to Avoid

All Loud Sounds . Wear earmuffs or earplugs when using chain saws, guns, lawn mowers, loud music or power tools. Exposure to loud sounds can make tinnitus worse.

Aspirin . Aspirin has been known to produce tinnitus or make existing tinnitus worse.

Caffeine . Caffeine strongly affects the loudness of tinnitus for some patients. It is a good idea to eliminate all caffeine from your diet for one month to see whether it has an effect on you. Remember that caffeine is in :

• coffee (including decaffeinated)
• tea
• cola drinks
• chocolate and cocoa

Excessive Use of Alcohol . Intoxication can make tinnitus worse, especially during a hangover.

Marijuana . Marijuana has been known to produce tinnitus or make existing tinnitus worse.