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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
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
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
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
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
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
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.