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What to do about tinnitus, the chronic ringing in your ears

A doctor examines a patient's ear in a clinic. (iStock)

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If you have ever had a ringing or buzzing in one or both ears after a live concert, you have experienced tinnitus — defined as the perception of noise where no external noise is present, according to the American Tinnitus Association. Aside from loud sound, a variety of issues, like excess ear wax, infections and nasal congestion, can cause short-term tinnitus.

After a loud event like a concert, the intrusive sounds usually fade within hours to days. But chronic tinnitus — where noise persistently waxes and wanes, or never disappears — affects about 11 percent of adults.

In some cases, this can lead to trouble sleeping or concentrating, isolation, anxiety, depression and stress. A 2019 research letter published in JAMA Otolaryngology Head & Neck Surgery found that women with undiagnosed tinnitus were even at increased risk of suicide.

Is there a covid-19 connection?

During the pandemic, reports of tinnitus rose, especially in people with covid-19. A study published online last March in the International Journal of Audiology estimated that almost 15 percent of those with covid-19 said they had tinnitus, often early in the course of the virus.

Can covid make your ears ring? What we know about its possible connection to tinnitus.

This typically lasted only a few days. But “there have been anecdotal reports from patients that they have experienced changes in hearing and tinnitus post-covid,” says Cleveland Clinic audiologist Sarah Sydlowski, president of the American Academy of Audiology. One theory is that the virus that causes covid-19 damages the auditory nerve at least temporarily, says Douglas Hildrew, an ear, nose, and throat (ENT) specialist at Yale Medicine.

Some people with chronic tinnitus have also seen an increase in severity after receiving the coronavirus vaccine. This is probably due to nerve inflammation and usually resolves within a couple of weeks, Hildrew says.

Diagnosing tinnitus

If you suddenly notice a new ringing or buzzing in the ears that lasts for more than a day or so, see an ENT as soon as possible, Hildrew says. “We can always prescribe steroids to reduce inflammation, especially if we think the tinnitus is due to an underlying viral infection,” he says. The doctor will also check your ears to rule out issues like an ear infection or Ménière’s disease, a chronic illness that sometimes causes vertigo and hearing loss, as well as tinnitus.

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After that, you’ll see an audiologist for a hearing check. “Tinnitus can be a sign of hearing loss,” says Angela Shoup, executive director of the Callier Center for Communication Disorders at the University of Texas at Dallas.

Finding relief

When tinnitus is related to hearing loss, a hearing aid can be helpful. Other treatments include:

Sound therapy. In some cases, your audiologist may suggest a white noise machine. “Tinnitus is usually most noticeable and annoying when someone is in a quiet setting,” Sydlowski says. “Using maskers, or even having a fan running or a radio in between stations, makes sure you are not in total quiet.”

Cognitive behavioral therapy (CBT). This teaches you to manage your response to tinnitus with coping strategies, distraction skills and relaxation techniques, says Lori Zitelli, director of the tinnitus retraining program at the University of Pittsburgh Medical Center. One 2018 study published in the journal Ear and Hearing found that CBT along with mindfulness techniques, such as meditation, significantly reduced tinnitus-related distress in about half of patients.

Tinnitus retraining therapy. Done by an audiologist, this involves training your brain to accept the sounds of tinnitus. In addition to counseling, you’ll wear a device that generates low-level noise all the time. Often, the best approach combines all three methods, Hildrew says. But while cannabidiol (or CBD), ginkgo biloba and melatonin have been touted for tinnitus, no research shows that they are effective, he says.

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