From the Guidelines
If you're experiencing ringing in your ears (tinnitus) one week after a concert, you should first give your ears more time to heal as temporary tinnitus often resolves within 2-3 weeks. In the meantime, avoid additional noise exposure and protect your ears from loud sounds. Over-the-counter pain relievers like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) may help reduce inflammation and discomfort, as suggested by general medical knowledge. White noise machines, fans, or soft music can help mask the ringing, making it less noticeable. Stay well-hydrated and get adequate rest to support your body's healing process.
Key Considerations
- According to the American Academy of Otolaryngology and Head and Neck Surgery Foundation (AAO-HNS) guidelines, as mentioned in 1, a targeted history and clinical examination are recommended as the initial evaluation for tinnitus.
- The guidelines also recommend a prompt and comprehensive audiological examination in patients with hearing problems or with unilateral persistent tinnitus, as stated in 1 and further emphasized in 1.
- It is essential to note that if the ringing persists beyond 2-3 weeks, becomes worse, is accompanied by hearing loss, dizziness, or ear pain, you should see a healthcare provider or audiologist for evaluation, as this could indicate a more serious underlying condition.
Management Strategies
- Education and counseling are crucial in managing tinnitus, as recommended in 1, with a focus on educating patients about management strategies.
- Cognitive-behavioral therapy (CBT) may be beneficial for patients with persistent, bothersome tinnitus, as suggested in 1.
- A comprehensive approach to managing tinnitus should include a combination of these strategies, prioritizing the patient's quality of life and addressing any underlying conditions that may be contributing to the tinnitus.
From the Research
Tinnitus Diagnosis and Treatment
- Tinnitus is the sensation of hearing a sound in the absence of an internal or external source, and it is a common problem encountered in primary care 2.
- A standard workup for tinnitus begins with a targeted history and physical examination to identify treatable causes and associated symptoms that may improve with treatment 2.
- Cognitive behavior therapy is the only treatment that has been shown to improve quality of life in patients with tinnitus 2, 3.
Treatment Options
- Sound therapy and tinnitus retraining therapy are treatment options, but evidence is inconclusive 2.
- Melatonin, antidepressants, and cognitive training may help with sleep disturbance, mood disorders, and cognitive impairments, respectively 2.
- Counselling, cognitive-behavioral therapy (CBT), hearing aids and cochlear implants for patients with a relevant hearing loss, sound generators, novel auditory stimulation approaches, tinnitus retraining therapy (TRT), pharmacological treatment, neurofeedback, brain stimulation, bimodal stimulation, Internet- and app-based digital approaches, and alternative treatment approaches are available treatment options 4.
Tinnitus and Psychological Factors
- Tinnitus distress results from a weave of physical and psychological processes, and reducing the power of the psychological processes will therefore reduce the degree of suffering 3.
- Epidemiologic studies have noted high comorbidity of tinnitus and depression, and findings from recent brain imaging studies have noted shared neural networks in depression and severe tinnitus 5.
- Psychiatric problems such as depression, anxiety and personality disorders are commonly associated with tinnitus, and stress, headache, cognitive processing speed and sleep disturbance are also associated with tinnitus 6.
Management of Tinnitus
- Avoidance of noise exposure may help prevent the development or progression of tinnitus 2.
- Providing information about the natural progression of tinnitus and being familiar with the causes that warrant additional evaluation, imaging, and specialist involvement are essential to comprehensive care 2.
- A comprehensive audiologic evaluation should be performed for patients who experience unilateral tinnitus, tinnitus that has been present for six months or longer, or that is accompanied by hearing problems 2.