Tinnitus and its treatment in Malaga and Granada.

Dear patient, if you are reading this post you are probably suffering tinnitus or even worse you have many doubts after consulting for your tinnitus problem. We will try to explain what we know, today, and will try to give you some clues that will help you to understand the tinnitus you are suffering. Nevertheless, don’t try to diagnose or treat you by yourself ¡do not hesitate contact us!.

Let’s start by the end. We still do not know many aspects of tinnitus and we are at the dawn of its treatment, but we know much compared to what the otolaryngologists used to know 10 years ago.

¡Tinnitus is treatable with a high success rate! and we know the causes leading to tinnitus. But before continuing, we want you to better understand the symptom you are suffering.

Tinnitus is a symptom, not a disease.

Yes, tinnitus is just a symptom. Tinnitus, ringing ears o acúfenos (in Spanish) are a very common health problem in the population, affecting 1 in 5 adult people. They are not a disease but a symptom of a disease, usually not serious.

Tinnitus has a heterogeneous presentation as it can be suffered in one ear, in both ears or be located in the head. They can be high-pitched or low-pitched, fixed or fluctuating.

Tinnitus, a symptom with high discomfort.

Tinnitus alters the quality of life of patients as it can trigger fatigue, stress, problems with sleep, concentration and memory, depression, anxiety and irritability. So many patients attends to Medical consultation.

We know the causes.

For years, the causes of tinnitus have been widely studied and actually we know the diseases responsible of them. Although hearing loss is the main cause of tinnitus, there are some others which should be addressed. Among them stand out:

1. Ear diseases: any ear disease can cause them. Otitis, tubal dysfunctions, otosclerosis, wax plugs, sensorineural hearing loss (presbycusis, sound trauma, Meniere’s syndrome), VIII cranial nerve neuromas.

2. Somatosensory problems: neck pain, muscle pain, temporomandibular joint disorders, etc.

3. Facial, cephalic and cervical injuries.

4. Cardiovascular diseases (atherosclerosis, high blood pressure, carotid stenosis, arteriovenous malformations, vascular tumors of the neck, etc.) and neurological diseases.

5. Psychological and psychiatric illnesses.

6. Drugs.

Hearing loss, the main cause of tinnitus.

Today, we (otolaryngologists) have understood that the main and fundamental cause is hearing loss. Sudden changes in hearing thresholds  favors the activation of a group of neurons in the central neural hearing pathway, as if they were trying to compensate the sudden changes in hearing patency. This new activation generates new electrical impulses, new ways of electrical discharge, which are recognised by the auditory cerebral cortex as a new sound, the tinnitus. 

But what if I don’t have hearing loss? It is one of the first considerations of many patients. To answer this, two clarifications should be made: 1) Hearing loss is sometimes not diagnosed because the hearing damage is usually focused on high frequencies (8-16KHz) and those frequencies are not usually studied in general otolaryngology clinics. Only high specialised clinics address this facts. 2) There are hidden hearing losses that even today cannot be diagnosed with the usual examinations but should be suspected when sound exposure, drugs or other factors have occurred. 

So the diagnosis is quite an adventure for the professionals dedicated to its treatment.

Today its diagnosis is a challange.

First of all, we must look for the cause and rule out pathologies. In the 21st century, this diagnosis is possible and requires knowing all the possible causes of tinnitus.

Audiological examinations will then be carried out: audiometry, high-frequency audiometry, otomicroscopy, tympanometry and psychoacoustic measures (pitch, loudness, suppression level, residual inhibition effect) should always be performed. They must always be accompanied by an evaluation of the quality of life through questionnaires (Tinnitus Handicap Inventory) and sometimes by more exhaustive questionnaires (esit-sq…).  Only occasionally, the search for the cause may require imaging tests such as CT, MRI, Doppler ultrasound, etc.


Indeed, tinnitus with a defined and treatable cause has pharmacological treatment and  new-onset tinnitus (less than 4 weeks) too, but do not delay the diagnosis, the results of  the pharmacological are better when they are early prescribed. If you are in this situation, there is no reason to despair. The vast majority of patients resolve their tinnitus without sequelae.

In this acute phase we treat the causes and if we cannot find it, we treat intensively with corticosteroids and benzodiazepines. We do not look for the cause and then treat. We treat by the time we are looking for the cause. 

Only some patients continue to have tinnitus after the pharmacological treatment but more treatments should be prescribed. According to the actual and valid Clinical Practice Guidelines you should know that:  

1) No drug have shown to be effective (not more effective than placebo). So please do not waste time nor money  on betahistine, Zn, Mg, ginkgo biloba or others. Why? Because today there is no miracle pill to cure hearing loss, the most frequent cause of tinnitus. Furthermore, many of these drugs are contraindicated according to current clinical practice guidelines.

2) Laser and transcraneal magnetic stimulation are also contraindicated. ¡Avoid them! They are provided without any scientific evidence and so by untrained professionals.

¿Which is the right treatment?

Treatment consists of helping the patient achieve habituation. Don’t get used to it but habituate! Habituation is a central neural phenomenon not a psychologist mechanism. Once habituation is achieved, the patient will either not hear tinnitus or will only hear it in quiet and only when you focused the attention on tinnitus. At this moment the tinnitus will not be a symptom anymore. Habituation is a physiological process that is achieved by more than 80% of patients without help and spontaneously. 

The problem lies in those patients who do not reach habituation spontaneously and tinnitus persist with the general affection for months. In them, tinnitus is a mayor health problem. Currently we can advance habituation or achieve it in patients with resistance to it.

Habituation is achieved with a set of internationally accepted measures, approved in the Clinical Practice Guidelines: cognitive behavioural psychological therapy and specific-patient hearing stimulation (hearing aids, sound generators or sound enrichment therapies).

Treatment results

With these proccedures, 80% of patients achieve habituation (from weeks to 2 years). The habituation period depends on each patient. An average of 18 months-2 years is stimated, but at 6 months there is usually a response (70-78% improvement).

Find your Otolaryngologist for Tinnitus.

Help yourself and look for a Otolaryngologist master in tinnitus. Since 2010, we work for tinnitus pacientes, supported by Hospital Universitario Virgen de las Nieves, Granada University and Clinica SENT.

Our tinnitus team, led by Dr. Garcia-Valdecasas (President of the Spanish Audiology Asociacition- AEDA), manage tinnitus according to scientific evidence. Otolaryngologists, audiologists and Psycologists work together for patients and the achievement of the best possible results.

You can find us in Clinica SENT, Granada (Spain). We are the leading Private Clinic in Andalucia for Tinnitus treatment.

Granada, is just 90 minutes away from Malaga airport.