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Dr. Crutchfield, my sister told me recently that she was suffering with severe ringing in her ears. Her doctor told her it was something called ‘tinnitus.” What is tinnitus? Great question. I’ve asked one of my colleagues, Inell Rosario, MD, an expert on the subject, to enlighten us with a discussion on tinnitus this week. Dr. Rosario: Tinnitus is a fairly common medical malady that afflicts many people in mild forms, although they may not always be aware of it. As many as 50 to 60 million people are affected by a phantom ringing, whistling or buzzing noise that is usually only perceived by them. A much smaller percentage (usually one to two percent) describes the condition as debilitating and, although there is no cure, must seek treatment to see a significant impact on their condition and to live a normal life. Most of the time, the cause of tinnitus is unclear. In the absence of damage to the auditory system (such as head or neck trauma), things like jaw-joint dysfunction (TMJ), chronic neck-muscle strain, and excessive noise exposure have been suggested as causes. Certain medications can also cause tinnitus, which, in this case, can either disappear again after usage of the medication ends or can cause irreparable damage that results in permanent tinnitus. Other causes may be wax buildup, cardiovascular disease, or a tumor that creates a strain on the arteries in the neck and head. These tumors are usually benign. Tinnitus can be managed through strategies that make it less bothersome. No single approach works for everyone, and there is no FDA-approved drug treatment, supplement, or herb proven to be any more effective than a placebo. Behavioral strategies and sound-generating devices often offer the best treatment results; this is partially why distracting the individual’s attention from these sounds can prevent a chronic manifestation. Some of the most effective methods are: Cognitive behavioral therapy (CBT) Uses techniques to relax and restructure the way patients think about and respond to tinnitus. Sessions are usually short-term and occur weekly for two to six months. CBT usually results in sounds that are less loud and significantly less bothersome, with the overall quality of life improved. Tinnitus retraining therapy Effective based on the assumption that the tinnitus results from abnormal neuronal activity. This therapy habituates the auditory system to the tinnitus signals, making them less noticeable or bothersome. Counseling and sound therapy are the main components, with a device that generates low-level noise that matches the pitch and volume of the tinnitus. Depending on the severity of the tinnitus, treatment may last one to two years. Masking Use of devices generating low-level white noise that can reduce the perception of tinnitus and what’s known as residual inhibition. Tinnitus will be less noticeable for a period of time after the masker is turned off. A radio, television, fan, or another sound-producing machine can also act as a masker. Biofeedback A relaxation technique that helps control stress by changing bodily responses to tinnitus. A patient’s physiological processes are mapped into a computer, and the individual learns how to alter these processes and reduce the body’s stress response by changing their thoughts and feelings. Treatment options are vast, but vary in effectiveness depending upon the type of tinnitus. Research shows more than 50 percent of tinnitus sufferers also have an inner-ear hearing impairment. While hearing aids act as an effective relief method for those with tinnitus by amplifying external sounds to make internal sounds less prevalent, they are not the only method. Careful diagnosis by a professional with years of experience creating solutions for tinnitus sufferers is essential.