A medical history, physical examination, and a series of special tests can help determine precisely where the tinnitus is originating. It is helpful for the doctor to know if the tinnitus is constant, intermittent or pulsating (synchronous with the heart beat, referred to as pulsatile tinnitus), or is it associated with hearing loss or loss of balance (vertigo). All patients with persisting unexplained tinnitus need a hearing test (audiogram). Patterns of hearing loss may lead the doctor to the diagnosis.
Other tests, such as the auditory brain stem response (ABR), a computerized test of the hearing nerves and brain pathways, computer tomography scan (CT scan) or, magnetic resonance imaging (MRI scan) may be needed to rule out a tumor occurring on the hearing or balance nerve. These tumors are rare, but they can cause tinnitus.
What is the treatment of tinnitus?
After a careful evaluation, your doctor may find an identifiable cause and be able to treat or make recommendations to treat the tinnitus. Once you have had a thorough evaluation, an essential part of treatment is your own understanding of the tinnitus (what has caused it, the person's specific symptoms, and options for treatment).
Tinnitus medications
In many cases, there is no specific treatment for tinnitus. It may simply go away on its own, or it may be a permanent disability that the patient will have to "live with." Some otolaryngologists (ear specialists) have recommended niacin to treat tinnitus. However, there is no scientific evidence to suggest that niacin helps reduce tinnitus, and it may cause problems with skin flushing.
The drug gabapentin (Neurontin, Gabarone), was studied in high doses, and reduced the annoyance level of the tinnitus in some patients, but did not decrease the volume of the noise, and was not found to be better than placebo.
A 2005 study in Brazil using acamprosate (Campral), a drug used to treat alcoholism, showed a nearly 87% rate of relief of symptoms. Studies of this drug for treatment of tinnitus are currently ongoing in the United States.
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