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Understanding Tinnitus -- Diagnosis and Treatment

What is Causing My Tinnitus?

To determine what underlying medical condition may be causing your tinnitus, your doctor will give you a general physical exam, including a careful examination of your ears. Be sure to inform your doctor of all medications you are taking, because tinnitus can be a side effect of some drugs.

If the source of the problem remains unclear, you may be sent to an otologist or an otolaryngologist (both ear specialists) or an audiologist (a hearing specialist) for hearing and nerve tests. As part of your examination, you may be given a hearing test called an audiogram. An imaging technique, such as an MRI or a CT scan, may also be recommended to reveal any structural problem.

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What Are the Treatments for Tinnitus?

If your tinnitus is a symptom of an underlying medical condition, the first step is to treat that condition. But if the tinnitus remains after treatment, or if it results from exposure to loud noise, health professionals recommend various non-medical options that may help reduce or mask the unwanted noise (See Masking Devices below). Sometimes, tinnitus goes away spontaneously, without any intervention at all. It should be understood, however, that not all tinnitus can be eliminated or reduced, no matter the cause.

If you are having difficulty coping with your tinnitus, you may find counseling and support groups helpful. Ask your doctor for a referral.

If the cause of your tinnitus is excessive earwax, your doctor will clean out your ears by suction with a small curved instrument called a curette, or gently flush it out with warm water. If you have an ear infection, you may be given prescription ear drops containing hydrocortisone to help relieve the itching and an antibiotic to fight the infection.

Surgery may be necessary in rare cases of a tumor, cyst, or otosclerosis (a calcium deposit on the ear bone).

If your tinnitus is the result of temporomandibular joint syndrome -- sometimes called TMJ -- your doctor will probably refer you to an orthodontist or other dental specialist for appropriate treatment.

Medications for Tinnitus

Many drugs have been studied for treating tinnitus. For some, treatment with low doses of anti-anxiety drugs -- such as Valium or antidepressants such as Elavil  -- help reduce tinnitus. The use of a steroid placed into the middle ear along with an anti-anxiety medicine called alprazolam has been shown to be effective for some people. Some small studies have shown that a hormone called misoprostol may be helpful in some cases.

Lidocaine, a medication used for the treatment of certain types of abnormal heart rhythms, has been shown to relieve tinnitus for some people, but it must be given intravenously or into the middle ear to be effective. However, the benefits of lidocaine are almost always outweighed by the risks of the drug and it is therefore not usually recommended for tinnitus.

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