10 ways to treat the ringing in the ears called tinnitus

RESEARCH IN NEW TINNITUS TREATMENTS Exciting new treatments for tinnitus are being studied at several universities. They are currently being tested as part of trials, but they could help

those with tinnitus find relief in the near future. This research has focused on ways to reprogram the brain to diminish the sound and so lessen its impact. Here are four examples of recent

research. DISRUPT THE TINNITUS NETWORK Dirk De Ridder is a professor of neurosurgery at the University of Otago in Dunedin, New Zealand. His most recent research includes what he calls a

“network” approach. “We are trying to block the networks in the brain that we think are involved in tinnitus,” he says. One way to do this is to try to disrupt the connections in the

tinnitus network using electrical stimulations to the brain, or psychedelics like LSD. “If these products are capable of disrupting the tinnitus networks, then we can use the stimulator to

try to rebuild the normal network, that is the non-tinnitus network,” he says. De Ridder is also working with the Delft University of Technology in the Netherlands on a different approach. 

When the brain attaches prominence to the tinnitus sound, it activates the sympathetic system, creating a fight-or-flight response. The lab in the Netherlands is building a device that can

make the tinnitus sound less important while at the same time reconditioning the brain. It does this by stimulating the parasympathetic or rest-and-digest-and-restore system. If the

tinnitus sound is always paired to this signal, the brain will connect the two and expect the rest-and-restore signal to kick in whenever the tinnitus sound appears. “It’s a Pavlovian

approach,” De Ridder says. DOUBLE STIMULI Bimodal auditory-somatosensory stimulation is a noninvasive technique that acts on the brain in two ways: Sounds are paired with electrical zaps.

At the University of Michigan, Susan Shore, a professor of otolaryngology, physiology and biomedical engineering, recently concluded a second clinical trial of a device. It includes

headphones that play a sound matching the tinnitus and small electrodes attached to the neck or cheek. These electrodes deliver weak impulses specifically timed with the sounds. The results

of the first clinical trial, published in 2018, were promising. Participants were trained to complete daily sessions of 30 minutes for four weeks. At the end, some participants reported a

12-decibel reduction in the tinnitus sound and two said their tinnitus had gone completely. The device, called Auricle, is waiting approval from the Food and Drug Administration (FDA).

Hubert Lim, a professor of biomedical engineering and otolaryngology at the University of Minnesota in Minneapolis, has developed a slightly different device. Headphones deliver sound to the

ears, but the electrical impulses are applied to the tongue. In 2022, 191 adults with tinnitus tested the device. After 12 weeks of one-hour daily treatments, more than 70 percent of the

participants reported that the effect of their tinnitus had been reduced. These effects lasted for up to a year after completion of the treatment. Lim’s device is available as Lenire in

Europe. It, too, is waiting for FDA approval before being released in the United States. MOBILE PHONE APP At the University of Auckland in New Zealand, Searchfield and his team are

developing a therapy that includes a smartphone-based digital app with headphones, a neck speaker and a dashboard so the clinician and patient can communicate. Searchfield calls the

prototype a “polytherapeutic approach” because there is no one-size-fits-all treatment for tinnitus. “We’re taking different approaches because certain aspects will be more beneficial for

certain people.”   These approaches include providing relief through background sounds and relaxation via guided exercises. Retraining is accomplished through auditory games that reward

patients for not listening to their tinnitus. “We want to get people involved in their therapy and remove the focus from the tinnitus onto other sounds,” he says. In a recent clinical trial,

participants were divided into two groups. Thirty individuals were part of the control group and used a white noise app that is readily available and has been shown to have some benefit in

reducing tinnitus distress. Thirty-one people used the new digital polytherapeutic system developed by Searchfield and his team. After 12 weeks, 65 percent of the group using the

polytherapeutic reported a significant improvement in how they experienced their tinnitus. Searchfield is working on a new version of the app, which he hopes to make commercially available

in six months. PROGRESSIVE TINNITUS MANAGEMENT Tinnitus is the number one disability reported by veterans returning from combat, says James Henry, a career scientist recently retired from

the National Center for Rehabilitative Auditory Research. Henry and his colleagues developed the five-step progressive tinnitus management (PTM) plan. The stepped approach means that every

patient can find the right level of support to help mitigate the effects of their individual tinnitus. “We’re teaching patients different skills so they can help themselves to live a more

normal life despite having tinnitus,” he says. There is a PTM self-help handbook, "How to Manage Your Tinnitus: A Step-by-Step Workbook," available online. Although this program

was developed within the Department of Veterans Affairs, “it is universal to anyone who has tinnitus,” Henry says. A 2019 study conducted by telephone with 205 tinnitus sufferers from

across the United States who were using PTM found that almost 84 percent of the participants felt more able to cope with their tinnitus and nearly 73 percent felt their overall quality of

life had improved.   NEW METHODS OF DIAGNOSING TINNITUS Traditionally, tinnitus is diagnosed by patients describing symptoms to their doctors. A primary care physician will conduct a

thorough physical exam as well as asking you about how your tinnitus started and what the noise sounds like. To date there has been no way of objectively diagnosing tinnitus in the way that 

cancer and heart disease can be diagnosed, but advances are being made in this area.  DIAGNOSING BY ELECTRICAL RESPONSES IN THE BRAIN An auditory brain stem response (ABR) may provide a

solution. Small electrodes attached to the head are connected to a computer. Clicks delivered via earphones are measured by the computer and reveal how the inner ear (the cochlea) and the

brain’s auditory pathways are working together. In 2022, Christopher C. Cederroth, a researcher at the department of physiology and pharmacology at the Karolinska Institutet in Stockholm,

and his colleagues conducted ABR tests on 405 individuals. Of those, 228 had tinnitus. The results showed a clear difference in brain stem responses between those with constant tinnitus and

those without. The scientists hope that being able to identify alterations in the brain connected with tinnitus will help with diagnosis. Westend61 / Andrew Brookes / Getty Images DIAGNOSING

BY GENETICS Another possibility for diagnosing tinnitus also comes from Cederroth and scientists at the Karolinska Institutet. In some cases, there may be a genetic component. A Swedish

study of more than 10,000 twins with tinnitus revealed that male twins showed bilateral tinnitus (tinnitus in both ears), suggesting a genetic link. Another study with adoptees revealed that

their odds of having tinnitus were increased if their biological parents were diagnosed with it, but not the adoptive parents.  “Patients have often been told to go home and learn to live

with [their tinnitus], nothing can be done — and it’s not really true,” said Henry, of the National Center for Rehabilitative Auditory Research, when he received an award for his work with

tinnitus. For those looking for help, the American Tinnitus Association is a good place to start. It provides access to the Tinnitus Advisor Program and a Volunteer Peer Support Network. The

new research builds on all that has gone before and benefits from new technologies. The hope is that eventually treatment will be more personalized — like drugs for cancer. “What we

prescribe as a therapy over time will be more and more targeted,” says the University of Auckland’s Searchfield. “So, the therapy itself becomes quicker, more effective, more efficient.”