Ent uk trading as British Academic Conference in Otolaryngology

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ENT UK trading as British Academic Conference in Otolaryngology (BACO) and

British Association of Otorhinolaryngology – Head and Neck Surgery (BAO-HNS)

Registered as a Company limited by Guarantee in England and Wales under Company No 06452601

Registered with the Charity Commission in England and Wales under Charity No 1125524


The Royal College of Surgeons of England

35-43 Lincoln’s Inn Fields

London  WC2A 3PE

ENT UK is the professional Association for British Ear, Nose 

and Throat Surgeons and related professionals.  This leaflet 

provides some background information about tinnitus.  It 

may be helpful in the discussions you have with your GP 

or specialist when deciding on possible treatment.   This 

information leaflet is to support and not to substitute the 

discussion between you and your doctor.  Before you give 

your consent to the treatment, you should raise any concerns 

with your GP or specialist.   



By Don McFerran

Treatment options 

Although there is no simple pill or operation to cure the 

majority of cases of tinnitus there are several strategies 

that are very helpful in ameliorating the condition.

For people with mild tinnitus simple explanation and 

reassurance may be all that is required. For more intrusive 

tinnitus a form of counselling may prove helpful. This can 

be administered as a standalone therapy or as part of 

a wider treatment strategy such as Tinnitus Retraining 

Therapy (TRT) which is a mixture of counselling and 

sound therapy.

If tinnitus is associated with hearing loss then trying to 

correct the hearing loss is usually very helpful. Depending 

on the cause of the hearing impairment, medication, 

surgery or hearing aids may be needed.

Sound therapy can help many people with tinnitus. This 

can take the form of an electronic device that sits at the 

person’s bedside and produces low level soothing sound 

to distract them from their tinnitus at night. During the 

daytime it is possible to wear a sound generator which is 

a small device that resembles a hearing aid and produces 

white noise.

Psychological techniques such as Cognitive Behavioural 

Therapy (CBT) and Mindfulness Meditation can be used 

in the management of tinnitus and Relaxation Therapy is 

very helpful for those who find that stress worsens their 


For a very small number of people, usually those with 

objective tinnitus, there may be a drug or surgical 

procedure that can cure the problem.

Monitoring and re-assessment

Tinnitus is such a variable symptom that it is extremely 

difficult to make any hard and fast rules regarding the 

long-term management. This is a very individual decision 

that will be made by you and your specialist.


There are many questions regarding tinnitus that remain 

to be answered regarding both the mechanisms by 

which it is generated and the search for more effective 

treatments. Various research avenues are currently being 

explored including the use of certain types of drug and 

electromagnetic stimulation of the auditory system.

If you have any problems or questions, please contact:

Please insert local department routine and emergency contact details here


This publication is designed for the information of patients. Whilst  

every effort has been made to ensure accuracy, the information contained may not be 

comprehensive and patients should not act upon it without seeking professional advice.

Last updated: November 2012 - Review due: November 2015

Copyright © 2010  ENT•UK                                                                     09028

Further information

Up to date advice is available from the British Tinnitus Association 




What is tinnitus? 

Tinnitus is a sensation or awareness of sound that is not 

caused by a real external sound source. It can be perceived 

in one or both ears, inside the head or in the person's 

immediate environment. Although it is commonly assumed 

to be a ringing noise, tinnitus can take almost any form 

including hissing, whistling, humming and buzzing. Some 

people even hear musical sounds or sounds resembling 

indistinct speech. Some people hear a single sound 

whereas others hear multiple noises. For some, the sound 

is constant: for others it is constantly changing.

What causes tinnitus? 

It is often assumed that tinnitus is caused by damage to the 

ears. This is true in some cases but it is perfectly possible 

to have tinnitus with normal ears and normal hearing. 

Several studies have been performed where people who 

do not have tinnitus were placed in soundproofed rooms 

and told to listen intently. In this situation almost everyone 

becomes aware of a sound sensation. 

Many scientists think that tinnitus is generated by random 

electrical signals that can occur in any part of the hearing 

pathway. Thus tinnitus may originate in the ears, in the 

hearing nerve or in the brain. Such random signals are 

common and usually we are not aware of them happening. 

Occasionally something happens that causes some people 

to interpret these random signals as sound. Common 

triggers for this process are emotional shocks and loss 

of hearing, either gradual or sudden. However, in many 

people, the trigger is unknown. Once we become aware 

of the tinnitus signal, it draws the attention of the brain 

making tinnitus even more distressing. This type of tinnitus 

is called subjective tinnitus because it is only heard by the 


A few people have tinnitus that is attributable to a real 

sound, generated inside the body by blood flow or 

muscular activity. This type of tinnitus may be detectable 

by other people, either just by careful listening or by using 

a stethoscope. This kind of tinnitus is known as objective 


What are the symptoms? 

•  Tinnitus is a symptom in itself. 

•  It may be accompanied by hearing loss, dizziness, pain

  in the ears (otalgia) or dislike of loud sounds (hyperacusis). 

•  Many people with tinnitus also feel that their ears

  are blocked.

Your specialist will consider these other symptoms 

when making a diagnosis and developing a plan for your 


How is tinnitus diagnosed? 

The first thing your specialist will do to diagnose your 

condition is to ask some questions about your symptom. 

This is actually all that is necessary to reach a diagnosis 

and there is no special ‘tinnitus test’. 

Of course your specialist will want to know as much 

as possible about your hearing and will perform a full 

examination of your ears. Other areas such as the nose, jaw 

joints and throat may be examined. If the specialist thinks 

that you may have objective tinnitus he or she may listen 

around your ear and neck with a stethoscope.

In almost all cases the specialist will arrange some 

tests. The most common test is a hearing test (pure tone 

audiogram). There are some hearing tests that try and 

match the persons’ tinnitus but they do not influence 

treatment greatly. Many specialists therefore do not 

request these tests. For selected patients, the doctor may 

wish to order an MRI scan though other tests such as CT 

scans or ultrasound scans are sometimes utilised. Blood 

tests may occasionally be required but this is unusual in 

the diagnosis of tinnitus.

What can I do to help myself? 

Tinnitus is extremely common. Approximately one in 10 

of the population have some degree of tinnitus.  In most 

people, the symptom is mild and does not interfere greatly 

with their lives. Many people think that tinnitus will never 

go away. This is incorrect and with time most tinnitus 

lessens or disappears. Knowledge of these simple facts 

can help many people to cope with it.

Most people with tinnitus find that it appears louder if 

they are sitting somewhere very quiet. Having a little bit 

of quiet background sound from a radio, CD player or 

television can help.

Many people notice that their tinnitus becomes more 

distressing if they become stressed or anxious. Learning 

to try and avoid stressful situations can help.

There have been anecdotal reports that certain foods and 

drinks can exacerbate tinnitus. People may therefore put 

themselves on exclusion diets. Caution should be urged 

in this respect: there is a little if any scientific evidence to 

support the theory that food causes tinnitus.

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