Tinnitus is that chronic, annoying humming, buzzing, ringing, roaring, or hissing you hear in your ears that IS NOT caused by an external source. It’s always there, and is louder at times for no good reason. In the U.S. it is estimated that 11%-12% of the population has some degree of tinnitus, but most patients don’t seek out a remedy and choose to learn to live with it.
One common thread, however, is the majority of sufferers have tinnitus because of prolonged exposure to loud noise, or because of an acute incident that resulted in damage to the Auditory division of the 8th cranial nerve: the Vestibulocochlear nerve.
I have tinnitus. What I hear is a sound very similar to the machine-like buzz made by cicadas when they are in full mating mode. It’s a loud, constant buzz that can be very disturbing. I have never found anything that helps it, and I know of NO MEDICATION that will relieve, or even suppress, it.
Then, what is there that will help? Is there anything that ear doctors rely on to give patients relief? American Family Physician in February ‘26 published guidelines for the treatment of tinnitus that were recommended by the Veteran’s Administration and the Department of Defense, now called the Department of of War. But before I begin, I must tell you there are at least 60 different treatments for tinnitus. We will discuss only those that have shown evidence of efficacy.
Those treatments are:
Educational Counseling: Understanding the condition and knowing the natural history and management options are helpful to accepting and dealing with tinnitus. Learning about helpful lifestyle changes and protecting our hearing prevent it from worsening.
Hearing Aids: Sound amplification with hearing aids significantly improves speech understanding, communication, and sound awareness. Amplification dampens out the tinnitus sensation and normal hearing is accentuated.
Removal of Wax from Ear Canals: The presence of wax muffles hearing acuity and can cause tinnitus. Removing it can help both problems.
Carotid Endarterectomy: A plaque in the carotid artery causes turbulence as blood flows to he brain. That turbulence can cause a noise called a bruit. A bruit can be interpreted as tinnitus. Removing the carotid plaque may relieve tinnitus but also prevent a stroke.
Assess Current Medications: Stop those drugs that cause tinnitus and replace them with those that don’t.
Cognitive Behavior Therapy: This improves tinnitus. Combining sound therapy with cognitive behavioral therapy improves tinnitus better than sound therapy alone. CBT is the basis for all treatments for tinnitus. I unable to provide details of CBT.
Invasive Neuromodulation: The purpose of neuromodulation is to replace the abnormal, annoying sound of tinnitus with more pleasant sound that dampens out the bad and accentuates the pleasant. This is done with the use of noisers and maskers that dampen out tinnitus. So-called “white noise” becomes preferred over tinnitus.
Accupuncture: Has been used for years for tinnitus. How exactly this is accomplished is not clear.
Tinnitus Retraining Therapy: Similar to CBT and counseling/education.
Cochlear Implantation: This procedure has better tinnitus-related outcomes, and is preferred over bone conduction devices.
Dr. G’s Opinion: I’m not an otolaryngologist so my experience with tinnitus is not professional, but personal. I have not sought treatment for my tinnitus, however, and have learned to live with it. As far as knowing which of the dozens of treatments is effective, my knowledge is lacking, but my thought is tinnitus is the ENT doctor’s nightmare diagnosis because treatment successes are few and far between. I recall only one patient I referred to ENT for tinnitus. He or she was treated with a tinnitus masker, an external device that produces “white noise” that blocks out (masks) tinnitus so is not annoying. What I don’t remember is if the masker helped.
References: Arnold MJ. Management of Tinnitus: Guidelines from the VA/DoD. Am Fam Phys 2026 Feb;113(2):194-195.
Zenner HP, et al. A Multidisciplinarian systematic review of the Treatment of Chronic Idiopathic Tinnitus Eur Arch Otorhinolaryngol 2017 May;274(5):2079-2091.
Deklerck AN, et al. Invasive Neuromodulation as a Treatment for Tinnitus: A Systematic Review. Neuromodulation 2020 June;23(4):451-462.
Michaels S. Somatosensory Tinnitus: Recent Developments in Diagnosis and Treatment. Assoc Res Otolaryngol 2023 Oct;24(5):465-472.
Yu S, Wu J, Sun Y, Lou J. Advances in accupuncture treatment for Tinnitus. Am J Otolaryngol 2024 May-June;45(3):104215.
