As the global pandemic continues, many are seeing an increase in their anxiety, social isolation and disruption of normal routines. This creates a perfect storm for those living with tinnitus.
Tinnitus is the perception of sound in the absence of any external stimulus. Symptoms can be unilateral or bilateral, present with or without hearing loss and resemble ringing, hissing, buzzing, humming or clicking sounds. The current opinion is that tinnitus is a consequence of modified neural activity in the central auditory system as a result of peripheral damage in the auditory structures.
Various treatments have been proposed for tinnitus therapy with unsuccessful or unproven results. Most cases of tinnitus are caused by SNHL (Sensori Neural Hearing Loss) and as SNHL cannot be reversed, therefore primary prevention is vital. Listening to high volume music through the headphones can cause damage to the inner ear. To prevent noise damage in the work place, employers must be aware of occupational exposure limits, arrange for regular hearing evaluation and provide appropriate hearing protection. Other lifestyle changes to improve sleep and reduce stress can be tried, caffeine and alcohol consumption can be reduced.
Some people with tinnitus find relief with the use of hearing aids, which acts as a masker by introducing more ambient noise. For patients in whom basic amplification is not sufficient, specialized tinnitus maskers like broadband noise can be used to provide additional relief. Other types of background noise like increasing the fan speed during the night also provides relief.
The role of pharmacotherapy is controversial. Medications like caroverine and ginko biloba have been used to manage tinnitus with variable results. Ginko biloba acts as a strong anti-oxidant within the cochlea, however its efficacy in tinnitus treatment is not proven. Current treatment guidelines recommend against the use of antidepressants or anxiolytics for the treatment of tinnitus.
Rehabilitation therapies like the Tinnitus Retraining therapy uses a combination of directive counseling and ear level noise generators. The tinnitus retraining therapy helps the patient understand and habituate to tinnitus. Cognitive behavioural therapy corrects a patient’s negative responses to tinnitus by counseling and relaxation techniques. Cognitive behavioural therapy improves the quality of life in tinnitus sufferers.
To date there has been no therapeutically successful treatment of tinnitus. It’s one of those conditions that continues to perplex scientists and still remains an enigma in the field of otolaryngology.
