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Tinnitus (Noise in the Ears)

 
Tinnitus (tin-i-tus) is the perception of a sound in your ear when there is no noise in the environment. It may sound like a ringing, roaring, clicking, or hissing sound. It can be constant or intermittent.
 
Tinnitus is generally associated with hearing loss. It can also be a symptom of other problems such as problems with blood vessels or rarely tumors. There are as many as 50 million Americans who have tinnitus. Approximately 2 to 4 million have it so severely that it interferes with their daily activities. People with severe cases of tinnitus may find it difficult to hear, work, or even sleep. 
 
Our Tinnitus Treatment Center works to find custom solutions to each patient’s specific needs. Headed by Jeff Carroll, Ph.D., our patients receive a research based cutting edge approach to managing the severity of their condition.  The Tinnitus team is comprised of Neurotologist Hamid Djalilian, M.D. and Audiologists Alicia Traktman, Au.D. and Ginger Stickney, Ph.D. A team approach allows for multidisciplinary treatments and management strategies to optimize therapy for each patient.
                                                                         Dr. Jeff Carroll
                                                                Tinnitus Center Director
 
Our center focuses on a program of habituation, or retraining of the brain to reduce the perception of your tinnitus. This system has many similar components to tinnitus retraining therapy (TRT). Our habituation protocol uses a combination of education and counseling along with devices.  Research shows that the efficacy of hearing aids and maskers for tinnitus treatment is dramatically improved through the addition of a structured education and counseling program. 
 
Treatment begins with a comprehensive audiological and tinnitus evaluation in order to determine the most likely source and nature of your tinnitus.  From there a custom program is designed to provide the necessary information and counseling as well as to find the most effective device or sound to speed habituation. Devices can be:
  • Body worn or discrete ear worn devices that provide tunable  noise bands
  • New technology such as the Neuromonics system
  • Tabletop generators or
  • Sound pillows for night use
 
Click here for more information on the Tinnitus research project headed by Drs. Djalilian and Zeng.
 
 
What causes tinnitus?
 
  •       Hearing loss. Most commonly, people with tinnitus have some kind of hearing loss. It is thought that the brain replaces the hearing loss with a perception of a noise.
  •       Loud noise. You may have noticed ringing in the ears after a loud concert or a loud noise exposure. Generally, a loud noise can cause a hearing loss, which in turn causes tinnitus.
  •       Medicine. Many different medicines can cause tinnitus. The most common medicines that cause tinnitus include aspirin, ibuprofen, naprosyn, among others.
  •       Other health problems. Tumors, problems in the heart and blood vessels, jaws, and neck can cause tinnitus.
 
What Treatments are Available?
Although there is no cure for tinnitus, scientists and doctors have discovered several treatments that may give you some relief. Not every treatment works for everyone, so you may need to try several to find the ones that help.

Treatments can include

  •       Neuromonics Device. This new device combines counseling with a music device with songs that are tailored to your hearing loss. UC Irvine is one of very few centers in Southern California that offers this treatment.
  •       Hearing aids. Most people with tinnitus have some degree of hearing loss. Wearing a hearing aid makes it easier for some people to hear the sounds they need to hear by making them louder. The better you hear other people talking or the music you like, the less you notice your tinnitus.
  •       Tinnitus Maskers. Maskers are small electronic devices that use sound to make tinnitus less noticeable. Maskers do not make tinnitus go away, but they make the ringing or roaring seem softer. For some people, maskers hide their tinnitus so well that they can barely hear it. The idea is to sound a sound that is bothersome with one that is not.

    Some people sleep better when they use maskers. Listening to static at a low volume on the radio or using bedside maskers can help. These are devices you can put by your bed instead of behind your ear. They can help you ignore your tinnitus and fall asleep. Other available products include speakers inside a pillow that can play the sound of the ocean or the rain.
  •       Medicine or drug therapy. Some medicines may ease tinnitus. These medicines are generally given to reduce the anxiety or depression associated with tinnitus.
  •       Tinnitus retraining therapy. This treatment uses a combination of counseling and maskers. Otolaryngologists and audiologists help you learn how to deal with your tinnitus better. You may also use maskers to make your tinnitus less noticeable. After a while, some people learn how to avoid thinking about their tinnitus. It takes time for this treatment to work, but it can be very helpful.
  •           Counseling. People with tinnitus may become depressed. Talking with a counselor or people in tinnitus support groups may be helpful.
  •           Relaxing. Learning how to relax is very helpful if the noise in your ears frustrates you. Stress makes tinnitus seem worse. By relaxing, you have a chance to rest and better deal with the sound.
What can I do to help myself?

The most important thing about dealing with tinnitus is to not think about it. The more you think about it, the more noticeable it will become and the more it will bother you. The vicious cycle will continue and can bring you to a point of disability. Think about things that will help you cope. Many people find listening to music very helpful. Focusing on music might help you forget about your tinnitus for a while. It can also help mask the sound. Other people like to listen to recorded nature sounds, like ocean waves, the wind, or even crickets.

Avoid anything that can make your tinnitus worse. This includes smoking, alcohol, and loud noise. If you are a construction worker, an airport worker, or a hunter, or if you are regularly exposed to loud noise at home or at work, wear ear plugs or special earmuffs to protect your hearing and keep your tinnitus from getting worse.

If it is hard for you to hear over your tinnitus, ask your friends and family to face you when they talk so you can see their faces. Seeing their expressions may help you understand them better. Ask people to speak louder, but not shout. Also, tell them they do not have to talk slowly, just more clearly.

How long does habituation take?
Since tinnitus can be greatly effected by the brain’s inappropriate response to tinnitus, habituation is the process by which you subconscious brain is ‘reprogrammed’ to respond appropriately to internal noise.  It generally can take anywhere from 6 to 18 months with a large amount of the work carried out in a self-paced manner.
 
What can I expect at my first visit?
The first step at our center will be a comprehensive audiological workup from one of our Audiologists. They will discuss the options through our tinnitus center.  The first visit to the Tinnitus Treatment Center will take about 2 hours and will consist of a auditory evaluation of your tinnitus and the creation of a custom program for successful habituation.
 
Who should I contact to schedule an appointment?
To schedule an appointment, please call our call center at 714-456-7017.
 
Who can I contact if I have any questions?
If you have any questions please contact:
 
Jeff Carroll, Ph.D.
Director, Tinnitus Treatment Center
Department of Otolaryngology-Head and Neck Surgery
carrollj@uci.edu
714-456-3083

 

To Make an Appointment to be seen in the Tinnitus Treatment Center, Please Call 714-456-7017 or click here to request an appointment via the web.

If you are interested in participating in our research project on the treatment of tinnitus and live in Southern California, please click here.

Back to UC Irvine Neurotology Division Page

 

(Some content adapted from National Institutes of Health)

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