Tinnitus

Tinnitus is the perception of noise generated somewhere within the auditory system, that can take many forms. It is very common, affecting up to 1 in 5 people, and can rarely  become a severe and disabling problem.

 

The most important fact to realise is that there are many things that we can do to gain control over tinnitus.

 

A full medical assessment often involving blood tests, a formal hearing test and scans is an important component of treatment, to exclude the more serious causes of tinnitus.

 

It is also important to realise that the auditory (hearing) pathways are hard wired to the limbic system (emotion centre) of the brain as well as to areas responsible for the jaw, neck and other areas of the head and neck.

 

Rarely, primary ear disease, and even more rarely intra-cranial disease, can be responsible. Once these have been excluded a stepwise approach to management is employed.

 

Initial therapy

 

  • Exclusion of significant underlying pathology

 

  • Avoidance of triggering factors: ear infections, dental and temporomandibular problems, cervical neck disease

 

  • Ensure adequate rest and relaxation, manage stress.

 

  • Hearing rehabilitation: hearing aids and assistive listening devices

 

  • Sound therapy: white noise such as the radio off the station is a good initial trial: A lot can be said of the old fashioned advice to live close to the sea. There are a number of good Apps such as white noise or sleep pillow that are a cheap, effective source of white noise.

 

  • Tinnitus retraining (a type of cognitive behavioural therapy): highly effective. A medicare rebate can be gained if the patient’s GP enrols them into a mental health care plan.

 

  • Alternative therapies: Of herbal remedies, gingko biloba is the only one with any, benefit, albeit minimal. Massage and acupuncture can be very useful adjuncts.

 

  • Very rarely, short to medium term sedatives can be helpful. In selected cases the involvement of a psychiatrist and use of anxiolytic medications are required to gain initial control.

 

 

 

Specialised devices

 

  • Sound generators

 

  • Combination sound generator and hearing aids

 

  • Neuromonics device: a relatively expensive but  effective therapy for a subset of patients , especially in those with normal or near normal hearing.

 

 

Contacts and resources

Tinnitus: a simple management approach for GPs and audiologists: (Dr Sean Flanagan: Tinnitus_with_images)

 

Australian tinnitus association

Phone: 02 8382-3331

www.tinnitus.asn.au,

Neurosensory

St Vincents Public Hospital
Level 4 Victoria Street
DARLINGHURST NSW 2010

Phone: 1300 13 4327

Live Well Centre
Suite 1B, Level 1

136 Willoughby Rd

Crows Nest, NSW, 2065

Phone: 0406 843 513

www.psychologyandhealth.com.au

American tinnitus association

www.ata.org

British tinnitus association

www.tinnitus.org.uk

Hyperacusis Network