Szumy uszne – Charakterystyka, pielęgnacja i opieka

Szumy uszne
Charakterystyka, pielęgnacja i opieka

Szumy uszne (tinnitus) to subiektywna percepcja dźwięków, takich jak dzwonienie, brzęczenie czy świszczenie, bez zewnętrznego źródła, dotykająca około 15% populacji, z czego 2% doświadcza znacznego pogorszenia jakości życia. Objaw ten może mieć charakter jednostronny lub obustronny, stały lub przerywany, i jest często powiązany z zaburzeniami psychicznymi, takimi jak lęk i depresja. Kompleksowa ocena pielęgniarska powinna obejmować szczegółowy wywiad dotyczący objawów (utrata słuchu, zawroty głowy, bezsenność, objawy depresji), badanie fizykalne oraz ocenę wpływu szumów na funkcjonowanie pacjenta. Diagnozy pielęgniarskie mogą obejmować zaburzenia komunikacji werbalnej, zaburzenia snu, lęk oraz ryzyko depresji. Interwencje pielęgniarskie koncentrują się na łagodzeniu objawów, edukacji pacjenta, wsparciu psychologicznym oraz modyfikacji środowiska (np. stosowanie terapii dźwiękowej, unikanie ciszy, eliminacja hałasów tła). Kluczowe jest także monitorowanie stanu pacjenta i współpraca interdyscyplinarna z audiologami, laryngologami, psychologami i innymi specjalistami.

Wprowadzenie do szumów usznych
Ocena pielęgniarska pacjenta z szumami usznymi

Wywiad i objawy
Diagnozy pielęgniarskie

Interwencje pielęgniarskie w szumach usznych

Wsparcie medyczne i diagnostyczne
Modyfikacja środowiska i terapia dźwiękowa
Wsparcie psychologiczne i edukacja

Zapobieganie i ochrona słuchu
Monitorowanie i ocena efektów

Monitorowanie objawów
Ocena efektów interwencji

Współpraca interdyscyplinarna

Zespół interdyscyplinarny
Kiedy skierować pacjenta do specjalisty

Specjalistyczne metody leczenia szumów usznych

Aparaty słuchowe i urządzenia maskujące
Terapie behawioralne
Farmakoterapia

Wpływ szumów usznych na jakość życia

Skutki psychologiczne i społeczne
Wsparcie pacjenta i rodziny

Postępy w leczeniu szumów usznych

Nowe technologie i badania
Terapie komplementarne i alternatywne

Rozwój zawodowy w opiece nad pacjentami z szumami usznymi

Specjalistyczne szkolenia i certyfikaty
Standardy opieki i wytyczne

Podsumowanie roli pielęgniarki w opiece nad pacjentem z szumami usznymi

Kolejne rozdziały

Wprowadzenie do szumów usznych

Szumy uszne (tinnitus) to percepcja dźwięku w uszach lub głowie bez obecności zewnętrznego źródła dźwięku. Zazwyczaj opisywane są jako dzwonienie, brzęczenie, syczenie, świszczenie lub szum w uszach lub głowie. Odczucia te mogą być stałe lub przerywane, jednostronne lub obustronne, a ich intensywność może być różna. Szumy uszne dotykają około 15% populacji, a około 2% osób dotkniętych tym problemem zgłasza znaczne obniżenie jakości życia z tego powodu¹. Szacuje się, że w samych Stanach Zjednoczonych około 50 milionów Amerykanów doświadcza szumów usznych, z czego około 16 milionów szuka pomocy medycznej, a 2 miliony nie są w stanie prowadzić normalnego życia²³.

Szumy uszne nie są chorobą, lecz objawem, który może wynikać z wielu różnych przyczyn, od łagodnych stanów po poważne schorzenia wymagające natychmiastowej interwencji. Może być również znaczącym obciążeniem psychospołecznym dla pacjentów i jest związany z lękiem i depresją⁴. Dlatego też opieka pielęgniarska w przypadku szumów usznych wymaga kompleksowego podejścia, uwzględniającego zarówno fizykalne, jak i psychologiczne aspekty tego schorzenia.

Ocena pielęgniarska pacjenta z szumami usznymi

Kompleksowa ocena pielęgniarska pacjenta z szumami usznymi jest kluczowym elementem opieki. Powinna obejmować szczegółową historię choroby, badanie fizykalne oraz ocenę wpływu szumów usznych na codzienne funkcjonowanie pacjenta⁵⁶.

Wywiad i objawy

Podczas zbierania wywiadu pielęgniarka powinna ocenić następujące objawy i czynniki⁷:

Drogi oddechowe, oddychanie i krążenie
Oznaki życiowe
Skargi na utratę słuchu
Ciągłe dzwonienie lub brzęczenie w uszach
Przerywane dzwonienie lub brzęczenie w uszach
Zawroty głowy
Bezsenność
Lęk
Objawy depresji, takie jak:
- Przytłaczający smutek
- Zmiany w schemacie snu
- Zmiany w apetycie
- Zmniejszona zdolność do wykonywania codziennych czynności
Uczucie ciśnienia w uchu
Stosowanie nowych leków
Przyjmowanie leków ototoksycznych, takich jak aspiryna

⁸

Pielęgniarka powinna również określić charakter szumów usznych poprzez zadawanie pytań dotyczących rodzaju dźwięków – czy przypominają one klikanie, pulsowanie, niskie lub wysokie dzwonienie⁹¹⁰. Istotne jest również ustalenie, czy szumy są jednostronne czy obustronne, stałe czy przerywane, oraz jak długo trwają¹¹.

Diagnozy pielęgniarskie

Na podstawie zebranych informacji pielęgniarka może sformułować następujące diagnozy pielęgniarskie¹²¹³:

Zaburzenia komunikacji werbalnej związane z utratą słuchu, przejawiające się:
- Przekrwieniem lub uczuciem pełności w uszach
- Zmniejszoną zdolnością słyszenia
Zaburzenia snu związane z szumami usznymi, przejawiające się:
- Ciągłym dzwonieniem lub brzęczeniem w uszach
- Trudnościami z zasypianiem i utrzymaniem snu
Lęk związany z przewlekłymi szumami usznymi i ich wpływem na codzienne funkcjonowanie
Ryzyko depresji związane z chronicznym charakterem schorzenia i jego wpływem na jakość życia

Interwencje pielęgniarskie w szumach usznych

Opieka pielęgniarska nad pacjentem z szumami usznymi obejmuje szereg interwencji mających na celu złagodzenie objawów, poprawę jakości życia oraz zapobieganie powikłaniom¹⁴.

Wsparcie medyczne i diagnostyczne

Pielęgniarka odgrywa kluczową rolę w procesie diagnostycznym i leczniczym szumów usznych¹⁵¹⁶:

Pomoc w umawianiu wizyt u lekarza podstawowej opieki zdrowotnej lub audiologa
Asystowanie pacjentowi w przygotowaniu się do testów audiologicznych
Pomoc w nauce używania i dbania o aparaty słuchowe, jeśli zostały zalecone
Monitorowanie zmian w stanie słuchu
Obserwacja pod kątem oznak depresji
Śledzenie skuteczności zastosowanych metod leczenia

W zależności od przyczyny szumów usznych, pielęgniarka może również wspierać leczenie schorzeń podstawowych, które mogą przyczyniać się do występowania szumów, takich jak zaburzenia endokrynologiczne, nadciśnienie tętnicze, choroby autoimmunologiczne czy nieprawidłowe funkcjonowanie tarczycy¹⁷.

Modyfikacja środowiska i terapia dźwiękowa

Ważnym elementem opieki pielęgniarskiej jest modyfikacja środowiska pacjenta w celu zmniejszenia percepcji szumów usznych¹⁸:

Utrzymywanie cichej atmosfery
Eliminowanie hałasów w tle
Zalecanie używania urządzeń generujących biały szum, szczególnie podczas snu
Pomoc w utrzymaniu rutynowej higieny snu
Doradztwo w zakresie unikania całkowitej ciszy, która może nasilać percepcję szumów usznych¹⁹

Terapia dźwiękowa jest często stosowaną metodą łagodzenia objawów szumów usznych. Pielęgniarka może informować pacjentów o różnych opcjach terapii dźwiękowej, takich jak²⁰:

Urządzenia maskujące, które zapewniają tło dźwiękowe, takie jak biały szum, dźwięki natury lub inne subtelne dźwięki
Aparaty słuchowe ze zintegrowanymi generatorami dźwięku
Terapia habituacyjna (przyzwyczajeniowa) szumów usznych (Tinnitus Retraining Therapy – TRT), która łączy poradnictwo z terapią dźwiękową²¹

Wsparcie psychologiczne i edukacja

Ze względu na psychologiczny wpływ szumów usznych, ważnym elementem opieki pielęgniarskiej jest wsparcie psychologiczne i edukacja pacjenta²²²³:

Edukacja na temat stanu, leczenia i oczekiwanych wyników
Informowanie o schemacie przyjmowania leków, jeśli zostały przepisane
Zachęcanie do udziału w grupach wsparcia
Pomoc w nauce technik relaksacyjnych, takich jak biofeedback, medytacja czy joga²⁴
Kierowanie na terapię poznawczo-behawioralną (CBT), która może pomóc pacjentom w radzeniu sobie z negatywnymi emocjami związanymi z szumami usznymi²⁵

Edukacja pacjenta powinna obejmować również informacje o czynnikach, które mogą nasilać szumy uszne, takich jak²⁶:

Kofeina
Alkohol
Palenie tytoniu
Stres
Zmęczenie
Niedostateczny odpoczynek

Zapobieganie i ochrona słuchu

Istotnym aspektem opieki pielęgniarskiej jest edukacja pacjentów w zakresie zapobiegania dalszemu uszkodzeniu słuchu i nasileniu szumów usznych²⁷²⁸:

Unikanie produktów zawierających aspirynę, chyba że są zalecane przez lekarza
Unikanie uczestnictwa w zajęciach o wysokim poziomie hałasu, takich jak:
- Koncerty
- Wyścigi pojazdów
- Wydarzenia sportowe
Używanie ochronników słuchu (zatyczek do uszu, nauszników) w hałaśliwych środowiskach
Kontrolowanie poziomu głośności podczas korzystania ze słuchawek

Pielęgniarka powinna również edukować pacjentów o znaczeniu regularnych badań słuchu i zachęcać do konsultacji z audiologiem w celu dopasowania indywidualnych środków ochrony słuchu, szczególnie dla osób narażonych zawodowo na hałas²⁹.

Monitorowanie i ocena efektów

Regularne monitorowanie stanu pacjenta i ocena efektów zastosowanych interwencji jest kluczowym elementem opieki pielęgniarskiej nad pacjentem z szumami usznymi³⁰³¹.

Monitorowanie objawów

Pielęgniarka powinna instruować pacjenta, aby zwracał uwagę na następujące zmiany i zgłaszał je personelowi medycznemu³²³³³⁴:

Nasilenie objawów
Przeniesienie szumów usznych z obu uszu do jednego ucha
Nagłe zmiany w widzeniu
Zawroty głowy
Utrata słuchu
Nagłe drętwienie, mrowienie lub osłabienie twarzy
Zmiana równowagi
Nudności lub wymioty
Pogorszenie słuchu w ciągu 1 dnia po urazie ucha
Brak poprawy szumów usznych lub utraty słuchu w ciągu 1 tygodnia po urazie ucha
Szumy uszne na tyle uciążliwe, że pacjent chce przyjmować leki, aby sobie z nimi poradzić

Ocena efektów interwencji

Oczekiwane efekty pielęgniarskiej opieki nad pacjentem z szumami usznymi obejmują³⁵:

Brak depresji lub jej minimalizacja
Poprawa jakości snu
Minimalizacja lub brak lęku
Utrzymanie lub odzyskanie słuchu poprzez zastosowanie aparatu słuchowego
Zrozumienie, jak używać i dbać o aparat słuchowy (jeśli został zalecony)
Rozwój strategii radzenia sobie z szumami usznymi
Poprawa ogólnej jakości życia

Pielęgniarka powinna regularnie oceniać skuteczność zastosowanych interwencji i w razie potrzeby dostosowywać plan opieki. Ważne jest, aby pamiętać, że podczas gdy nie ma lekarstwa na większość przypadków przewlekłych szumów usznych, istnieją sposoby na zarządzanie tym stanem i zmniejszenie jego wpływu na życie pacjenta³⁶.

Współpraca interdyscyplinarna

Kompleksowa opieka nad pacjentem z szumami usznymi wymaga współpracy interdyscyplinarnej, obejmującej różnych specjalistów³⁷³⁸.

Zespół interdyscyplinarny

W zależności od przyczyny i nasilenia szumów usznych, w opiekę nad pacjentem mogą być zaangażowani następujący specjaliści³⁹⁴⁰:

Audiolodzy – specjaliści w diagnostyce i leczeniu zaburzeń słuchu, mogą przeprowadzać badania słuchu i dopasowywać aparaty słuchowe
Otolaryngolodzy (lekarze laryngolodzy) – specjaliści od chorób uszu, nosa i gardła, mogą diagnozować i leczyć podstawowe schorzenia medyczne
Psycholodzy i psychiatrzy – pomagają w leczeniu współistniejących problemów psychicznych, takich jak lęk, depresja czy bezsenność
Neurolodzy – mogą być zaangażowani w przypadkach, gdy szumy uszne wynikają z zaburzeń neurologicznych
Dentyści – mogą pomóc, jeśli szumy uszne są związane z dysfunkcją stawu skroniowo-żuchwowego (TMJ)
Fizjoterapeuci – mogą być pomocni w przypadku szumów usznych związanych z napięciem mięśni szyi i głowy

Pielęgniarka odgrywa kluczową rolę w koordynowaniu opieki między tymi specjalistami, upewniając się, że pacjent otrzymuje kompleksowe i spójne leczenie⁴¹.

Kiedy skierować pacjenta do specjalisty

Pielęgniarka powinna być świadoma sytuacji, które wymagają skierowania pacjenta do specjalisty⁴²:

Nagłe pojawienie się szumów usznych
Jednostronne szumy uszne (występujące tylko w jednym uchu), które mogą wskazywać na chorobę podstawową
Tętniące szumy uszne, które mogą być objawem zaburzeń naczyniowych
Wyniki testów audiometrycznych sugerujące stan otologiczny lub neuro-otologiczny, taki jak nerwiak nerwu słuchowego lub stan ucha środkowego, jak otoskleroza
Współistniejące choroby, takie jak lęk, depresja lub bezsenność
Choroby ogólnoustrojowe, takie jak nadciśnienie, choroby autoimmunologiczne i nieprawidłowe funkcjonowanie tarczycy

W przypadku tętniących szumów usznych, które mogą być objawem poważnego problemu z naczyniami krwionośnymi w głowie, niezbędne jest natychmiastowe skierowanie do otolaryngologa lub na oddział ratunkowy w celu oceny przyczyny⁴³⁴⁴.

Specjalistyczne metody leczenia szumów usznych

Pielęgniarka powinna być zaznajomiona z różnymi metodami leczenia szumów usznych, aby móc informować pacjentów o dostępnych opcjach i wspierać ich w procesie leczenia⁴⁵.

Aparaty słuchowe i urządzenia maskujące

Dla pacjentów z utratą słuchu i szumami usznymi, aparaty słuchowe mogą przynieść podwójną korzyść⁴⁶⁴⁷:

Poprawiają słyszenie przez wzmacnianie niektórych dźwięków
Mogą zmniejszyć percepcję szumów usznych poprzez zwiększenie ogólnego poziomu dźwięku otoczenia
Niektóre aparaty słuchowe mają wbudowane generatory dźwięku, które mogą być dodane do wzmocnionego dźwięku otoczenia

Urządzenia maskujące to urządzenia przypominające aparaty słuchowe, które wytwarzają delikatny szum maskujący szumy uszne. Mogą one zapewnić natychmiastową ulgę poprzez odwrócenie uwagi od szumów usznych⁴⁸.

Terapie behawioralne

Różne terapie behawioralne mogą pomóc pacjentowi żyć z przewlekłymi szumami usznymi⁴⁹⁵⁰:

Terapia habituacyjna szumów usznych (TRT) – łączy poradnictwo z terapią dźwiękową. Celem jest przekierowanie podświadomej części układu słuchowego, aby akceptowała dźwięki związane z szumami usznymi jako normalne, naturalne dźwięki, a nie dźwięki drażniące.
Terapia poznawczo-behawioralna (CBT) – uczy pacjentów, jak zarządzać swoimi psychologicznymi reakcjami na szumy uszne. Pomaga zidentyfikować i zmienić nieprzystosowawcze myśli i zachowania, osiągając ulgę.
Biofeedback – technika relaksacyjna, która uczy osobę kontrolowania pewnych funkcji organizmu, takich jak częstość akcji serca i oddychanie.
Techniki relaksacyjne – takie jak medytacja, joga czy progresywna relaksacja mięśni, mogą pomóc w zmniejszeniu stresu, który może nasilać szumy uszne.

Farmakoterapia

Obecnie nie ma leku, który został zatwierdzony specjalnie do leczenia szumów usznych. Jednak różne leki mogą być stosowane w celu złagodzenia objawów towarzyszących lub podstawowych stanów⁵¹⁵²:

Leki przeciwdepresyjne
Leki przeciwlękowe
Leki nasenne
Leki przeciwdrgawkowe
Akamprozat (Campral)
Leki uspokajające

Pielęgniarka powinna informować pacjentów, że metody behawioralne powinny być stosowane przed rozważeniem farmakoterapii, a wszelkie leki powinny być przyjmowane wyłącznie pod nadzorem lekarza⁵³.

Wpływ szumów usznych na jakość życia

Szumy uszne mogą mieć znaczący wpływ na jakość życia pacjentów, dlatego ważne jest, aby pielęgniarki rozumiały te skutki i potrafiły odpowiednio wspierać pacjentów⁵⁴.

Skutki psychologiczne i społeczne

Szumy uszne mogą wpływać na różne aspekty życia pacjenta⁵⁵⁵⁶:

Problemy ze snem i bezsenność
Trudności z koncentracją
Lęk i niepokój
Depresja
Zmniejszona produktywność w pracy
Izolacja społeczna
Zmęczenie
Problemy z pamięcią
Ogólne obniżenie jakości życia

Stopień dyskomfortu może być łagodny, umiarkowany lub intensywny i często nie jest związany z głośnością szumów usznych. Pacjenci z łagodnymi szumami usznymi mogą odczuwać objawy tylko w określonych sytuacjach, pacjent z umiarkowanymi szumami usznymi jest świadomy objawu, ale nie jest nim zaniepokojony. Pacjenci z intensywnymi szumami usznymi są zaniepokojeni stale obecnym doznaniem i postrzegają je jako nie do zniesienia⁵⁷.

Wsparcie pacjenta i rodziny

Pielęgniarka odgrywa kluczową rolę we wspieraniu pacjenta i jego rodziny w radzeniu sobie z szumami usznymi⁵⁸:

Edukacja pacjenta i rodziny na temat szumów usznych i ich zarządzania
Zachęcanie do aktywnego udziału w leczeniu
Wspieranie w tworzeniu silnych sieci wsparcia, które mogą pomóc pacjentowi w trudnych okresach
Informowanie o grupach wsparcia i zasobach społecznościowych
Kierowanie do odpowiednich specjalistów w razie potrzeby

Ważne jest, aby pacjenci edukowali się na temat szumów usznych i ich leczenia, aby mogli być swoimi własnymi rzecznikami w procesie opieki zdrowotnej⁵⁹.

Postępy w leczeniu szumów usznych

Pielęgniarki powinny być na bieżąco z najnowszymi postępami w leczeniu szumów usznych, aby móc informować pacjentów o wszystkich dostępnych opcjach⁶⁰.

Nowe technologie i badania

Aktualnie prowadzone są badania nad nowymi metodami leczenia szumów usznych⁶¹⁶²:

Stymulacja elektryczna – używana do stymulacji układu słuchowego, wykazała, że zapewnia ulgę w przypadku szumów usznych w niektórych przypadkach.
Przezczaszkowa stymulacja magnetyczna (TMS) – dostarcza pole elektryczne do kory mózgowej, modulując pobudliwość w obszarze kory mózgowej, który jest uważany za związany z szumami usznymi.
Neuromodulacja – urządzenia takie jak Lenire wykorzystują technikę neuromodulacji bimodalnej, która stymuluje „przeprogramowanie” mózgu i modyfikuje zachowanie nerwów, stosując łagodne impulsy do języka wraz z relaksującymi dźwiękami przez słuchawki.

System Lenire jest urządzeniem do neuromodulacji bimodalnej, które leczy subiektywne szumy uszne. Badania kliniczne wykazały, że to urządzenie medyczne skutecznie łagodzi szumy uszne i może zapewnić długotrwałą ulgę⁶³.

Terapie komplementarne i alternatywne

Niektórzy pacjenci mogą korzystać z terapii komplementarnych i alternatywnych, takich jak⁶⁴:

Ekstrakty z miłorzębu japońskiego (Ginkgo biloba)
Akupunktura
Tlenoterapia hiperbaryczna

Pielęgniarka powinna informować pacjentów, że efektywność tych metod w leczeniu szumów usznych nie została jednoznacznie potwierdzona naukowo, ale niektórzy pacjenci mogą odczuwać subiektywną poprawę⁶⁵.

Rozwój zawodowy w opiece nad pacjentami z szumami usznymi

Zapewnienie wysokiej jakości opieki pacjentom z szumami usznymi wymaga od pielęgniarek ciągłego rozwoju zawodowego i specjalistycznego szkolenia⁶⁶.

Specjalistyczne szkolenia i certyfikaty

Pielęgniarki mogą zdobywać specjalistyczną wiedzę w zakresie opieki nad pacjentami z szumami usznymi poprzez⁶⁷⁶⁸:

Programy certyfikacyjne, takie jak Program Certyfikacji Opiekuna Pacjentów z Szumami Usznymi (Tinnitus Care Provider Certificate Program)
Konferencje dotyczące szumów usznych, takie jak te oferowane przez Stowarzyszenie Praktyków Szumów Usznych (Tinnitus Practitioners Association – TPA) i Inicjatywę Badawczą Szumów Usznych (Tinnitus Research Initiative – TRI)
Kursy edukacyjne dotyczące fizjologii, psychologii, pomiarów, zarządzania i organizacji praktyki związanej z szumami usznymi

Doskonalenie zawodowe w tej dziedzinie może przynieść znaczące korzyści, w tym rozwój zawodowy, zaawansowaną edukację i networking⁶⁹.

Standardy opieki i wytyczne

Pielęgniarki powinny być zaznajomione z najnowszymi wytycznymi dotyczącymi opieki nad pacjentami z szumami usznymi⁷⁰⁷¹:

Narodowy Instytut Zdrowia i Opieki (National Institute for Health and Care Excellence – NICE) wydał w marcu 2020 r. nowe wytyczne „Szumy uszne: Ocena i zarządzanie” (NG155)
Amerykańska Akademia Otolaryngologii – Chirurgii Głowy i Szyi (American Academy of Otolaryngology-Head and Neck Surgery) opracowała wytyczne praktyki klinicznej dotyczące szumów usznych

Ważne jest, aby rozwijać specyficzne protokoły i poprawiać kursy edukacyjne dla pielęgniarek zajmujących się szumami usznymi, uwzględniając aspekty kulturowe⁷².

Podsumowanie roli pielęgniarki w opiece nad pacjentem z szumami usznymi

Pielęgniarka odgrywa kluczową rolę w opiece nad pacjentem z szumami usznymi, obejmującą szeroki zakres działań⁷³⁷⁴⁷⁵:

Kompleksowa ocena pacjenta, obejmująca wywiad, badanie fizykalne i ocenę wpływu szumów usznych na codzienne funkcjonowanie
Formułowanie diagnoz pielęgniarskich i planowanie interwencji dostosowanych do indywidualnych potrzeb pacjenta
Wdrażanie interwencji mających na celu złagodzenie objawów, poprawę jakości życia i zapobieganie powikłaniom
Edukacja pacjenta i rodziny na temat schorzenia, jego leczenia i samoopieki
Wsparcie psychologiczne i emocjonalne
Współpraca z interdyscyplinarnym zespołem specjalistów
Monitorowanie stanu pacjenta i ocena efektów zastosowanych interwencji
Kierowanie pacjenta do odpowiednich specjalistów w razie potrzeby

Chociaż szumy uszne mogą być przewlekłym i uciążliwym schorzeniem, odpowiednia opieka pielęgniarska może znacząco poprawić jakość życia pacjentów i pomóc im skutecznie radzić sobie z tym problemem⁷⁶.

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

Materiały źródłowe

#1 Tinnitus: systematic approach to primary care assessment and management
https://pmc.ncbi.nlm.nih.gov/articles/PMC8966951/
Tinnitus is a symptom in which patients report the perception of sound in the absence of external stimuli. The nature of the sound is variable; it may include buzzing, ringing, humming, or whistling. Tinnitus affects up to 15% of the population. It affects all ages but is most common in older people with presbycusis. Two per cent are significantly affected, reporting reduced quality of life outcomes. A recent international systematic review estimated the cost of tinnitus management to be as high as 7246 Euros (6115 GBP) per patient per year. Despite this disease burden, the pathophysiology of tinnitus remains poorly understood. It is thought to be multifactorial in nature, resulting from dysregulated neural activity at any point along the auditory pathway from the cochlea to auditory cortex. The perception of tinnitus is associated with hearing loss or being in a quiet environment because of a lack of masking by background noise. Tinnitus may present as an isolated symptom or may be indicative of a range of pathologies from benign conditions to clinical emergencies. It may also pose a significant psychosocial burden on patients and is associated with anxiety and depression.
#2 Evaluation and Treatment of Tinnitus: A Comparative Effectiveness Review | Effective Health Care (EHC) Program
https://effectivehealthcare.ahrq.gov/products/tinnitus/research-protocol
Tinnitus is the perception of sound in the absence of an external auditory stimulus. Tinnitus is a distressing condition that can disturb ones day-to-day life in a number of ways including distress and annoyance, disruption of sleep, anxiety, and depression. An estimated 16 percent of the American population (50 million people) experience tinnitus to some extent, with up to 16 million seeking medical help and 2 million being unable to lead a normal life. […] […] The severity of tinnitus experienced by patients may vary or depend on comorbidities. Tinnitus often co-occurs with hearing loss, and the bothersome effects of tinnitus may be alleviated by the use of hearing aids. Individuals who are dual sensory impaired (deaf and blind) may be confused by tinnitus because visual information does not help them understand that their tinnitus is not an external sound. It is common for tinnitus to aggravate or be aggravated by mental health conditions. […]
#3 Progressive Tinnitus Management
https://www.research.va.gov/research_in_action/Progressive-Tinnitus-Management.cfm
Progressive Tinnitus Management is an audiology program that has been adopted nationwide in both VA and Department of Defense clinics to treat tinnitus. […] Tinnitus is ringing, buzzing, whistling, or other sounds in the ears without an external source. The condition can disrupt sleep, affect a person’s work and social life, and sharply increase the risk of depression or anxiety. […] The program approaches tinnitus care with five different levels of treatment. Most patients need only basic education on how to manage the condition. As the levels progress, therapy gets more intensive and long-term. Patients needing higher levels of care might use sound generators or other approaches such as tinnitus masking or cognitive behavioral therapy. […] NCRAR has developed clinical handbooks and other educational material on tinnitus care. A manual called How to Manage Your Tinnitus: A Step-by-Step Workbook is now used widely in VA clinics and patients. […] VA researchers recently developed a telehealth version of progressive tinnitus management. A controlled trial showed that the program can improve tinnitus outcomes when delivered remotely.
#4 Tinnitus: systematic approach to primary care assessment and management
https://pmc.ncbi.nlm.nih.gov/articles/PMC8966951/
Tinnitus is a symptom in which patients report the perception of sound in the absence of external stimuli. The nature of the sound is variable; it may include buzzing, ringing, humming, or whistling. Tinnitus affects up to 15% of the population. It affects all ages but is most common in older people with presbycusis. Two per cent are significantly affected, reporting reduced quality of life outcomes. A recent international systematic review estimated the cost of tinnitus management to be as high as 7246 Euros (6115 GBP) per patient per year. Despite this disease burden, the pathophysiology of tinnitus remains poorly understood. It is thought to be multifactorial in nature, resulting from dysregulated neural activity at any point along the auditory pathway from the cochlea to auditory cortex. The perception of tinnitus is associated with hearing loss or being in a quiet environment because of a lack of masking by background noise. Tinnitus may present as an isolated symptom or may be indicative of a range of pathologies from benign conditions to clinical emergencies. It may also pose a significant psychosocial burden on patients and is associated with anxiety and depression.
#5 Tinnitus: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/tinnitus/
Tinnitus Nursing Care Plan […] Nursing Considerations […] Tinnitus Assessment […] Assess signs and symptoms, such as: […] Airway, breathing, and circulation […] Vital signs […] Complaints of hearing loss […] Continuous ringing or buzzing in the ears […] Intermittent ringing or buzzing in the ears […] Vertigo or dizziness […] Insomnia […] Anxiety […] Depression signs or symptoms, such as: […] Overwhelming sadness […] Changes in sleep pattern […] Changes in appetite […] Decreased ability to complete activities of daily living […] A feeling of pressure in the ear […] Use of new medication […] Consuming ototoxic medications such as aspirin […] Nursing Diagnosis/Risk For […] Impaired verbal communication related to hearing loss as evidenced by: […] Congestion or fullness in the ears
#6
https://journals.lww.com/tnpj/fulltext/2012/10000/tinnitus_evaluation_in_primary_care.6.aspx
Tinnitus is a common, yet poorly understood problem. This symptom has many causes, both benign as well as serious. Patients can experience significant changes in quality-of-life related to symptom severity and duration. This article explores causes of tinnitus, evaluation in a primary care setting, and management strategies. […] Tinnitus is a significant clinical issue that can impact a patient’s quality of life, cause anxiety, and negatively impact activities of daily living. It affects concentration, emotional stability, sleep habits, work productivity, and social activity. […] The degree of discomfort may be mild, moderate, or intense and is often unrelated to the loudness of the tinnitus. Patients with mild tinnitus may perceive the symptom only in particular situations, and a patient with moderate tinnitus is aware of the symptom but is not bothered by it. Patients with intense tinnitus are disturbed by the ever-present sensation and view it as unbearable.
#7 Tinnitus: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/tinnitus/
Tinnitus Nursing Care Plan […] Nursing Considerations […] Tinnitus Assessment […] Assess signs and symptoms, such as: […] Airway, breathing, and circulation […] Vital signs […] Complaints of hearing loss […] Continuous ringing or buzzing in the ears […] Intermittent ringing or buzzing in the ears […] Vertigo or dizziness […] Insomnia […] Anxiety […] Depression signs or symptoms, such as: […] Overwhelming sadness […] Changes in sleep pattern […] Changes in appetite […] Decreased ability to complete activities of daily living […] A feeling of pressure in the ear […] Use of new medication […] Consuming ototoxic medications such as aspirin […] Nursing Diagnosis/Risk For […] Impaired verbal communication related to hearing loss as evidenced by: […] Congestion or fullness in the ears
#8 Tinnitus: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/tinnitus/
Tinnitus Nursing Care Plan […] Nursing Considerations […] Tinnitus Assessment […] Assess signs and symptoms, such as: […] Airway, breathing, and circulation […] Vital signs […] Complaints of hearing loss […] Continuous ringing or buzzing in the ears […] Intermittent ringing or buzzing in the ears […] Vertigo or dizziness […] Insomnia […] Anxiety […] Depression signs or symptoms, such as: […] Overwhelming sadness […] Changes in sleep pattern […] Changes in appetite […] Decreased ability to complete activities of daily living […] A feeling of pressure in the ear […] Use of new medication […] Consuming ototoxic medications such as aspirin […] Nursing Diagnosis/Risk For […] Impaired verbal communication related to hearing loss as evidenced by: […] Congestion or fullness in the ears
#9 Specialized Tinnitus Care Starts Here | Iowa Audiology
https://iowaaudiology.com/hearing-loss/tinnitus-symptoms-management/
Tinnitus is typically diagnosed based on a patients symptoms. Our office will provide a referral to connect you with these services. To determine an underlying cause, our provider will ask what noises are present. Does it sound like clicking, pulsing, low-pitched ringing or high-pitched ringing? […] If testing suggests the need for medical intervention to manage an underlying disorder, our team will connect you with the provider that can help. Options for management might include: […] Counseling can connect you with emotional coping techniques and strategies that will, in turn, help reduce potential side effects of tinnitus, including depression, fatigue and insomnia. By eliminating your anxiety around tinnitus, the noises no longer seem like a danger, and youll be able to focus on other things.
#10 Specialized Tinnitus Care Starts Here | Toledo Clinic ENT
https://toledoclinicent.com/audiologist/tinnitus/
Tinnitus is typically diagnosed based on a patients symptoms. Our office will provide a referral to connect you with these services. To determine an underlying cause, our provider will ask what noises are present. Does it sound like clicking, pulsing, low-pitched ringing or high-pitched ringing? […] If testing suggests the need for medical intervention to manage an underlying disorder, our team will connect you with the provider that can help. Options for management might include: […] Counseling: Techniques like cognitive behavioral therapy, or CBT, can help reduce the stress, anxiety and sleeplessness that often arise as a side effect of tinnitus. […] The goal of tinnitus retraining therapy is to teach patients about their condition and ways to change how they react to and perceive the sound of tinnitus, ultimately removing the emotional reaction to it. Acoustic therapy will help mask the sound, and counseling will reduce the bothersome elements of the noise. […] Tinnitus might seem daunting, but you dont have to face it yourself. At Toledo Clinic ENT, we can help you manage your symptoms. Whether its providing you with more information about tinnitus or helping you find acoustic therapy, were here to help.
#11 Specialized Tinnitus Care Starts Here | Northern Hearing Services
https://hearalaska.com/hearing-loss/tinnitus-symptoms-management/
Tinnitus is a ringing noise in one or both ears that might be constant or come and go. It can last anywhere from a few days to years. […] If testing suggests the need for medical intervention to manage an underlying disorder, our team will connect you with the provider that can help. Options for management might include: […] Counseling can connect you with emotional coping techniques and strategies that will, in turn, help reduce potential side effects of tinnitus, including depression, fatigue and insomnia. […] The goal of tinnitus retraining therapy is to teach patients about their condition and ways to change how they react to and perceive the sound of tinnitus, ultimately removing the emotional reaction to it. Acoustic therapy will help mask the sound, and counseling will reduce the bothersome elements of the noise. […] At Northern Hearing Services Inc, we can help you manage your symptoms. Whether its providing you with more information about tinnitus or helping you find acoustic therapy, were here to help.
#12 Tinnitus: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/tinnitus/
Tinnitus Nursing Care Plan […] Nursing Considerations […] Tinnitus Assessment […] Assess signs and symptoms, such as: […] Airway, breathing, and circulation […] Vital signs […] Complaints of hearing loss […] Continuous ringing or buzzing in the ears […] Intermittent ringing or buzzing in the ears […] Vertigo or dizziness […] Insomnia […] Anxiety […] Depression signs or symptoms, such as: […] Overwhelming sadness […] Changes in sleep pattern […] Changes in appetite […] Decreased ability to complete activities of daily living […] A feeling of pressure in the ear […] Use of new medication […] Consuming ototoxic medications such as aspirin […] Nursing Diagnosis/Risk For […] Impaired verbal communication related to hearing loss as evidenced by: […] Congestion or fullness in the ears
#13 Tinnitus: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/tinnitus/
Decreased hearing capacity […] Disturbed sleep pattern related to tinnitus as evidenced by: […] Continuous ringing or buzzing sound in ears […] Interventions […] Follow up with a healthcare provider or audiologist […] Assist the person with setting up or attending an appointment for audiology testing […] Assist the person with how to use and care for a hearing aid […] Help the person to maintain routine sleep hygiene […] Recommend a white noise machine […] Monitor for changes in hearing status […] Monitor for signs of depression […] Decrease stimulation […] Maintain a quiet atmosphere […] Speak slowly and clearly […] Eliminate background noises […] Expected Outcomes […] Remains free of depression […] Improved quality of sleep […] Verbalizes minimal or no anxiety
#14 Tinnitus: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/tinnitus/
Decreased hearing capacity […] Disturbed sleep pattern related to tinnitus as evidenced by: […] Continuous ringing or buzzing sound in ears […] Interventions […] Follow up with a healthcare provider or audiologist […] Assist the person with setting up or attending an appointment for audiology testing […] Assist the person with how to use and care for a hearing aid […] Help the person to maintain routine sleep hygiene […] Recommend a white noise machine […] Monitor for changes in hearing status […] Monitor for signs of depression […] Decrease stimulation […] Maintain a quiet atmosphere […] Speak slowly and clearly […] Eliminate background noises […] Expected Outcomes […] Remains free of depression […] Improved quality of sleep […] Verbalizes minimal or no anxiety
#15 Tinnitus: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/tinnitus/
Decreased hearing capacity […] Disturbed sleep pattern related to tinnitus as evidenced by: […] Continuous ringing or buzzing sound in ears […] Interventions […] Follow up with a healthcare provider or audiologist […] Assist the person with setting up or attending an appointment for audiology testing […] Assist the person with how to use and care for a hearing aid […] Help the person to maintain routine sleep hygiene […] Recommend a white noise machine […] Monitor for changes in hearing status […] Monitor for signs of depression […] Decrease stimulation […] Maintain a quiet atmosphere […] Speak slowly and clearly […] Eliminate background noises […] Expected Outcomes […] Remains free of depression […] Improved quality of sleep […] Verbalizes minimal or no anxiety
#16 Tinnitus (Ringing in Ears): Causes & Treatment
https://my.clevelandclinic.org/health/symptoms/14164-tinnitus
Tinnitus treatment depends on the cause. To learn more about the ringing in your ears, a healthcare provider (usually an audiologist) will do a physical examination and check your ears for any obvious issues. […] Because tinnitus is a symptom of many conditions, providers may be able to treat it by addressing the underlying cause. But they may need to run tests to get an accurate diagnosis. […] For many people, tinnitus sound therapy can be very effective in decreasing how noticeable or bothersome your tinnitus is over time. […] Left untreated, ringing in your ears could lead to: Anxiety. […] Audiologists can fit custom hearing protection. Consider seeing an audiologist for this service if you participate in one or more of these activities frequently. […] The experts at Cleveland Clinic can make a treatment plan to help manage your tinnitus.
#17 Tinnitus: systematic approach to primary care assessment and management
https://pmc.ncbi.nlm.nih.gov/articles/PMC8966951/
The National Institute for Health and Care Excellence (NICE) released new guidance, Tinnitus: Assessment and Management (NG155), in March 2020 aimed at both primary and secondary healthcare professionals. Tinnitus is a common presentation, so an understanding of assessment and classification as well as red-flag features is crucial in decision making when determining management. […] The mainstay of tinnitus management in primary care includes treatment of underlying pathology such as impacted wax or infection, medication review, and patient education. Systemic causes should be considered; thyroid function tests, full blood count, lipid levels, blood glucose, and HbA1c may be performed to exclude endocrine or high-output cardiovascular states that can cause tinnitus. Patients should be reassured that tinnitus is often idiopathic, a common symptom, and not usually indicative of an underlying health condition. Patients should be advised with regards to sound therapy (use of background sounds to distract from tinnitus) and good aural hygiene practice including noise protection, and signposted towards reliable information sources such as the British Tinnitus Association.
#18 Tinnitus: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/tinnitus/
Decreased hearing capacity […] Disturbed sleep pattern related to tinnitus as evidenced by: […] Continuous ringing or buzzing sound in ears […] Interventions […] Follow up with a healthcare provider or audiologist […] Assist the person with setting up or attending an appointment for audiology testing […] Assist the person with how to use and care for a hearing aid […] Help the person to maintain routine sleep hygiene […] Recommend a white noise machine […] Monitor for changes in hearing status […] Monitor for signs of depression […] Decrease stimulation […] Maintain a quiet atmosphere […] Speak slowly and clearly […] Eliminate background noises […] Expected Outcomes […] Remains free of depression […] Improved quality of sleep […] Verbalizes minimal or no anxiety
#19 Tinnitus Diagnosis and Treatment | University Hospitals | Cleveland, Ohio | University Hospitals
https://www.uhhospitals.org/services/ear-nose-and-throat-services/conditions-and-treatments/tinnitus
Most patients who seek medical help for their tinnitus learn that there is no serious medical problem causing their condition. This knowledge alone is often enough to allow some to adapt to the sounds they hear. Other people experience tinnitus as disruptive and stress-inducing and need help learning how to cope with the sounds. […] Most patients who seek medical help for their tinnitus learn that there is no serious medical problem causing their condition. This knowledge alone is often enough to allow some to adapt to the sounds they hear. Other people experience tinnitus as disruptive and stress-inducing and need help learning how to cope with the sounds. […] Avoid silence. Tinnitus can sound louder when you are in total silence. Listening to soothing music or nature sounds can promote a comfortable state of relaxation. Other soothing sound suggestions are an aquarium, dehumidifier or electric fan.
#20 Tips for Helping Your Patients Manage Tinnitus | Rendia
https://rendia.com/resources/insights/helping-patients-manage-tinnitus/
Sound therapy is another common and often effective method for alleviating tinnitus symptoms. One example is sound masking devices or applications that provide generic background noise such as white noise, nature sounds, or other subtle sounds that can temporarily mask a patients perception of tinnitus and provide relaxation and relief. […] Hearing aids and sound therapy can help some tinnitus patients; others will need a referral to an ENT to determine if underlying conditions are present. […] Some tinnitus cases will require a referral to an ENT for a comprehensive medical exam. According to AudiologyOnline, these include: Sudden onset of tinnitus, or tinnitus thats unilateral (occurring on only one side of the body), which could indicate underlying disease; Audiometric testing suggests otologic or neuro-otologic conditions such as an acoustic neuroma, or a middle ear condition such as otosclerosis. In some cases, treatment of the underlying medical condition may resolve the tinnitus; Comorbidities such as anxiety, depression, or insomnia; Systemic diseases such as hypertension, autoimmune disease, and abnormal thyroid functioning.
#21 Patient education: Tinnitus (ringing in the ears) (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/tinnitus-ringing-in-the-ears-beyond-the-basics
A number of behavioral therapies can help a person to live with chronic tinnitus. […] Tinnitus retraining therapy (TRT) involves retraining the subconscious part of the auditory system to accept the sounds associated with tinnitus as normal, natural sounds rather than annoying sounds. […] Masking devices resemble hearing aids and produce low-level sounds, which help to reduce or eliminate the tinnitus noise in some patients. […] Biofeedback is a relaxation technique that teaches a person to control certain body functions, such as heart and breathing rate. […] The goal of cognitive behavioral therapy (CBT) is to teach patients to manage their psychological responses to tinnitus. […] The impact of tinnitus on everyday life varies, often depending upon the severity of the tinnitus noise. About 25 percent of sufferers report an increase in tinnitus severity over time. Long-term tinnitus is unlikely to go away completely. However, it often becomes less bothersome over time, especially when hearing loss is also present.
#22 Tinnitus: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/tinnitus/
Maintains hearing or regains loss of hearing by receiving a hearing aid […] Understands how to use and care for a hearing aid […] Individual/Caregiver Education […] Provide the following education: […] Continue to attend follow-up appointments with the healthcare provider […] Condition, treatment, and expected outcomes […] Medication regimen […] Notify a healthcare provider of: […] Worsening symptoms […] Sudden changes in vision […] Feeling dizzy […] Loss of hearing […] Sudden numbness, tingling, or weakness in your face […] Change in balance […] Nausea or vomiting […] Avoid products containing aspirin unless recommended by the healthcare provider […] Avoid attending activities that have a high level of noise such as: […] Concerts […] Vehicle races […] Sporting events […] Continue to use music or white noise as directed by the healthcare provider
#23 Evaluation and Treatment of Tinnitus: A Comparative Effectiveness Review | Effective Health Care (EHC) Program
https://effectivehealthcare.ahrq.gov/products/tinnitus/research-protocol
In addition to its association with many physical health problems, tinnitus is also associated with many clinical and subclinical psychological health problems, both as a cause and consequence of tinnitus. For example, individuals with tinnitus may experience difficulties with attention and anxiety, but those who are most distressed by tinnitus may be psychologically vulnerable. Interventions such as cognitive behavioral therapy may effectively increase quality of life by increasing the patients ability to deal with chronic tinnitus by restructuring thought patterns and habituating those patterns when the patient is reacting to tinnitus.
#24
https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf7982
Many people have some ringing sounds in their ears once in a while. […] Ringing in the ears that doesn’t get better or go away is called tinnitus. […] Your doctor may suggest one or more treatments to help you cope with it. You can also do things at home to help reduce symptoms. […] Follow-up care is a key part of your treatment and safety. […] Do not smoke or use other tobacco products. Nicotine reduces blood flow to the ear and makes tinnitus worse. […] Relax using biofeedback, meditation, or yoga. Feeling stressed and being tired can make tinnitus worse. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: Your tinnitus moves from both ears to one ear. […] Your tinnitus bothers you enough that you want to take medicines to help you cope with it.
#25 Tinnitus: Diagnosis and Management | AAFP
https://www.aafp.org/pubs/afp/issues/2021/0601/p663.html
Tinnitus is the sensation of hearing a sound in the absence of an internal or external source and is a common problem encountered in primary care. A standard workup begins with a targeted history and physical examination to identify treatable causes and associated symptoms that may improve with treatment. Cognitive behavior therapy is the only treatment that has been shown to improve quality of life in patients with tinnitus. […] 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. […] Treatment of tinnitus should focus on an underlying cause when identified, as in the case of secondary tinnitus. The following treatment options are for chronic, bothersome, primary tinnitus, and focus on alleviating or reducing the severity of patient distress and conditions associated with tinnitus. Cognitive behavior therapy (CBT) is the only treatment with moderate- to high-quality evidence to suggest benefit on the primary tinnitus outcome. […] Counseling patients to avoid loud noise exposure and initiating CBT early in the course may minimize the effect of tinnitus on quality of life and help patients develop coping skills that may reduce the impact of the condition.
#26 Tinnitus Information | Mount Sinai – New York
https://www.mountsinai.org/health-library/symptoms/tinnitus
Tinnitus is often more noticeable when you go to bed at night because your surroundings are quieter. To mask tinnitus and make it less irritating, background noise using the following may help: […] Home care of tinnitus mainly includes: […] Learning ways to relax. It is not known if stress causes tinnitus, but feeling stressed or anxious can worsen it. […] Avoiding things that may make tinnitus worse, such as caffeine, alcohol, and smoking. […] Getting enough rest. Try sleeping with your head propped up in an elevated position. This lessens head congestion and may make noises less noticeable. […] Protecting your ears and hearing from further damage. Avoid loud places and sounds. Wear ear protection, such as earplugs, if you need them. […] Tinnitus can be managed. Talk with your provider about a management plan that works for you.
#27 Tinnitus: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/tinnitus/
Maintains hearing or regains loss of hearing by receiving a hearing aid […] Understands how to use and care for a hearing aid […] Individual/Caregiver Education […] Provide the following education: […] Continue to attend follow-up appointments with the healthcare provider […] Condition, treatment, and expected outcomes […] Medication regimen […] Notify a healthcare provider of: […] Worsening symptoms […] Sudden changes in vision […] Feeling dizzy […] Loss of hearing […] Sudden numbness, tingling, or weakness in your face […] Change in balance […] Nausea or vomiting […] Avoid products containing aspirin unless recommended by the healthcare provider […] Avoid attending activities that have a high level of noise such as: […] Concerts […] Vehicle races […] Sporting events […] Continue to use music or white noise as directed by the healthcare provider
#28 Tinnitus Symptoms and Treatment | Ringing in Ears
https://www.ceenta.com/conditions-and-treatments/tinnitus
Tinnitus is a symptom, not a disease itself, so it can have a number of causes. […] The best way to prevent it is to avoid exposure to loud noises and to use protective hearing devices, such as earplugs or earmuffs. […] CEENTA has audiologists in locations across North and South Carolina skilled in treating this condition. While there is no cure, there are fortunately some treatment options. Sound therapy, such as white noise or nature sound machines, has been beneficial in alleviating the condition by helping sufferers to avoid silence. Hearing aids can treat the hearing loss often associated with it. The audiologists at CEENTA also fit devices that use built-in sound generators to provide pleasant sound to the auditory cortex that disrupts the awareness of the signal in the brain.
#29 Tinnitus (Ringing in Ears): Causes & Treatment
https://my.clevelandclinic.org/health/symptoms/14164-tinnitus
Tinnitus treatment depends on the cause. To learn more about the ringing in your ears, a healthcare provider (usually an audiologist) will do a physical examination and check your ears for any obvious issues. […] Because tinnitus is a symptom of many conditions, providers may be able to treat it by addressing the underlying cause. But they may need to run tests to get an accurate diagnosis. […] For many people, tinnitus sound therapy can be very effective in decreasing how noticeable or bothersome your tinnitus is over time. […] Left untreated, ringing in your ears could lead to: Anxiety. […] Audiologists can fit custom hearing protection. Consider seeing an audiologist for this service if you participate in one or more of these activities frequently. […] The experts at Cleveland Clinic can make a treatment plan to help manage your tinnitus.
#30 Tinnitus: Care Instructions | Kaiser Permanente
https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.tinnitus-care-instructions.uf7982
Tinnitus is usually caused by long-term exposure to loud noise. This damages the nerves in the inner ear. It can occur with all types of hearing loss. It may be a symptom of almost any ear problem. […] Your doctor may suggest one or more treatments to help you cope with it. You can also do things at home to help reduce symptoms. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. […] Talk to your doctor about whether to stop taking aspirin and similar products such as ibuprofen or naproxen. […] Watch closely for changes in your health, and be sure to contact your doctor if: Your tinnitus moves from both ears to one ear. Your hearing loss gets worse within 1 day after an ear injury. Your tinnitus or hearing loss does not get better within 1 week after an ear injury. Your tinnitus bothers you enough that you want to take medicines to help you cope with it.
#31
https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf7982
Many people have some ringing sounds in their ears once in a while. […] Ringing in the ears that doesn’t get better or go away is called tinnitus. […] Your doctor may suggest one or more treatments to help you cope with it. You can also do things at home to help reduce symptoms. […] Follow-up care is a key part of your treatment and safety. […] Do not smoke or use other tobacco products. Nicotine reduces blood flow to the ear and makes tinnitus worse. […] Relax using biofeedback, meditation, or yoga. Feeling stressed and being tired can make tinnitus worse. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: Your tinnitus moves from both ears to one ear. […] Your tinnitus bothers you enough that you want to take medicines to help you cope with it.
#32 Tinnitus: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/tinnitus/
Maintains hearing or regains loss of hearing by receiving a hearing aid […] Understands how to use and care for a hearing aid […] Individual/Caregiver Education […] Provide the following education: […] Continue to attend follow-up appointments with the healthcare provider […] Condition, treatment, and expected outcomes […] Medication regimen […] Notify a healthcare provider of: […] Worsening symptoms […] Sudden changes in vision […] Feeling dizzy […] Loss of hearing […] Sudden numbness, tingling, or weakness in your face […] Change in balance […] Nausea or vomiting […] Avoid products containing aspirin unless recommended by the healthcare provider […] Avoid attending activities that have a high level of noise such as: […] Concerts […] Vehicle races […] Sporting events […] Continue to use music or white noise as directed by the healthcare provider
#33 Tinnitus: Care Instructions | Kaiser Permanente
https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.tinnitus-care-instructions.uf7982
Tinnitus is usually caused by long-term exposure to loud noise. This damages the nerves in the inner ear. It can occur with all types of hearing loss. It may be a symptom of almost any ear problem. […] Your doctor may suggest one or more treatments to help you cope with it. You can also do things at home to help reduce symptoms. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. […] Talk to your doctor about whether to stop taking aspirin and similar products such as ibuprofen or naproxen. […] Watch closely for changes in your health, and be sure to contact your doctor if: Your tinnitus moves from both ears to one ear. Your hearing loss gets worse within 1 day after an ear injury. Your tinnitus or hearing loss does not get better within 1 week after an ear injury. Your tinnitus bothers you enough that you want to take medicines to help you cope with it.
#34
https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf7982
Many people have some ringing sounds in their ears once in a while. […] Ringing in the ears that doesn’t get better or go away is called tinnitus. […] Your doctor may suggest one or more treatments to help you cope with it. You can also do things at home to help reduce symptoms. […] Follow-up care is a key part of your treatment and safety. […] Do not smoke or use other tobacco products. Nicotine reduces blood flow to the ear and makes tinnitus worse. […] Relax using biofeedback, meditation, or yoga. Feeling stressed and being tired can make tinnitus worse. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: Your tinnitus moves from both ears to one ear. […] Your tinnitus bothers you enough that you want to take medicines to help you cope with it.
#35 Tinnitus: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/tinnitus/
Decreased hearing capacity […] Disturbed sleep pattern related to tinnitus as evidenced by: […] Continuous ringing or buzzing sound in ears […] Interventions […] Follow up with a healthcare provider or audiologist […] Assist the person with setting up or attending an appointment for audiology testing […] Assist the person with how to use and care for a hearing aid […] Help the person to maintain routine sleep hygiene […] Recommend a white noise machine […] Monitor for changes in hearing status […] Monitor for signs of depression […] Decrease stimulation […] Maintain a quiet atmosphere […] Speak slowly and clearly […] Eliminate background noises […] Expected Outcomes […] Remains free of depression […] Improved quality of sleep […] Verbalizes minimal or no anxiety
#36 Patient education: Tinnitus (ringing in the ears) (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/tinnitus-ringing-in-the-ears-beyond-the-basics
Patient education: Tinnitus (ringing in the ears) (Beyond the Basics) […] Tinnitus is the perception of a ringing, buzzing, hissing, or roaring sound in one or both ears. […] Although tinnitus can be annoying, it is not usually a sign of a serious problem. There are ways to mask and adapt to the symptoms to minimize the impact of tinnitus on daily life. […] The management of tinnitus involves treating any underlying disorders or abnormalities as well as addressing the tinnitus itself. Although there is no cure for most cases of chronic tinnitus, there are ways to manage the condition. […] Hearing aids may improve tinnitus symptoms in people with age-related hearing loss. […] Depression is common in people with tinnitus. Safe and effective treatments for depression are available and antidepressant medications may improve the symptoms of tinnitus in some people.
#37 Who To See for Tinnitus Help | American Tinnitus Association
https://www.ata.org/about-tinnitus/why-are-my-ears-ringing/who-should-i-see-for-help/
If you, or someone you know, have tinnitus that is causing a problem, you can seek help from a variety of healthcare providers, including, but not limited to, audiologists, otolaryngologists, psychologists, licensed clinical social workers, dentists, and physical therapists. […] It is important to note that individual providers may not specialize in the evaluation and management of tinnitus. […] Audiologists may recommend hearing aids to make day-to-day listening easier, improve awareness, and help with tinnitus. […] Some audiologists may also have additional training in the specialized evaluation and management of tinnitus and provide services such as Tinnitus Retraining Therapy, Tinnitus Activities Treatment, Progressive Tinnitus Management, etc. […] If your tinnitus continues beyond a week, becomes bothersome, starts to interfere with your sleep and/or your concentration, or makes you depressed or anxious, seek help from a trained healthcare professional.
#38
https://journals.lww.com/tnpj/fulltext/2012/10000/tinnitus_evaluation_in_primary_care.6.aspx
The exact physiology of tinnitus is unknown, but a variety of conditions and environmental exposures can lead to the development of the symptom. These underlying conditions range from simple cerumen impactions to more serious ones such as acoustic neuromas or arteriovenous malformations that require immediate attention. […] Since tinnitus is a subjective symptom, history and physical exam are important to identify possible causes. Although diagnostic testing is limited in primary care settings, the nurse practitioner (NP) can use basic screening tools to decide if more extensive testing is needed. In addition, benign etiologies can usually be distinguished from those requiring an immediate referral to a specialist. […] Tinnitus management is based on the underlying cause of the symptom. The symptom may be mild, and removal of the cause, such as infection or medication, can result in reversal or nonprogression. Evaluation may indicate that no treatment is needed. Any obvious underlying health condition, including dental issues or TMJ dysfunction, should be treated. Management of tinnitus often requires an interdisciplinary approach.
#39 Who To See for Tinnitus Help | American Tinnitus Association
https://www.ata.org/about-tinnitus/why-are-my-ears-ringing/who-should-i-see-for-help/
If you, or someone you know, have tinnitus that is causing a problem, you can seek help from a variety of healthcare providers, including, but not limited to, audiologists, otolaryngologists, psychologists, licensed clinical social workers, dentists, and physical therapists. […] It is important to note that individual providers may not specialize in the evaluation and management of tinnitus. […] Audiologists may recommend hearing aids to make day-to-day listening easier, improve awareness, and help with tinnitus. […] Some audiologists may also have additional training in the specialized evaluation and management of tinnitus and provide services such as Tinnitus Retraining Therapy, Tinnitus Activities Treatment, Progressive Tinnitus Management, etc. […] If your tinnitus continues beyond a week, becomes bothersome, starts to interfere with your sleep and/or your concentration, or makes you depressed or anxious, seek help from a trained healthcare professional.
#40 Tinnitus Management Clinic | Cleveland Clinic
https://my.clevelandclinic.org/departments/head-neck/depts/tinnitus-management-clinic
Cleveland Clinic’s Tinnitus Management Clinic (TMC) provides a comprehensive approach to the evaluation and management of patients with tinnitus through a multidisciplinary team focused on patient care, education and research. […] While there is no evidence-based cure for tinnitus, there are options for managing tinnitus symptoms. Most of our patients benefit from one or a combination of management options. […] For patients with both hearing loss and tinnitus, treatment of the hearing loss is an essential aspect of tinnitus management. […] You will learn about the prevalence of tinnitus, potential causes of tinnitus, anatomy and physiology of the head and neck as it relates to tinnitus and a variety of management options. Segments of the presentation will cover the role of audiology, dentistry, neurology, psychology, and physical therapy in tinnitus management. […] During those visits a comprehensive evaluation will be conducted and a management plan designed.
#41 Tinnitus Treatment Program | UPMC Center for Audiology
https://www.upmc.com/services/ear-nose-throat/services/hearing-and-balance/audiology/tinnitus-treatment
People with tinnitus (noise in the ears) and decreased sound tolerance have access to an innovative treatment program at the UPMC Center for Audiology and Hearing Aids. […] Our goal is to evaluate, diagnose, and treat tinnitus and decreased sound tolerance so effectively that it will no longer be a problem. […] Our center employs a multidisciplinary approach to diagnosing and treating tinnitus and decreased sound tolerance. […] Our team consists of: Nursing staff. […] The first step to treatment is a medical and audiological evaluation. […] The audiologist will perform an array of tests that will provide information about your tinnitus, hearing, and decreased sound tolerance. […] After your evaluation at UPMC’s Center for Audiology and Hearing Aids, the next step is a counseling session.
#42 Tips for Helping Your Patients Manage Tinnitus | Rendia
https://rendia.com/resources/insights/helping-patients-manage-tinnitus/
Sound therapy is another common and often effective method for alleviating tinnitus symptoms. One example is sound masking devices or applications that provide generic background noise such as white noise, nature sounds, or other subtle sounds that can temporarily mask a patients perception of tinnitus and provide relaxation and relief. […] Hearing aids and sound therapy can help some tinnitus patients; others will need a referral to an ENT to determine if underlying conditions are present. […] Some tinnitus cases will require a referral to an ENT for a comprehensive medical exam. According to AudiologyOnline, these include: Sudden onset of tinnitus, or tinnitus thats unilateral (occurring on only one side of the body), which could indicate underlying disease; Audiometric testing suggests otologic or neuro-otologic conditions such as an acoustic neuroma, or a middle ear condition such as otosclerosis. In some cases, treatment of the underlying medical condition may resolve the tinnitus; Comorbidities such as anxiety, depression, or insomnia; Systemic diseases such as hypertension, autoimmune disease, and abnormal thyroid functioning.
#43
https://journals.lww.com/tnpj/fulltext/2012/10000/tinnitus_evaluation_in_primary_care.6.aspx
Patients with tinnitus may be desperate to find any type of relief and turn to the Internet for information. The NP needs to steer the patient to reliable information. Beneficial resources for patients and families about tinnitus and its management are the American Tinnitus Association and the American Academy of Otolaryngology-Head and Neck Surgery. […] Tinnitus can be a bothersome symptom that affects quality of life. In some cases, this symptom may be a warning sign of a more ominous vascular condition. Although the underlying causes are numerous, taking a focused history and physical is the key to determining possible etiologies. Benign causes may require little testing. Unilateral or pulsatile tinnitus warrants immediate referral to the otolaryngologist or emergency department for evaluation of cause. Management of tinnitus is determined by the severity of the symptom, and may warrant an interdisciplinary approach including the NP, physician, audiologist, therapist, or counselor. Severe cases necessitate referral for evaluation by medical or dental specialists. In nonbenign cases, surgical intervention is often necessary. However, in most patients with tinnitus, education and the use of targeted devices are the only necessary treatments.
#44 Pulsatile Tinnitus Causes and Treatments | UCSF Radiology
https://radiology.ucsf.edu/pulsatile-tinnitus
Pulsatile Tinnitus can have many different origins, some fairly benign, others potentially life-threatening. […] Even when the causes of Pulsatile Tinnitus are fairly benign, its effects are sufficiently incapacitating for most patients to seek help. […] Pulsatile tinnitus can be a symptom of a dangerous problem with the blood vessels in the head, but not always. […] Therefore, pulsatile tinnitus should prompt you to see a doctor to further assist you. Pulsatile tinnitus can also significantly impact your mood, and sometimes needs to be treated for this. […] Yes. Unfortunately not all physicians are experienced in pulsatile tinnitus, and referral to a high volume institution such as ours may be needed. […] Understanding what is causing the pulsatile tinnitus is key to determining the best course of action. […] A doctor should help you determine whether your pulsatile tinnitus is dangerous or not, and then you can decide whether to leave it untreated or not. […] Our team are experts in the diagnosis and treatments of all causes of pulsatile tinnitus.
#45 Treatment for Tinnitus | Stanford Health Care
https://stanfordhealthcare.org/medical-conditions/ear-nose-and-throat/tinnitus/treatments.html
Specific treatment for tinnitus will be determined by your physician based on: […] Currently, there is no known cure for tinnitus. However, experts suggest trying one of the following to find relief: […] Hearing aids – may benefit some people with tinnitus who have hearing loss. Using a hearing aid may help some people with tinnitus by making some sounds louder. […] Maskers – provide help for some individuals by making tinnitus less noticeable. This small electronic device creates sound that may make the ringing or roaring seem softer. […] Medications – may ease tinnitus by addressing a problem related to the condition. […] Tinnitus retraining therapy – uses a combination of counseling and maskers. Otolaryngologists and audiologists can help a person learn how to deal with the tinnitus. […] Counseling – offers a person with tinnitus the opportunity to meet with a counselor or support group. […] Relaxing – provides relief for some people as stress may make tinnitus worse.
#46 Treatment for Tinnitus | Stanford Health Care
https://stanfordhealthcare.org/medical-conditions/ear-nose-and-throat/tinnitus/treatments.html
Specific treatment for tinnitus will be determined by your physician based on: […] Currently, there is no known cure for tinnitus. However, experts suggest trying one of the following to find relief: […] Hearing aids – may benefit some people with tinnitus who have hearing loss. Using a hearing aid may help some people with tinnitus by making some sounds louder. […] Maskers – provide help for some individuals by making tinnitus less noticeable. This small electronic device creates sound that may make the ringing or roaring seem softer. […] Medications – may ease tinnitus by addressing a problem related to the condition. […] Tinnitus retraining therapy – uses a combination of counseling and maskers. Otolaryngologists and audiologists can help a person learn how to deal with the tinnitus. […] Counseling – offers a person with tinnitus the opportunity to meet with a counselor or support group. […] Relaxing – provides relief for some people as stress may make tinnitus worse.
#47 Tinnitus Diagnosis and Treatment | University Hospitals | Cleveland, Ohio | University Hospitals
https://www.uhhospitals.org/services/ear-nose-and-throat-services/conditions-and-treatments/tinnitus
Amplification. If a patient has hearing loss AND tinnitus, a hearing aid will help the patient hear ambient sounds that can take the focus away from the tinnitus. […] Maskers. A device that resembles a hearing aid and produces a shhh sound to cover the tinnitus. […] Retraining therapy. Attempts to retrain the brain to ignore the tinnitus sounds. The duration of this treatment can be more than one year. […] Cognitive behavior therapy. Helps patients identify and alter maladaptive thoughts and behaviors and achieve relief. […] Biofeedback. Teaches stress management and how to control your blood pressure, heart rate and skin temperature. […] Drug therapy. Some medications have been investigated for use in relieving tinnitus; however, medications are primarily used to help with anxiety, depression and sleep difficulties that can be associated with tinnitus. Treating these problems can indirectly help the tinnitus patient.
#48 Tinnitus Diagnosis and Treatment | University Hospitals | Cleveland, Ohio | University Hospitals
https://www.uhhospitals.org/services/ear-nose-and-throat-services/conditions-and-treatments/tinnitus
Amplification. If a patient has hearing loss AND tinnitus, a hearing aid will help the patient hear ambient sounds that can take the focus away from the tinnitus. […] Maskers. A device that resembles a hearing aid and produces a shhh sound to cover the tinnitus. […] Retraining therapy. Attempts to retrain the brain to ignore the tinnitus sounds. The duration of this treatment can be more than one year. […] Cognitive behavior therapy. Helps patients identify and alter maladaptive thoughts and behaviors and achieve relief. […] Biofeedback. Teaches stress management and how to control your blood pressure, heart rate and skin temperature. […] Drug therapy. Some medications have been investigated for use in relieving tinnitus; however, medications are primarily used to help with anxiety, depression and sleep difficulties that can be associated with tinnitus. Treating these problems can indirectly help the tinnitus patient.
#49 Patient education: Tinnitus (ringing in the ears) (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/tinnitus-ringing-in-the-ears-beyond-the-basics
A number of behavioral therapies can help a person to live with chronic tinnitus. […] Tinnitus retraining therapy (TRT) involves retraining the subconscious part of the auditory system to accept the sounds associated with tinnitus as normal, natural sounds rather than annoying sounds. […] Masking devices resemble hearing aids and produce low-level sounds, which help to reduce or eliminate the tinnitus noise in some patients. […] Biofeedback is a relaxation technique that teaches a person to control certain body functions, such as heart and breathing rate. […] The goal of cognitive behavioral therapy (CBT) is to teach patients to manage their psychological responses to tinnitus. […] The impact of tinnitus on everyday life varies, often depending upon the severity of the tinnitus noise. About 25 percent of sufferers report an increase in tinnitus severity over time. Long-term tinnitus is unlikely to go away completely. However, it often becomes less bothersome over time, especially when hearing loss is also present.
#50 Tinnitus (Ringing in the Ears) | Froedtert & MCW
https://www.froedtert.com/tinnitus
Although negative psychological or emotional reactions are associated with distressing tinnitus, it isnt all in your head. Tinnitus is a real problem it is not imagined. Almost all patients indicate that stress or tension makes their tinnitus worse. Since stress is highly correlated with tinnitus increases, stress management and nervous system regulation strategies are often used. […] Other management options include: Tinnitus coaching, Counseling, Stress management, Relaxation therapy, Habituation therapies, TMJD treatment, Acupuncture, Physical therapy. […] Our tinnitus specialists are trained in using multiple tools to address all possible related issues. If hearing aids have been recommended, you can work with a tinnitus-trained professional to ensure the appropriate style and features are available to maximize your hearing and reduce tinnitus-related issues.
#51 Evaluation and Treatment of Tinnitus: A Comparative Effectiveness Review | Effective Health Care (EHC) Program
https://effectivehealthcare.ahrq.gov/products/tinnitus/research-protocol
No drug has been approved by the U.S. Food and Drug Administration (FDA) for treating tinnitus. However, various pharmacological treatments, including antidepressants, anxiolytics, vasodilators and vasoactive substances, and intravenous lidocaine have been prescribed for tinnitus. These treatments have been indirect solutions because they focus on tinnitus-associated symptoms such as depression, stress, or sleep disturbance. […] […] Tinnitus, vertigo, and otalgia are symptoms that have been linked to temporomandibular joint (TMJ) disease. TMJ disease consists of a collection of medical and dental conditions that affect the temporomandibular joint, masticulatory muscles, and/or the adjoining structures and cause pain and tenderness, most frequently felt in the jaw and the temple but also in the ear and surrounding area. Treatment of TMJ disease can range from the use of dental orthotics and self-care instructions to surgery in instances where injury to the jaw is the underlying cause. […]
#52 Tinnitus: Symptoms, Causes, and Treatments for Ringing in the Ears
https://resources.healthgrades.com/right-care/ear-nose-and-throat/tinnitus
Healthcare professionals have investigated many medications for treating tinnitus, but there is no single medication that can make tinnitus go away. These medicines may be effective for tinnitus or the problems it can cause: antianxiety drugs, antidepressants, anticonvulsants, acamprosate (Campral), sedatives. […] Your doctor will manage any treatable underlying causes of tinnitus, which may make your symptoms go away. This may include assessing your medications to determine whether any are causing the symptoms.
#53 Evaluation and Treatment of Tinnitus: A Comparative Effectiveness Review | Effective Health Care (EHC) Program
https://effectivehealthcare.ahrq.gov/products/tinnitus/research-protocol
Various clinical evaluation instruments, as identified above, can be used to characterize a subjective diagnosis and evaluate the severity of tinnitus. Some patients with tinnitus may receive no treatment following a medical examination with education and assurance of the benign nature of the phenomenon. The complex relationships between tinnitus and a range of physical and mental health conditions have complicated the development and the evaluation of intervention strategies. Comorbidities such as hearing loss, mental health problems, or sleep disorders may modulate the experience of tinnitus and direct treatment of those conditions may help to alleviate reactions to tinnitus. […] […] For cases of subjective idiopathic tinnitus in which tinnitus-specific intervention is indicated, the patient can be treated by suggesting ways to cope with the discomfort associated with tinnitus, including sound therapy or relaxation or stress-reduction techniques. Treatment methods are not able to reduce or eliminate the sensation of tinnitus on any consistent basis. Therefore, treatment should focus on providing methods to reduce reactions to tinnitus. While drugs are used for tinnitus, there is no drug that has been approved specifically for its treatment. Behavioral methods should be used before considering the use of drugs. […]
#54
https://journals.lww.com/tnpj/fulltext/2012/10000/tinnitus_evaluation_in_primary_care.6.aspx
Tinnitus is a common, yet poorly understood problem. This symptom has many causes, both benign as well as serious. Patients can experience significant changes in quality-of-life related to symptom severity and duration. This article explores causes of tinnitus, evaluation in a primary care setting, and management strategies. […] Tinnitus is a significant clinical issue that can impact a patient’s quality of life, cause anxiety, and negatively impact activities of daily living. It affects concentration, emotional stability, sleep habits, work productivity, and social activity. […] The degree of discomfort may be mild, moderate, or intense and is often unrelated to the loudness of the tinnitus. Patients with mild tinnitus may perceive the symptom only in particular situations, and a patient with moderate tinnitus is aware of the symptom but is not bothered by it. Patients with intense tinnitus are disturbed by the ever-present sensation and view it as unbearable.
#55
https://journals.lww.com/tnpj/fulltext/2012/10000/tinnitus_evaluation_in_primary_care.6.aspx
Tinnitus is a common, yet poorly understood problem. This symptom has many causes, both benign as well as serious. Patients can experience significant changes in quality-of-life related to symptom severity and duration. This article explores causes of tinnitus, evaluation in a primary care setting, and management strategies. […] Tinnitus is a significant clinical issue that can impact a patient’s quality of life, cause anxiety, and negatively impact activities of daily living. It affects concentration, emotional stability, sleep habits, work productivity, and social activity. […] The degree of discomfort may be mild, moderate, or intense and is often unrelated to the loudness of the tinnitus. Patients with mild tinnitus may perceive the symptom only in particular situations, and a patient with moderate tinnitus is aware of the symptom but is not bothered by it. Patients with intense tinnitus are disturbed by the ever-present sensation and view it as unbearable.
#56 Tinnitus | Conditions | UCSF Health
https://www.ucsfhealth.org/conditions/tinnitus
Tinnitus is a perception of sound often described as a ringing, buzzing or humming in the ears or head that affect millions of people. […] For some, tinnitus symptoms are associated with depression, anxiety, sleep disturbance and interference with concentration. […] At UCSF, our audiologists and ear specialists provide state-of-the-art evaluation and treatment for tinnitus. […] We also have a variety of treatment options to improve symptoms. […] Often, the best treatment plan includes a combination of behavioral counseling and acoustic therapy. […] Counseling helps patients manage the depression, anxiety and distraction that can accompany tinnitus. […] Our team works with each patient to tailor a plan to individual needs. […] If you think that you have tinnitus, consult your doctor to determine if a cause for the tinnitus can be found and subsequently treated.
#57
https://journals.lww.com/tnpj/fulltext/2012/10000/tinnitus_evaluation_in_primary_care.6.aspx
Tinnitus is a common, yet poorly understood problem. This symptom has many causes, both benign as well as serious. Patients can experience significant changes in quality-of-life related to symptom severity and duration. This article explores causes of tinnitus, evaluation in a primary care setting, and management strategies. […] Tinnitus is a significant clinical issue that can impact a patient’s quality of life, cause anxiety, and negatively impact activities of daily living. It affects concentration, emotional stability, sleep habits, work productivity, and social activity. […] The degree of discomfort may be mild, moderate, or intense and is often unrelated to the loudness of the tinnitus. Patients with mild tinnitus may perceive the symptom only in particular situations, and a patient with moderate tinnitus is aware of the symptom but is not bothered by it. Patients with intense tinnitus are disturbed by the ever-present sensation and view it as unbearable.
#58 Who To See for Tinnitus Help | American Tinnitus Association
https://www.ata.org/about-tinnitus/why-are-my-ears-ringing/who-should-i-see-for-help/
It is also important that tinnitus patients educate themselves about tinnitus and its management so they can be their own advocates in the healthcare process. […] While it is true that there are no cures for subjective tinnitus, there are proven tools that can significantly lower the burden of tinnitus and improve a patientâs overall quality of life. […] A behavioral health therapist can help a tinnitus patient cope more effectively with the negative emotions associated with tinnitus. […] Many of the best tinnitus management therapies (cognitive behavioral therapy and tinnitus retraining therapy, for instance) require ongoing, active patient participation, over the course of 3-12 months. […] Patients who successfully manage their tinnitus often have strong support networks to help them during challenging periods.
#59 Who To See for Tinnitus Help | American Tinnitus Association
https://www.ata.org/about-tinnitus/why-are-my-ears-ringing/who-should-i-see-for-help/
It is also important that tinnitus patients educate themselves about tinnitus and its management so they can be their own advocates in the healthcare process. […] While it is true that there are no cures for subjective tinnitus, there are proven tools that can significantly lower the burden of tinnitus and improve a patientâs overall quality of life. […] A behavioral health therapist can help a tinnitus patient cope more effectively with the negative emotions associated with tinnitus. […] Many of the best tinnitus management therapies (cognitive behavioral therapy and tinnitus retraining therapy, for instance) require ongoing, active patient participation, over the course of 3-12 months. […] Patients who successfully manage their tinnitus often have strong support networks to help them during challenging periods.
#60 Progressive Tinnitus Management
https://www.research.va.gov/research_in_action/Progressive-Tinnitus-Management.cfm
Progressive Tinnitus Management is an audiology program that has been adopted nationwide in both VA and Department of Defense clinics to treat tinnitus. […] Tinnitus is ringing, buzzing, whistling, or other sounds in the ears without an external source. The condition can disrupt sleep, affect a person’s work and social life, and sharply increase the risk of depression or anxiety. […] The program approaches tinnitus care with five different levels of treatment. Most patients need only basic education on how to manage the condition. As the levels progress, therapy gets more intensive and long-term. Patients needing higher levels of care might use sound generators or other approaches such as tinnitus masking or cognitive behavioral therapy. […] NCRAR has developed clinical handbooks and other educational material on tinnitus care. A manual called How to Manage Your Tinnitus: A Step-by-Step Workbook is now used widely in VA clinics and patients. […] VA researchers recently developed a telehealth version of progressive tinnitus management. A controlled trial showed that the program can improve tinnitus outcomes when delivered remotely.
#61 Evaluation and Treatment of Tinnitus: A Comparative Effectiveness Review | Effective Health Care (EHC) Program
https://effectivehealthcare.ahrq.gov/products/tinnitus/research-protocol
Electrical stimulation has been used to stimulate the auditory system and has been shown to provide tinnitus relief in some cases. However, the underlying mechanisms of this effect are not yet understood, and no commercial treatment using this technique is currently available. Transcranial magnetic stimulation (TMS), although not commonly used, delivers an electrical field to the cerebral cortices modulating the excitability in the area of the cerebral cortex believed to be associated with tinnitus. […] […] Complementary and alternative medicine therapies including Gingko biloba extracts, acupuncture, and hyperbaric oxygen are also being used by patients with tinnitus. Extracts from G. biloba leaves are a traditional Chinese medicinal treatment used to increase blood flow, inhibit the platelet-activating factor, alter neuron metabolism, and prevent free radicals from damaging cell membranes. […]
#62 Lenire Â® – Tinnitus Treatment Using Bimodal Neuromodulation
https://www.lenire.com/
Tinnitus can be distressing and cause sleep, social and concentration issues. Lenire soothes tinnitus so you can live life your way. […] Lenire works with hearing care and tinnitus experts worldwide to ensure patients receive the best quality of care. […] Lenire is a bimodal neuromodulation device that treats Subjective Tinnitus. […] If you are experiencing tinnitus, it is recommended to seek advice from a medical professional with an understanding of tinnitus. […] It is recommended that people who notice tinnitus should speak with an audiologist that specialises in tinnitus care. […] Lenire is clinically proven to provide relief from tinnitus. Lenires clinical trials have demonstrated that the medical device is effective at soothing tinnitus and can provide long term relief. Additionally, Lenire has been proven to be more effective than audio-only therapy at soothing tinnitus.
#63 Lenire Â® – Tinnitus Treatment Using Bimodal Neuromodulation
https://www.lenire.com/
Tinnitus can be distressing and cause sleep, social and concentration issues. Lenire soothes tinnitus so you can live life your way. […] Lenire works with hearing care and tinnitus experts worldwide to ensure patients receive the best quality of care. […] Lenire is a bimodal neuromodulation device that treats Subjective Tinnitus. […] If you are experiencing tinnitus, it is recommended to seek advice from a medical professional with an understanding of tinnitus. […] It is recommended that people who notice tinnitus should speak with an audiologist that specialises in tinnitus care. […] Lenire is clinically proven to provide relief from tinnitus. Lenires clinical trials have demonstrated that the medical device is effective at soothing tinnitus and can provide long term relief. Additionally, Lenire has been proven to be more effective than audio-only therapy at soothing tinnitus.
#64 Evaluation and Treatment of Tinnitus: A Comparative Effectiveness Review | Effective Health Care (EHC) Program
https://effectivehealthcare.ahrq.gov/products/tinnitus/research-protocol
Electrical stimulation has been used to stimulate the auditory system and has been shown to provide tinnitus relief in some cases. However, the underlying mechanisms of this effect are not yet understood, and no commercial treatment using this technique is currently available. Transcranial magnetic stimulation (TMS), although not commonly used, delivers an electrical field to the cerebral cortices modulating the excitability in the area of the cerebral cortex believed to be associated with tinnitus. […] […] Complementary and alternative medicine therapies including Gingko biloba extracts, acupuncture, and hyperbaric oxygen are also being used by patients with tinnitus. Extracts from G. biloba leaves are a traditional Chinese medicinal treatment used to increase blood flow, inhibit the platelet-activating factor, alter neuron metabolism, and prevent free radicals from damaging cell membranes. […]
#65 Tinnitus | Conditions | UCSF Health
https://www.ucsfhealth.org/conditions/tinnitus
Psychological intervention aimed at successfully reducing the stress, distress and distraction associated with the tinnitus can be very productive and often produces the most attainable goals. […] The very high correlation between stress and tinnitus disturbance underscores the need to maintain one’s composure and logic when trying to cope with tinnitus. […] Other options that may help patients with tinnitus include: Support groups, Dental treatment, Nutritional counseling, Biofeedback, Alternate approaches.
#66 Assessing the Quality of Nursing Care in Tinnitus Management: A Systematic Review
https://www.tinnitusjournal.com/articles/assessing-the-quality-of-nursing-care-in-tinnitus-management-a-systematic-review-30383.html
The purpose of this research therefore is to undertake a systematic review that evaluates the quality of care delivered to patients with tinnitus in KSA. […] The quality assessment of the selected studies therefore entailed consideration of their methodological stand and suitability in the Saudi context. […] The synthesis described some of the areas these papers covered including, efficiency of different nursing activities, patients satisfaction and influence on the alleviation of symptoms. […] This systematic review highlights a number of deficiencies in the quality of nursing care for tinnitus treatment in Saudi Arabia thus calling for improved measures and guidelines. […] National guidelines on tinnitus care and provisions of periodical training programs for the nurses will enhance the quality of a care provided to a patient.
#67 Eligibility
https://hub.ihsinfo.org/tinnitus/tcp-program
Tinnitus affects approximately 15% of the overall population and roughly 80% – 90% of tinnitus sufferers also have aidable hearing loss. The Tinnitus Care Provider Certificate Program is a comprehensive workshop and assessment to help you care for patients with tinnitus. As a result of this program, you’ll have the skills necessary to help patients with tinnitus and the resources to market yourself as a Tinnitus Care Provider. […] Jurisdictions vary in their laws and rules related to tinnitus management and its place in the scope of practice for hearing aid specialists and other hearing healthcare professionals. All Tinnitus Care Provider Certificate Program participants and certificate holders are expected to understand and abide by all applicable local, state/provincial, and federal laws and rules governing scope of practice and permissible titles.
#68
https://www.ihsinfo.org/tinnitus
The Tinnitus Care Provider Certificate Program is a comprehensive course and assessment focused on tinnitus patient care involving physiology, psychology, measurement, management, and practice organization. Participants who complete the course and pass the assessment are awarded a Tinnitus Care Provider certificate. […] Completing the course is the first step to achieve this title. […] Complete the Tinnitus Care Provider Certificate Program by assessing the skills learned in the course. […] 94% Tinnitus Care Provider Program participants have reported considerable benefits, including professional growth, advanced education, and networking.
#69
https://www.ihsinfo.org/tinnitus
The Tinnitus Care Provider Certificate Program is a comprehensive course and assessment focused on tinnitus patient care involving physiology, psychology, measurement, management, and practice organization. Participants who complete the course and pass the assessment are awarded a Tinnitus Care Provider certificate. […] Completing the course is the first step to achieve this title. […] Complete the Tinnitus Care Provider Certificate Program by assessing the skills learned in the course. […] 94% Tinnitus Care Provider Program participants have reported considerable benefits, including professional growth, advanced education, and networking.
#70 Clinical Practice Guideline: Tinnitus – American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS)
https://www.entnet.org/quality-practice/quality-products/clinical-practice-guidelines/tinnitus/
The purpose of this guideline is to provide evidence-based recommendations for clinicians managing patients with tinnitus. The target audience is any clinician, including non-physicians, involved in managing these patients. Patients with tinnitus will often be evaluated by a variety of healthcare providers including primary care clinicians, specialty physicians, and non-physician providers such as audiologists and mental health professionals. The target patient population is limited to adults (18 years and older) with primary tinnitus that is persistent and bothersome. […] Research Needs section from Tinnitus CPG.
#71 Assessing the Quality of Nursing Care in Tinnitus Management: A Systematic Review
https://www.tinnitusjournal.com/articles/assessing-the-quality-of-nursing-care-in-tinnitus-management-a-systematic-review-30383.html
The purpose of this research therefore is to undertake a systematic review that evaluates the quality of care delivered to patients with tinnitus in KSA. […] The quality assessment of the selected studies therefore entailed consideration of their methodological stand and suitability in the Saudi context. […] The synthesis described some of the areas these papers covered including, efficiency of different nursing activities, patients satisfaction and influence on the alleviation of symptoms. […] This systematic review highlights a number of deficiencies in the quality of nursing care for tinnitus treatment in Saudi Arabia thus calling for improved measures and guidelines. […] National guidelines on tinnitus care and provisions of periodical training programs for the nurses will enhance the quality of a care provided to a patient.
#72 Assessing the Quality of Nursing Care in Tinnitus Management: A Systematic Review
https://www.tinnitusjournal.com/articles/assessing-the-quality-of-nursing-care-in-tinnitus-management-a-systematic-review-30383.html
The purpose of this research therefore is to undertake a systematic review that evaluates the quality of care delivered to patients with tinnitus in KSA. […] The quality assessment of the selected studies therefore entailed consideration of their methodological stand and suitability in the Saudi context. […] The synthesis described some of the areas these papers covered including, efficiency of different nursing activities, patients satisfaction and influence on the alleviation of symptoms. […] This systematic review highlights a number of deficiencies in the quality of nursing care for tinnitus treatment in Saudi Arabia thus calling for improved measures and guidelines. […] National guidelines on tinnitus care and provisions of periodical training programs for the nurses will enhance the quality of a care provided to a patient.
#73 Tinnitus: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/tinnitus/
Tinnitus Nursing Care Plan […] Nursing Considerations […] Tinnitus Assessment […] Assess signs and symptoms, such as: […] Airway, breathing, and circulation […] Vital signs […] Complaints of hearing loss […] Continuous ringing or buzzing in the ears […] Intermittent ringing or buzzing in the ears […] Vertigo or dizziness […] Insomnia […] Anxiety […] Depression signs or symptoms, such as: […] Overwhelming sadness […] Changes in sleep pattern […] Changes in appetite […] Decreased ability to complete activities of daily living […] A feeling of pressure in the ear […] Use of new medication […] Consuming ototoxic medications such as aspirin […] Nursing Diagnosis/Risk For […] Impaired verbal communication related to hearing loss as evidenced by: […] Congestion or fullness in the ears
#74 Tinnitus: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/tinnitus/
Decreased hearing capacity […] Disturbed sleep pattern related to tinnitus as evidenced by: […] Continuous ringing or buzzing sound in ears […] Interventions […] Follow up with a healthcare provider or audiologist […] Assist the person with setting up or attending an appointment for audiology testing […] Assist the person with how to use and care for a hearing aid […] Help the person to maintain routine sleep hygiene […] Recommend a white noise machine […] Monitor for changes in hearing status […] Monitor for signs of depression […] Decrease stimulation […] Maintain a quiet atmosphere […] Speak slowly and clearly […] Eliminate background noises […] Expected Outcomes […] Remains free of depression […] Improved quality of sleep […] Verbalizes minimal or no anxiety
#75 Tinnitus: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/tinnitus/
Maintains hearing or regains loss of hearing by receiving a hearing aid […] Understands how to use and care for a hearing aid […] Individual/Caregiver Education […] Provide the following education: […] Continue to attend follow-up appointments with the healthcare provider […] Condition, treatment, and expected outcomes […] Medication regimen […] Notify a healthcare provider of: […] Worsening symptoms […] Sudden changes in vision […] Feeling dizzy […] Loss of hearing […] Sudden numbness, tingling, or weakness in your face […] Change in balance […] Nausea or vomiting […] Avoid products containing aspirin unless recommended by the healthcare provider […] Avoid attending activities that have a high level of noise such as: […] Concerts […] Vehicle races […] Sporting events […] Continue to use music or white noise as directed by the healthcare provider
#76 Tinnitus
https://www.uvmhealth.org/medcenter/conditions-and-treatments/tinnitus
Your treatment plan will depend on your specific symptoms and their severity. We work with each patient individually to tailor an effective treatment plan. […] A hearing aid may be recommended if tests show that you have hearing loss along with tinnitus. Treating hearing loss can help reduce the perception of tinnitus. […] Ear level sound generators have a similar look and it as hearing aids. This device produces white noise or other suitable sounds that reduce the perception of your tinnitus. […] Tinnitus retraining therapy combines counseling with the use of an ear-level sound generator or combination hearing aid. The goal is to help you get used to and be desensitized to the tinnitus sound your hear. […] If deemed appropriate, your audiologist may recommend a cognitive behavior therapy with a behavioral health specialist. This specialist will work with you to develop an individualized treatment plan. […] The audiology specialists at the UVM Medical Center is one of the most experienced teams in the region. Our specialists have a combined 40 years of experience in caring for patients with tinnitus.