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Tinnitus

What is tinnitus?

Tinnitus is the perception of sound within the human ear in the absence of corresponding external sound. It can be subjective or objective; continuous or intermittent; loud or weak and the sounds vary; some patients report hearing sounds like a bell, ringing, crickets, white noise, blood pumping or whistle etc. Tinnitus may cause distress but is not life-threatening and many patients may return to normal lives after therapy

Tinnitus Assessment

Other than seeing an Ear Nose and Throat specialist, tinnitus patients should also contact an Audiologist for hearing test and tinnitus matching tests. Tinnitus assessments usually include a pure tone audiogram, impedance audiometry, tinnitus evaluation(i.e. most prominent pitch, tinnitus loudness match, minimum masking level) and a tinnitus handicap inventory.

When you see an Audiologist, the procedure is usually as follows:

  1. Otoscopic examination:
    the Audiologist will take a look at your outer ears to check for the condition in the outer ear canal and eardrum, also to see if there are foreign objects or infections.
  2. Pure tone audiogram
    through air and bone conduction, the Audiologist will be able to assess the hearing thresholds and the type and degree of (if present) hearing loss.
  3. Impedance audiometry
    this test can assess whether the middle ear is functioning normally and is useful in diagnosing middle ear effusion, otosclerosis and/or Eustachian tube dysfunction.
  4. Tinnitus matching tests
    this is a batch of tests to assess the loudness, pitch and the minimum level of noise that can mask the tinnitus. This is useful information for the Audiologist for further therapy purposes.
  5. Tinnitus handicap inventory
    this is a survey to assess the disturbance of tinnitus caused to the patient’s daily life and mental health.

Treatment (ENT Laser Tinnitus Treatment Program)

The Concept behind Tinnitus Treatment

Tinnitus is not a diagnosis, rather a symptom. The concept behind tinnitus treatment is to improve the symptom rather than to cure it like a disease. Therefore the method used to treat tinnitus is a multidisciplinary approach to improve the annoyance of this symptom rather than to eliminate the sound.

Determining the Origin

After taking a detailed case history and understanding the symptoms, the Ear Nose and Throat specialist will perform examinations of the ear, eardrum, nose, nasopharynx and pharynx in hope to determine the cause of tinnitus. The patient will also need to have hearing tests performed by an Audiologist to determine if the hearing is normal because hearing loss may also cause tinnitus. Since there are many problems that may cause tinnitus, specialists have to determine the origin of cause in order to eliminate all external problems first. A portion of tinnitus patients experience relief from tinnitus after the core problem has been solved. For example, if tinnitus was caused by ear infections, the cure of course would be anti-inflammatory medication; if tinnitus was caused by otosclerosis, insertion of a new prosthesis as a replacement of the stapes would be considered; if tinnitus was caused by perforation of the eardrum, surgical measures may be taken to repair the eardrum. Moreover, patients with degeneration in the inner ear may be suggested to take medication to improve vascular activity and if the patient is diagnosed with hearing loss, he/she may consider wearing hearing aids so with the help of external environmental sounds, the tinnitus may be masked.

ENT Laser Tinnitus Treatment Program (requires 18 months' time for entire treatment)

  1. A detailed examination by the Ear Nose and Throat specialist to determine if medication is needed. Medications used are usually relaxants in limiting stress and or insomnia and/or provides action on blood circulation and viscosity.
  2. A detailed examination by the Audiologist, including a pure-tone audiogram, impedance audiometry, tinnitus matching tests (most prominent pitch test, tinnitus loudness matching test and minimum masking level test) and tinnitus handicap inventory. If the tinnitus patient is diagnosed with hearing loss, hearing aid prescription will be suggested to improve tinnitus. If the patient's hearing is normal, a low level "noise-masker" would be suggested to be worn around 8 hours a day. This way, the brain may begin to desensitize from the distorted signals and improve tinnitus.
  3. Counselling and Sound Therapy will be provided to accompany the use of hearing aid and/or noise-maskers. Sound therapy will be used to relax the patient and auditory system. Like the noise-maskers, it aims to desensitize the brain from focusing on distorted signals. Counseling will be used to explain the origin of tinnitus to the patient to relieve their anxiety of the symptom and together with sound therapy the therapist will utilize the human brain's plasticity to lead the patient in habituating to the tinnitus, in turn decreasing perception of annoyance of tinnitus.

During therapy, try to avoid the following activities:

  • avoid stimulating foods such as: coffee, tea and chili
  • avoid exposure to extremely loud environments
  • avoid excessive stress or fatigue, rest is of utmost importance
  • avoid listening to music through headphones/earphones

Tinnitus Products

  • Sleeping Pillow: The sleeping pillow is used to generate sounds to alleviate tinnitus symptoms affecting sleep especially suitable for those with sleeping partner. 

  • Desk-top Sound Generator: The desk-top sound generator is used to generate sounds to alleviate tinnitus symptoms affecting concentration in the study room, at work or during sleep. 

  • Sound Generators: The sound generators range from pure generators to combined devices (for those with hearing loss and tinnitus). These are suitable for those with severe tinnitus symptoms and an Audiologists’ prescription is needed.