Tinnitus or “ringing in the ear” is any noise in the ears that is audible to only you. It is not related to any sound that is heard in the environment. Outside sounds can aggravate tinnitus or even trigger it. The most important thing is there is hope and treatment to manage tinnitus.

Tinnitus is most evident when you are in a quiet environment, like when you are in bed. Often times, other noises “mask” or cover up the tinnitus. The analogy used most often is a candle—when a candle is in a bright room, its light is not as obvious. Same for tinnitus, it cannot be heard over the din of background noise. When a room is dark, that same candle appears brighter because it is the only source of light. In quiet, tinnitus seems so much louder because it is the only source of noise

Tinnitus can sound like crickets, high pitched whistles, pulsating noises, roaring sounds, white noise etc. There are over 50 million people in the United States alone that have tinnitus. It is rarely a debilitating condition but when it is, it requires attention.


Most often tinnitus is caused by any degree of hearing loss or loud noise exposure. Other less common causes can be medications, tension in your jaw, some disease processes, recent dental work and medical problems, such as Lyme’s disease.


Tinnitus treatment plans are always individualized. Many people have been very successful with noise management strategies that are as simple as listening to your IPod in quiet or hearing aids with tinnitus maskers. There are more complex programs like Tinnitus Retraining Therapy (TRT) or management programs like Serenade. There have also been people that have had success with the over the counter riboflavins that decrease the toxic stress that tinnitus can cause, thus reducing the magnitude of the tinnitus.

A team approach is always best. Mindfulness training and cognitive therapy has helped many people.

Evaluation Process

  1. Your tinnitus evaluation begins with your case history, including all supplements and medications.
  2. A complete audiology evaluation.
  3. Tympanometry with acoustic reflexes.
  4. Otoacoustic emissions (OAE).
  5. Tinnitus matching for frequency and intensity.
  6. Habituation attempts with masking.
  7. Treatment plan.
  8. Follow-ups.

What’s most important is there is treatment and there is hope.