Tinnitus has a broad range of possible causes. Mainly we can differentiate tinnitus as subjective and objective tinnitus. Objective tinnitus is caused by pathophysiological changes in the middle-ear, which can be heard and measured objectively. Depending on the cause of these changes, the physician needs to decide if surgery or medication can cure the problem. Some of the possible treatments are, with varying success, Gamma knife radiosurgery (glomus jugulare), shielding of cochlea by teflon implant, botulinum toxin (palatal tremor), propranolol and clonazepam (arterial anatomic variation), clearing ear canal (in the case of earwax plug), using a Neurostimulator.
On the other hand, objective tinnitus covers less than 1% of all tinnitus cases; more than 99% are to be considered as subjective tinnitus. Subjective tinnitus has a long list of possible causes, e.g. otologic problems, sensorineural hearing loss, analgesic and antibiotic medications, chemotherapy, diuretics, psychedelic drugs, neurologic disorders, head injury, metabolic disorders like vitamin B12 deficiency, hyperlipidemia, iron deficiency anemia, psychiatric disorders like depression and anxiety, just to mention roughly the most important and most common causes for subjective tinnitus.
Along with the multitude of possible causes there comes also a multitude of possible cures:
Drugs and nutrients
- Lidocaine, injection into the inner ear found to suppress the tinnitus for 20 minutes, according to a Swedish study.
- Benzodiazepines (lorazepam, clonazepam) in small doses
- Tricyclics (amitriptyline, nortriptyline) in small doses
- Avoidance of caffeine, nicotine, salt
- The consumption of alcohol has can both increase and decrease the severity of tinnitus. Therefore alcohol’s effect on the severity of tinnitus is dependent on the causes of the individual’s affliction and cannot be considered a treatment.
- Zinc supplementation ( with serum zinc deficiency)
- Etidronate or sodium fluoride (otosclerosis)
- Lignocaine or anticonvulsants ( in patients responsive to white noise masking)
- Carbamazepine ( anticonvulsive drug)
- Melatonin (especially for those with sleep disturbance)
- Sertraline ( oral antidepressant)
- Vitamin combinations (Lipoflavonoid)
Electrical stimulation
- Repetitive transcranial magnetic stimulation, a noninvasive method to excite neurons inside of the brain.
- Transcutaneous electrical nerve stimulation, also a noninvasive method to influence nervous potentials via electric current placed on the skin of the patient.
- Direct implantation of electrodes into the auditory cortex.
External sound
- Low-pitched sound treatment has shown some positive, encouraging results.
- Tinnitus masker (white noise, or better ’shaped’ or filtered noise).
- Tinnitus retraining therapy.
- Auditive stimulation therapy (music therapy).
- Auditive destimulation therapy (also called “notched music” therapy) uses individually designed music with the patients’ favorite music altered to remove the musical tones that match the aural frequencies associated with their tinnitus. The removal of these tones alleviates the tinnitus by destimulating brain activity for these specific frequencies.
- Compensation for lost frequencies by use of a hearing aid.
- Ultrasonic bone-conduction external acoustic stimulation.
- Avoidance of outside noise (exogenous tinnitus).
Psychological, cognitive behavioral therapy.
Also, there’s natural tinnitus cure.
According to medical sources, tinnitus has a fairly good chance of being cured (So called ears ringing cure), depending on its nature and cause. But it is inevitable to diagnose the cause properly, in order to be able to apply the appropriate therapy. Some of the therapies, like music or white noise therapy, go over an extended period of time, and the chances of success depend mainly on the intensive cooperation and compliance of the patient.
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