Tinnitus is the perception of ringing or buzzing in the ears without an external sound actually being present. Tinnitus comes in many forms – high-pitched, low-pitched, constant, rhythmic, buzzing, whooshing, crackling or even resembling the sound of crickets. Most people experience some form of tinnitus and are usually not bothered by it. However, for some, the perceived tinnitus may be severe and have significant effect on daily activities (i.e., mood, concentration, sleep etc.).
A full medical history and physical examination will first be performed by the ENT doctor to assess if there are any medical conditions that could be causing the tinnitus. Tinnitus, like pain, is not a diagnosis, but a symptom of an underlying pathology. It is important to patiently and carefully determine what is the exact underlying pathology or mix of contributing factors.
In children, unless tinnitus is specifically probed for, it is often missed. Early treatment results in the best outcomes for tinnitus, as chronic tinnitus has less effective treatment outcomes, and severe tinnitus may also result in anxiety, fear and depression. It is a phantom sensation, and many patients thus feel helpless as it can occur without warning, and stress further worsens the perception. Indeed, hearing loss and ear related conditions are the most common cause of tinnitus. However, tinnitus can also be due to problems of the neck, brain, seizures, migraine, temporo-mandibular joint, blood vessels, drug side effects, somatic associations like myofascial trigger points and psychiatric disorders. It can even be associated with menopause and certain genetic markers, and is thus a very challenging diagnosis if not a straightforward ear diagnosis. A multidisciplinary team approach is sometimes needed.
A hearing test will also be performed to assess hearing as tinnitus is often related to hearing loss. If the tinnitus remains even after comprehensive medical intervention by the ENT doctor, tinnitus management is provided by the audiologist who will assess the patient’s specific needs. Together, the patient and the audiologist will come up with a personalized program to identify the factors that impact tinnitus severity and explore different coping strategies that will help the patient find some relief. The goal of the tinnitus management program is to provide relief and restore quality of life by reducing the perception of sounds in the ears through education, use of sound-based methods and also by managing the reactions to the tinnitus.
Regular check-ins and continued follow-up for patients with tinnitus is important. The tinnitus management program consists of three 90-minute sessions over the course of three months. The program is a holistic approach to finding relief for your tinnitus and includes take-home exercises as well as monitoring throughout and after the program according to the patient’s individual needs.
Session 1: Education and Counselling
- Administer tinnitus questionnaire
- Education and counselling session
Session 2: Sound-Based Tinnitus Therapy
- Trial & loan sound devices for tinnitus therapy based on individual needs
- Sound plan worksheet
Changing Thoughts and Managing Feelings
- Learn behaviours & exercises that can help manage reactions to tinnitus
- Take-home exercises
- Milestone check