Tinnitus - Treatment

Treatment

Many treatments for tinnitus have been claimed, with varying degrees of statistical reliability:

Objective tinnitus:

  • Gamma knife radiosurgery (glomus jugulare)
  • Shielding of cochlea by teflon implant
  • Botulinum toxin (palatal tremor)
  • Clearing ear canal (in the case of earwax plug)
  • Using a neurostimulator

Subjective tinnitus:

  • Drugs and nutrients
    • Melatonin (especially for those with sleep disturbance)
    • Lidocaine injection into the inner ear was found to suppress the tinnitus for 20 minutes, according to a Swedish study.
    • Older benzodiazepines, e.g. diazepam, are sometimes used for tinnitus; however, there are significant risks associated with the long-term use of benzodiazepines.
    • Tricyclics (amitriptyline, nortriptyline) in small doses
    • Avoidance of caffeine, nicotine, or salt can reduce symptoms, but, tinnitus can also be induced by reducing caffeine and/or smoking.
    • The consumption of alcohol has been found to 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 (where serum zinc deficiency is present)
    • Acamprosate
    • Etidronate or sodium fluoride (otosclerosis)
    • Lignocaine or anticonvulsants (usually in patients responsive to white noise masking)
    • Carbamazepine
    • Sertraline
    • Vitamin combinations (lipoflavonoid)
  • Electrical stimulation
    • Transcranial magnetic stimulation or transcranial direct current stimulation
    • Transcutaneous electrical nerve stimulation
    • Direct stimulation of auditory cortex by implanted electrodes
    • Berthold Langguth, a German neurologist, would apply an electric or magnetic current for stimulation over the head of the patient to reduce the ringing sound. Dirk De Ridder, a Belgian neurosurgeon, implanted electrodes to the brain of sufferers to normalise overactive neurons. Cambridge University scientists also found lidocaine, an anaesthetic, reduces the sound in 2/3 of patients for 5 minutes, but it needs another drug to suppress its dangerous effects.
    • Vagus nerve stimulation
  • Surgery
    • Repair of the perilymph fistula
  • 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

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