If you have ringing in your ears, and you can’t hear the sounds you would like to hear, it can drive you crazy. Over 50 million people in the U.S. suffer from tinnitus (ringing in the ears).
Dr. Aaron Spingarn, board-certified ear, nose, and throat doctor at St. John’s Riverside Hospital discusses Tinnitus and the treatment options available if you suffer from this annoying and sometimes painful disorder.
Selected Podcast
Do You Have Ringing in Your Ears? It Might be Tinnitus
Featured Speaker:
Aaron Spingarn, MD
Aaron Spingarn, MD is a board-certified ear, nose, and throat doctor at St. John’s Riverside Hospital. Trained in California and New York, he is certified by the American Board of Otolaryngology. He was awarded his medical degree from the University of Southern California and completed his residency Otolaryngology and Head and Neck Surgery at Manhattan Eye, Ear, and Throat Hospital. He has a particular interest in hearing loss and diseases of the head and neck. Transcription:
Do You Have Ringing in Your Ears? It Might be Tinnitus
Melanie Cole (Host): If you have ringing in your ears and you can’t hear the sounds you would like to hear, it could drive you crazy. Over 50 million people in the United States suffer from tinnitus. My guest today is Dr. Aaron Spingarn. He’s a board-certified ENT at St. John’s Riverside Hospital. Dr. Spingarn what is tinnitus?
Aaron Spingarn, MD (Guest): Good after Melanie. Tinnitus is people who have ringing in the ears. It could be any sound that you hear that basically shouldn’t be there.
Melanie: So, is it something that comes and goes? Is it a constant ringing? What would send somebody to the doctor? How long would they have to have this before they go see somebody?
Dr. Spingarn: Some people have it on and off. Some people have it suddenly appear. For some people it comes and goes. It can be all over the map. And the time to go see a doctor is if you have it and if it is staying.
Melanie: Do we know what causes it?
Dr. Spingarn: In some cases, we do, in some cases we don’t. There are so many moving parts in an ear that any of them can malfunction and cause ringing in the ear and as a result, you need a medical evaluation to figure out if there is something that needs to be treated or if it’s something that you need to worry about or if it’s just something that’s going to be an annoyance.
Melanie: How do you diagnose it? Other people can’t hear it, right?
Dr. Spingarn: Most of the time. There is actually a kind of tinnitus that other people can hear but that’s kind of unusual. So, what you do is you go to an ear, nose and throat doctor and say I have this sound in my ear and the doctor will do a question and answer session and then an examination to look at your ears and try and figure out if there is something physically obvious that might be causing the problem because if there is that might be fixable. For instance, ear wax build-up inside the ear can sometimes be a cause. And then if there is nothing that needs to be obviously treated; then you are going to need some testing in order to figure out what the problem is.
Melanie: What kind of testing?
Dr. Spingarn: Typically, there is an audiogram which is just a measurement of your hearing. And then sometimes we are looking for deeper problems inside the nerve that connects your ear into your brainstem. And so, there are some computerized tests that are sometimes done for that. And some people even need a brain scan to look for deeper problems.
Melanie: Wow it can be really – it can make people crazy Dr. Spingarn, what have you seen that is the social impact of this? Because I think it would just be so frustrating.
Dr. Spingarn: For a lot of people, once they get used to it; which takes an adjustment period; it’s not a big deal in their life but there are some people that it affects so badly that they actually stop being social, they stop being around other people. It just takes over their lives.
Melanie: And what about triggers? Are certain things more likely to cause an onset like a concert or if you are at a party and loud people, a lot of people around?
Dr. Spingarn: Absolutely. Sometimes, loud noise exposures or just certain types of noise exposures can trigger it or if it’s just there all the time can make it worse.
Melanie: So, what can be done about it?
Dr. Spingarn: A lot of times, people have their medical evaluation and once we determine that it’s nothing to worry about; they relax about it and they don’t need any specific treatment. But for those people where it’s very frustrating or it’s very depressing or it’s just taking over their lives; they have the options to try and treat the emotional response to the tinnitus or to actually try and treat the noise itself and so if you are going for the treatment of the emotional reaction to it; then you typically end up seeing somebody like a mental health professional, but that’s not the same as trying to fix the problem. And then if you don’t have some horrible emotional reaction to it, but you want to treat it directly; then there is something called sound therapy that people can do where you basically take some sort of external sound and you try and use that to either distract or reduce the tinnitus that they have inside their own ears.
Melanie: Wow and so it doesn’t really make it go away, it’s just kind of giving them something else that overrides it. Is that correct?
Dr. Spingarn: Well it depends. Because there are different types of sound therapy and some of the sound therapies actually can reduce or even eliminate the ringing. The goal is typically to try and make it go away. But for those people who are not appropriate candidates for that type of therapy for whatever reason; then yes it just becomes a distracting issue. So, you use your sound therapy to create a different sound environment. For instance, in your bedroom at night, you turn on a fan or something that you can control. You can control that sound. You can control the volume of that sound and then it’s enough to sort of drown out the sound inside your head.
Melanie: Well you mentioned psychotherapy. Is there – is this like a behavioral cognitive therapy that somebody could go through and is there any medicational intervention for this?
Dr. Spingarn: Both actually are applicable. Cognitive behavioral therapy is a mental health treatment that doesn’t involve medications. So, it basically just helps you cope with your symptoms by talking through how you should be responding to it and that’s done medication-free. But some people don’t respond well to that or some people prefer medication and it’s perfectly reasonable in those cases to see somebody who can dispense medications. Again, the medication won’t fix the problem, but it can definitely modify how emotionally upset you get when you hear the sound.
Melanie: Oh, so the medications are intended like an antidepressant in a way where it would just help you to accept it more but there are no medications that can actually make the ringing go away?
Dr. Spingarn: That’s correct. It’s more of a coping strategy.
Melanie: Does it ever become surgical doctor?
Dr. Spingarn: It can. There are actually surgically treatable conditions that can cause ringing in the ear. Unfortunately, that’s a minority. But for instance, some people have a ringing in the ear because they have lost some hearing. Typically, that’s the most common reason why somebody would have ringing in their ear. And so, some types of hearing loss are surgically correctable. For instance, somebody might have an infection in their ear and the infection can be treated with medications or some people might have a whole in their eardrum related to something that happened to them. For instance, a trauma even or an infection that didn’t get treated and you can fix the whole in the eardrum. Some people even have a nerve disease or a tumor and that can potentially be treated with some kind of an operation or some other kind of treatment.
Melanie: And when we were talking about cognitive behavioral therapy; along those lines, are there some things as we think about triggers that people can do that can also help them as far as maybe blood pressure or caffeine, nicotine. Are any of these things? Does exercise, can that help? Are there any other things that we can do?
Dr. Spingarn: Absolutely. For some people, they have a ringing in the ear related to their blood pressure and if they do, then modifying the blood pressure by getting it treated can be very helpful. And so, nicotine and caffeine; those can definitely be contributing factors and so if you start living a healthier lifestyle; that can help some people.
Melanie: Wrap it up for us Dr. Spingarn with your best advice. If somebody is suffering from tinnitus and they are not sure where to turn or what to do; what do you tell them?
Dr. Spingarn: They need to see a qualified practitioner in the ear, nose and throat field. They need to have a good physical examination to look at their ears and make sure there isn’t something that needs to be fixed and then they need to have testing so that the proper medical advice can be given to them because for everybody it’s a different reason and we just need to figure out a diagnosis and then once we do then we can recommend some sort of appropriate treatment. You don’t have to continue to suffer. There are treatment options.
Melanie: Thank you so much doctor, for sharing your expertise. What great information and such a great summary and wrap up for people that they don’t have to suffer with this. Thank you again, for joining us. You’re listening to Riverside Radio HealthCast. For more information please visit www.riversidehealth.org, that’s www.riversidehealth.org. This is Melanie Cole. Thanks so much for tuning in.
Do You Have Ringing in Your Ears? It Might be Tinnitus
Melanie Cole (Host): If you have ringing in your ears and you can’t hear the sounds you would like to hear, it could drive you crazy. Over 50 million people in the United States suffer from tinnitus. My guest today is Dr. Aaron Spingarn. He’s a board-certified ENT at St. John’s Riverside Hospital. Dr. Spingarn what is tinnitus?
Aaron Spingarn, MD (Guest): Good after Melanie. Tinnitus is people who have ringing in the ears. It could be any sound that you hear that basically shouldn’t be there.
Melanie: So, is it something that comes and goes? Is it a constant ringing? What would send somebody to the doctor? How long would they have to have this before they go see somebody?
Dr. Spingarn: Some people have it on and off. Some people have it suddenly appear. For some people it comes and goes. It can be all over the map. And the time to go see a doctor is if you have it and if it is staying.
Melanie: Do we know what causes it?
Dr. Spingarn: In some cases, we do, in some cases we don’t. There are so many moving parts in an ear that any of them can malfunction and cause ringing in the ear and as a result, you need a medical evaluation to figure out if there is something that needs to be treated or if it’s something that you need to worry about or if it’s just something that’s going to be an annoyance.
Melanie: How do you diagnose it? Other people can’t hear it, right?
Dr. Spingarn: Most of the time. There is actually a kind of tinnitus that other people can hear but that’s kind of unusual. So, what you do is you go to an ear, nose and throat doctor and say I have this sound in my ear and the doctor will do a question and answer session and then an examination to look at your ears and try and figure out if there is something physically obvious that might be causing the problem because if there is that might be fixable. For instance, ear wax build-up inside the ear can sometimes be a cause. And then if there is nothing that needs to be obviously treated; then you are going to need some testing in order to figure out what the problem is.
Melanie: What kind of testing?
Dr. Spingarn: Typically, there is an audiogram which is just a measurement of your hearing. And then sometimes we are looking for deeper problems inside the nerve that connects your ear into your brainstem. And so, there are some computerized tests that are sometimes done for that. And some people even need a brain scan to look for deeper problems.
Melanie: Wow it can be really – it can make people crazy Dr. Spingarn, what have you seen that is the social impact of this? Because I think it would just be so frustrating.
Dr. Spingarn: For a lot of people, once they get used to it; which takes an adjustment period; it’s not a big deal in their life but there are some people that it affects so badly that they actually stop being social, they stop being around other people. It just takes over their lives.
Melanie: And what about triggers? Are certain things more likely to cause an onset like a concert or if you are at a party and loud people, a lot of people around?
Dr. Spingarn: Absolutely. Sometimes, loud noise exposures or just certain types of noise exposures can trigger it or if it’s just there all the time can make it worse.
Melanie: So, what can be done about it?
Dr. Spingarn: A lot of times, people have their medical evaluation and once we determine that it’s nothing to worry about; they relax about it and they don’t need any specific treatment. But for those people where it’s very frustrating or it’s very depressing or it’s just taking over their lives; they have the options to try and treat the emotional response to the tinnitus or to actually try and treat the noise itself and so if you are going for the treatment of the emotional reaction to it; then you typically end up seeing somebody like a mental health professional, but that’s not the same as trying to fix the problem. And then if you don’t have some horrible emotional reaction to it, but you want to treat it directly; then there is something called sound therapy that people can do where you basically take some sort of external sound and you try and use that to either distract or reduce the tinnitus that they have inside their own ears.
Melanie: Wow and so it doesn’t really make it go away, it’s just kind of giving them something else that overrides it. Is that correct?
Dr. Spingarn: Well it depends. Because there are different types of sound therapy and some of the sound therapies actually can reduce or even eliminate the ringing. The goal is typically to try and make it go away. But for those people who are not appropriate candidates for that type of therapy for whatever reason; then yes it just becomes a distracting issue. So, you use your sound therapy to create a different sound environment. For instance, in your bedroom at night, you turn on a fan or something that you can control. You can control that sound. You can control the volume of that sound and then it’s enough to sort of drown out the sound inside your head.
Melanie: Well you mentioned psychotherapy. Is there – is this like a behavioral cognitive therapy that somebody could go through and is there any medicational intervention for this?
Dr. Spingarn: Both actually are applicable. Cognitive behavioral therapy is a mental health treatment that doesn’t involve medications. So, it basically just helps you cope with your symptoms by talking through how you should be responding to it and that’s done medication-free. But some people don’t respond well to that or some people prefer medication and it’s perfectly reasonable in those cases to see somebody who can dispense medications. Again, the medication won’t fix the problem, but it can definitely modify how emotionally upset you get when you hear the sound.
Melanie: Oh, so the medications are intended like an antidepressant in a way where it would just help you to accept it more but there are no medications that can actually make the ringing go away?
Dr. Spingarn: That’s correct. It’s more of a coping strategy.
Melanie: Does it ever become surgical doctor?
Dr. Spingarn: It can. There are actually surgically treatable conditions that can cause ringing in the ear. Unfortunately, that’s a minority. But for instance, some people have a ringing in the ear because they have lost some hearing. Typically, that’s the most common reason why somebody would have ringing in their ear. And so, some types of hearing loss are surgically correctable. For instance, somebody might have an infection in their ear and the infection can be treated with medications or some people might have a whole in their eardrum related to something that happened to them. For instance, a trauma even or an infection that didn’t get treated and you can fix the whole in the eardrum. Some people even have a nerve disease or a tumor and that can potentially be treated with some kind of an operation or some other kind of treatment.
Melanie: And when we were talking about cognitive behavioral therapy; along those lines, are there some things as we think about triggers that people can do that can also help them as far as maybe blood pressure or caffeine, nicotine. Are any of these things? Does exercise, can that help? Are there any other things that we can do?
Dr. Spingarn: Absolutely. For some people, they have a ringing in the ear related to their blood pressure and if they do, then modifying the blood pressure by getting it treated can be very helpful. And so, nicotine and caffeine; those can definitely be contributing factors and so if you start living a healthier lifestyle; that can help some people.
Melanie: Wrap it up for us Dr. Spingarn with your best advice. If somebody is suffering from tinnitus and they are not sure where to turn or what to do; what do you tell them?
Dr. Spingarn: They need to see a qualified practitioner in the ear, nose and throat field. They need to have a good physical examination to look at their ears and make sure there isn’t something that needs to be fixed and then they need to have testing so that the proper medical advice can be given to them because for everybody it’s a different reason and we just need to figure out a diagnosis and then once we do then we can recommend some sort of appropriate treatment. You don’t have to continue to suffer. There are treatment options.
Melanie: Thank you so much doctor, for sharing your expertise. What great information and such a great summary and wrap up for people that they don’t have to suffer with this. Thank you again, for joining us. You’re listening to Riverside Radio HealthCast. For more information please visit www.riversidehealth.org, that’s www.riversidehealth.org. This is Melanie Cole. Thanks so much for tuning in.