Other than identifying and managing any underlying issues, the aim of tinnitus treatment is to reduce the impact of symptoms on the patient’s life. Much of this happens organically over time, as the person adapts to the noise sensation, but addressing any anxiety or depression (cognitive behavioural therapy can be very effective), and providing reassurance are also helpful. If hearing loss is a problem, referral to audiology for a hearing aid is essential. 

One way in which the impact of tinnitus can be minimised is sound enrichment. This is particularly useful in quiet environments, when opening a window to let in sounds from outside, putting a radio on in the background, or having a fan or white noise app running can reduce the intrusiveness of the tinnitus. Higher volumes that mask tinnitus may seem a good idea, but they can make the symptom more noticeable when the covering noise is turned off or down. Secondary care specialists may arrange tinnitus retraining therapy to encourage habituation. 

NICE has just started work on a clinical guideline for tinnitus, with publication expected in late 2019 or early 2020.

Reflective exercises

• Do you know what the legal requirements are regarding driving when suffering from vertigo?
• Many people with ear problems worry that they aren’t able to travel by air. The British Tinnitus Association may help you answer their questions.