New Treatment For Tinnitus

What causes tinnitus?

Tinnitus can be categorized as either primary or secondary, based on whether an underlying cause can be identified. The exact cause of primary tinnitus is unclear. However, most cases are linked to sensorineural hearing loss, which occurs when a lesion disrupts the transmission of neural impulses from the inner ear to the brain. Hearing loss leads to fewer external sound stimuli reaching the brain, causing the brain to undergo neuroplastic changes in how it processes different sound frequencies. Common disorders associated with sensorineural hearing loss include presbycusis (age-related hearing loss) and noise-induced hearing loss, where exposure to loud or chronic noise damages the sensory hair cells of the inner ear.

In contrast, causes of secondary tinnitus include impacted earwax, ototoxic medications such as aminoglycosides, antimalarials, or chemotherapeutics, inner or middle ear infections, head or neck injuries, and other disorders affecting the inner ear, like Ménière's disease, which impacts the balance mechanism in the inner ear. Less commonly, secondary tinnitus may be caused by more serious conditions such as inner ear tumors, like a vestibular schwannoma, or disorders affecting blood vessels, such as arteriovenous malformations or vascular tumors (Hernández, Ana, 2023). 

What are the signs and symptoms of tinnitus?

Tinnitus is not a condition but a symptom, and while it is typically not linked to serious health issues, it can greatly affect one's quality of life. Many individuals describe tinnitus as a high-pitched ringing in the ears, while others experience it as humming, hissing, buzzing, roaring, or a sound akin to cicadas. This sound can be heard in one or both ears and may seem to come from within the head or from a distance. The perception of the sound may be constant, intermittent, steady, or pulsating. Almost everyone has experienced temporary, spontaneous tinnitus for a few seconds to minutes, often after exposure to loud noise, such as after a music concert. Tinnitus that persists for more than six months is considered chronic tinnitus.

Although rarely indicative of a serious health issue, tinnitus can be highly disruptive and negatively impact daily living. Individuals with tinnitus often report difficulties with sleep, concentration, social activities, and hearing conversations (Hernández, Ana, 2023). 

How is tinnitus treated?

Managing tinnitus involves addressing any underlying causes and identifying factors that can either alleviate or exacerbate the condition. Although there is no definitive cure for primary tinnitus, it often becomes less noticeable and more manageable over time. Specific treatments can help reduce symptom severity and improve quality of life. For instance, cognitive behavioral therapy (CBT) is a form of talk therapy that assists individuals in developing alternative coping strategies to lessen the impact of tinnitus. Other helpful therapies include acoustic stimulation, hearing aids, or sound generators to mask the noise. Additionally, treating associated conditions such as depression, anxiety, insomnia, and pain with medication or psychotherapy can also help mitigate the effects of tinnitus (Hernández, Ana, 2023). 

Better medications and hearing therapy

There are currently no FDA-approved drugs specifically for tinnitus. However, there are pharmacological options to address the stress, anxiety, and depression that are caused by (and can sometimes exacerbate) tinnitus.

There are no medications that have been shown to reverse the neural hyperactivity that is thought to cause tinnitus. Drugs cannot cure tinnitus, but they may provide relief from the negative distress caused by severe tinnitus.

Patients should consult their healthcare providers for guidance on medications that may be appropriate for their situation. Not all drugs are effective or appropriate for all patients. Moreover, the introduction of any drug can result in undesired side effects and/or counteract existing prescription drug treatments (American Tinnitus Association, 2024).

Antidepressants and anxiolytics

Los medicamentos que se utilizan con mayor frecuencia en el tratamiento del tinnitus son los fármacos psicoactivos que tratan los problemas de conducta relacionados con el tinnitus. Estos medicamentos pueden ayudar a aliviar el estrés, la ansiedad y la depresión relacionados con el tinnitus, minimizando la carga psicológica de la afección. Debido a que existe una relación circular entre las emociones negativas y el tinnitus (el tinnitus causa ansiedad, lo que hace que el tinnitus parezca peor, lo que causa más ansiedad...) los fármacos psicoactivos pueden hacer que el tinnitus en sí sea menos perceptible para algunos pacientes. Los medicamentos antidepresivos comunes utilizados en relación con el tinnitus incluyen: Clomipramina (Anafranil), Desipramina (Norpramina), Imipramina (Tofranil), Nortriptilina (Pamelor), Protriptilina (Vivactil) (American Tinnitus Association, 2024).

However, these types of drugs are NOT recommended for all people since the diagnosis is particular depending on the condition of each individual. For this reason, natural products are becoming popular with effectiveness that exceeds 80% relief and without generating anxiety or contraindications. One of the studies done recently that is causing a stir in the American and European market is ZenCortex, a product with features against Tinnitus (ZenCortex, 2024).

Hearing therapy

Can sound therapy help tune out tinnitus?

There isn't a cure for tinnitus, but it can become less noticeable over time. However, there are methods to ease the symptoms and help manage the noise's impact. Treatments often involve a trial-and-error approach, as their effectiveness can vary between individuals.

One commonly suggested strategy is sound therapy, which uses external noise to alter the perception or reaction to tinnitus. Research indicates that sound therapy can effectively suppress tinnitus for some people. Two prevalent types of sound therapy are masking and habituation.

Masking: This involves exposing a person to background noise, such as white noise, nature sounds, or ambient sounds, to mask or distract from the tinnitus noise. Sound machines, music through headphones, or other devices can provide temporary relief from tinnitus perception. Household items like electric fans, radios, and TVs can also help. Many tinnitus sufferers also have some degree of hearing loss, and hearing aids can be used to amplify external sounds, effectively masking tinnitus, especially when hearing loss and tinnitus occur within the same frequency range, according to the American Tinnitus Association.

Habituation: Also known as tinnitus retraining therapy, this process trains the brain to become accustomed to tinnitus. It involves listening to noise similar to the tinnitus sound for extended periods, which helps the brain eventually ignore both the external tone and the tinnitus sound itself. This is similar to how one can become accustomed to the feel of glasses on their nose. This therapy is guided by a specialist and typically takes 12 to 24 months to complete (Matthew Solan, Executive Editor, Harvard Men's Health Watch, 2024).

Identify the dangers of loud sound

Tinnitus is characterized by hearing ringing or other sounds in one or both ears when there is no external sound present, and it cannot usually be heard by others. It's a common issue, affecting approximately 15% to 20% of people, particularly older adults. The condition is typically linked to an underlying issue such as age-related hearing loss, ear injuries, or circulatory system problems. For many, tinnitus can improve with treatment addressing the underlying cause or through other methods that help reduce or mask the noise, making it less perceptible (mayoclinic, 2024).

Also, authors such as Couth et al. (2019), determined that tinnitus levels were greatest for music and construction industries compared with finance, and these differences were accounted for by occupational and music noise exposure, as well as older age. These findings emphasize the need to promote hearing conservation in occupational and music settings, with a particular focus on high-risk demographic subgroups.

The meaning of how it affects the structure of the ear

The noise of tinnitus can vary in pitch, from a low roar to a loud screech, and can be heard in one or both ears. In some cases, the sound may be so loud that it can interfere with your ability to concentrate or hear an external sound.

Tinnitus can cause alterations in the auditory cortex of the central nervous system, which is responsible for processing sounds. This alteration in the internal structure of the ear can be caused by almost any anomaly that affects the auditory pathways, for example, otitis, tumors, stroke, anomaly of the inner ear (Ménière's disease) among other conditions. That is, the internal structure of the ear could change or not and Tinnitus persist. This is an aspect that is still being studied by science and that, to date, is being treated adequately, with natural products with excellent results such as Zencortex, which is a new product on the market and is regularly sold out, due to its high efficiency and demand in the European and American market.

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REFERENCIAS

·     Baldo, P., Doree, C., Molin, P., McFerran, D. and Cecco, S. (2012) “Antidepressants for Patients with Tinnitus.”Cochrane Database of Systematic Reviews, Issue 9. Art. No.: CD003853. DOI: 10.1002/14651858.CD003853.pub3.

·     Cederroth, C. R., Lugo, A., Edvall, N. K., Lazar, A., Lopez-Escamez, J. A., Bulla, J., ... & Gallus, S. (2020). Association between hyperacusis and tinnitus. Journal of Clinical Medicine, 9(8), 2412.

·     Couth S, Mazlan N, Moore DR, Munro KJ, Dawes P. Hearing Difficulties and Tinnitus in Construction, Agricultural, Music, and Finance Industries: Contributions of Demographic, Health, and Lifestyle Factors. Trends in Hearing. 2019;23. doi:10.1177/2331216519885571.

·      Folmer, R.L., Theodoroff, S.M., Martin, W.H., Shi, Y. (2014) “Experimental, Controversial and Futuristic Treatments for Chronic Tinnitus.” Journal of the American Academy of Audiology, 25:106-125.

·         Henton, A., & Tzounopoulos, T. (2021). What’s the buzz? The neuroscience and the treatment of tinnitus. Physiological reviews, 101(4), 1609-1632.

· Hernández, Ana. 06 marzo de 2023.Tinnitus.What Is It, Causes, Treatment, and More. Osmosis.org. Recuperado de https://www.osmosis.org/answers/tinnitus).

·     Hilton, M.P., Zimmermann, E.F. and Hunt, W.T. (2013) “Ginkgo Biloba for Tinnitus.”Cochrane Database of Systematic Reviews, Issue 3. Art. No.: CD003852. DOI: 10.1002/14651858.CD003852.pub3.

·         Hoekstra, C.E.L., Rynja, S.P., van Zanten, G.A. and Rovers, M.M. (2011)  “Anticonvulsants for Tinnitus.”Cochrane Database of Systematic Reviews, Issue 7. Art. No.: CD007960. DOI: 10.1002/14651858.CD007960.pub2.

·         Kleinjung, T., & Langguth, B. (2020). Avenue for future tinnitus treatments. Otolaryngologic Clinics of North America, 53(4), 667-683.

·         Mayo clinic, 2024. 30 Noviembre de 2022. https://mayocl.in/3xCSOnq

·         Salvi, R., Lobarinas, E., and Sun, W. (2009) “Pharmacological Treatments for Tinnitus: New and Old.”Drugs of the Future, 34(5): 381–400.

·      Simoes, J., Neff, P., Schoisswohl, S., Bulla, J., Schecklmann, M., Harrison, S., ... & Schlee, W.(2019). Toward personalized tinnitus treatment: an exploratory study based on internet crowdsensing. Frontiers in public health, 7, 157. 

.    Langguth, Berthold, Ana Belen Elgoyhen, and Christopher R. Cederroth. "Therapeutic approaches to the treatment of tinnitus." Annual review of pharmacology and toxicology 59.1 (2019): 291-313. 

·         Solan Matthew. 08 de Diciembre de 2021. https://bit.ly/45TMuEQ

·         American Tinnitus Association. 2024. https://bit.ly/4bvciYS

 Frequent Questions

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