The persistent ringing, buzzing, or whistling sounds that only you can hear could be tinnitus–a common but often frustrating auditory condition affecting millions of Americans. While not typically dangerous, untreated tinnitus can significantly impact your quality of life, affecting sleep, concentration, and emotional well-being. Dr. Michael Cohen provides expert evaluation and comprehensive treatment options for patients with tinnitus throughout Long Island, helping them manage symptoms and regain comfort.
I’ve seen Dr. Cohen and staff multiple times for chronic sinus infections. Him and his team are always so helpful! They treat me nicely and always have me leaving knowing I’ll feel better. From start to finish the whole staff have been great.
Our Expertise and Philosophy
Dr. Cohen brings over 25 years of specialized experience in diagnosing and treating tinnitus. As a board-certified otolaryngologist recognized as a Top Doctor by NY Top Docs for 25 consecutive years, he understands the complex nature of tinnitus and the importance of a thorough evaluation to identify underlying causes.
At our practice, we recognize that tinnitus is often a symptom rather than a standalone condition. Dr. Cohen’s philosophy emphasizes comprehensive assessment to identify potential underlying causes, followed by a personalized treatment approach addressing both the tinnitus sounds and their impact on your daily life. For patients with persistent or severe tinnitus, we offer a range of evidence-based management strategies tailored to their specific symptoms and needs.
Understanding Tinnitus
Tinnitus refers to the perception of sound when no external sound source is present. Often described as “ringing in the ears,” tinnitus can manifest as various sounds, including buzzing, hissing, whistling, clicking, roaring, or whooshing. This phantom sound perception affects approximately 50 million Americans, with about 20 million experiencing bothersome chronic tinnitus and 2 million suffering from debilitating cases that significantly impact their quality of life.
Tinnitus is not a disease itself but rather a symptom that can result from a wide range of underlying conditions. It can be subjective (heard only by the affected person) or, rarely, objective (sounds that can be heard by an examiner with specialized equipment). Most cases of tinnitus are subjective and categorized as either:
Primary Tinnitus
Occurs without an identifiable cause beyond hearing loss, often associated with age-related or noise-induced hearing damage that affects auditory pathways
Secondary Tinnitus
Results from an identifiable underlying medical condition, medication side effect, or specific ear pathology that can potentially be treated directly
Acute Tinnitus
Temporary tinnitus lasting less than three months, often following exposure to loud noise or other temporary triggers with good resolution prognosis
Chronic Tinnitus
Persistent symptoms lasting more than three months, requiring long-term management strategies and often involving neuroplastic changes in the brain
Tinnitus can affect one ear (unilateral) or both ears (bilateral), and the perceived sound may be constant or intermittent, loud or soft, high or low pitched. This variability contributes to the complex nature of tinnitus and necessitates personalized evaluation and treatment approaches.
Common Causes and Contributing Factors
Tinnitus can arise from numerous sources, with the most common including:
Hearing Loss and Auditory System Damage
Age-related hearing loss (presbycusis) and noise-induced hearing damage are the most frequent causes of tinnitus. When hair cells in the inner ear are damaged, they may send random electrical impulses to the brain that are interpreted as sound.
Middle and Inner Ear Conditions
Various ear disorders can trigger tinnitus, including otosclerosis (abnormal bone growth in the middle ear), Ménière’s disease (inner ear fluid disorder), or ear infections that affect the delicate structures responsible for hearing.
Excessive Earwax
Buildup of cerumen (earwax) in the ear canal can block sound transmission and create pressure that results in tinnitus symptoms.
Temporomandibular Joint (TMJ) Disorders
Problems with the jaw joint can affect nearby auditory structures and nerves, potentially causing or exacerbating tinnitus.
Cardiovascular Issues
Blood vessel abnormalities, high blood pressure, atherosclerosis, or turbulent blood flow near the ears can cause a rare type of tinnitus called pulsatile tinnitus, which is synchronized with the heartbeat.
Medication Side Effects
Over 200 medications list tinnitus as a potential side effect, with common culprits including certain antibiotics, cancer medications, diuretics, high doses of aspirin, and some antidepressants.
Head and Neck Injuries
Trauma to the head, neck, or ear can damage auditory pathways or affect neural connections, resulting in tinnitus symptoms.
Neurological Disorders
Conditions affecting the brain’s auditory processing centers or neural pathways can contribute to tinnitus perception.
Stress and Anxiety
While not direct causes, stress and anxiety can significantly worsen tinnitus perception and make symptoms more noticeable and distressing.
Common Reasons Patients Seek Tinnitus Relief from an ENT
Patients with tinnitus often experience several significant challenges that prompt them to seek evaluation and treatment:
Sleep Disruption
Many tinnitus sufferers report difficulty falling or staying asleep due to the increased perception of tinnitus in quiet environments, leading to sleep deprivation and related health issues.
Concentration Problems
The persistent sound can make it difficult to focus on work, reading, or conversations, affecting professional performance and daily activities.
Emotional Distress
Untreated tinnitus is strongly associated with increased rates of anxiety, depression, and irritability, creating a cycle where emotional distress makes tinnitus more noticeable.
Hearing Difficulties
Tinnitus often accompanies hearing loss, and the combination can significantly impair communication abilities and social interactions.
Fear of Serious Underlying Conditions
Many patients worry that their tinnitus may signal a brain tumor, stroke, or other serious medical condition, creating anxiety that requires proper evaluation for reassurance.
Impact on Quality of Life
Persistent tinnitus can affect overall enjoyment of activities, relationships, and social participation, leading many patients to seek solutions for long-term management.
Concerns About Progression
Patients often worry that their tinnitus will continue to worsen over time if left untreated, driving them to seek early intervention.
Dr. Cohen’s Customized Approach to Tinnitus Evaluation and Treatment
Dr. Cohen employs a comprehensive approach to diagnosing and managing tinnitus:
Thorough Diagnostic Evaluation
Dr. Cohen begins with a detailed medical history and physical examination, focusing on when the tinnitus began, its characteristics, and any associated symptoms or triggers. This comprehensive assessment helps identify potential underlying causes and guides treatment planning.
Advanced Audiological Testing
Working with skilled audiologists, Dr. Cohen ensures that each patient receives detailed hearing tests to measure hearing function and identify any hearing loss that may be associated with tinnitus. These evaluations help determine the type and degree of any hearing impairment and its relationship to tinnitus symptoms.
Medical Imaging When Indicated
For patients with asymmetric tinnitus (affecting one ear more than the other), pulsatile symptoms, or other concerning features, Dr. Cohen may recommend imaging studies such as MRI to rule out structural abnormalities that could be causing the tinnitus.
Addressing Underlying Medical Conditions
When tinnitus is secondary to an identifiable cause such as excessive earwax, ear infections, or cardiovascular issues, Dr. Cohen prioritizes treating these underlying conditions, which often improves or resolves tinnitus symptoms.
Customized Treatment Planning
Based on the evaluation findings, Dr. Cohen develops individualized treatment plans that may include several therapeutic approaches:
- Hearing Aids: For patients with hearing loss, properly fitted hearing aids can often provide significant tinnitus relief by enhancing external sounds that help mask the tinnitus and by reducing the strain of hearing, which can worsen tinnitus perception.
- Sound Therapy: Various devices that produce white noise, nature sounds, or customized sound patterns can help mask tinnitus, make it less noticeable, and promote habituation to the unwanted sounds.
- Tinnitus Retraining Therapy (TRT): This specialized approach combines sound therapy with educational counseling to help retrain the brain’s reaction to tinnitus, reducing awareness of and distress from the sounds.
- Medication Management: While no medication directly cures tinnitus, certain medications may help manage associated symptoms such as anxiety, depression, or sleep disturbances that can worsen tinnitus perception.
- Lifestyle Modifications: Dr. Cohen provides recommendations regarding stress management, sound environment optimization, and avoidance of triggers that can exacerbate tinnitus.
Collaborative Care Coordination
For patients with severe or complex tinnitus, Dr. Cohen coordinates care with other specialists as needed, such as audiologists, neurologists, psychiatrists, or sleep medicine physicians, ensuring comprehensive management of all aspects of tinnitus and its effects.
Is Tinnitus Treatment Right for You?
While not everyone with tinnitus requires intervention, you should consider seeking evaluation and treatment if:
- Your tinnitus is persistent (lasting more than three months) or bothersome
- Tinnitus interferes with your sleep, concentration, or daily activities
- You experience associated symptoms such as dizziness, hearing loss, or ear fullness
- Your tinnitus is pulsatile (synchronized with your heartbeat)
- Tinnitus affects only one ear or is accompanied by unilateral hearing loss
- You’ve developed significant anxiety or depression related to your tinnitus
- You have trouble coping with or managing your reaction to the tinnitus
During your consultation, Dr. Cohen will determine whether your tinnitus requires medical treatment or would benefit from management strategies to reduce its impact on your quality of life.
What to Expect During Your Evaluation
Your initial tinnitus assessment with Dr. Cohen typically includes:
Comprehensive Medical History
Dr. Cohen will discuss your tinnitus symptoms in detail, including when they began, their characteristics, pattern, and severity. He will also inquire about associated symptoms, medical conditions, medications, noise exposure history, and lifestyle factors that might contribute to tinnitus.
Physical Examination
A thorough examination of your ears, head, and neck will help identify any visible abnormalities that might be causing or contributing to your tinnitus, such as earwax impaction, eardrum perforation, or signs of infection.
Hearing Assessment
A comprehensive audiological evaluation will measure your hearing sensitivity across different frequencies and evaluate your speech recognition abilities. This testing helps determine if hearing loss is present and its potential relationship to your tinnitus.
Specialized Tinnitus Assessment
In some cases, specialized tests may be conducted to characterize your tinnitus, including pitch matching (determining the frequency of your tinnitus), loudness matching (measuring its perceived intensity), and maskability testing (evaluating how easily external sounds can cover the tinnitus).
Additional Testing When Indicated
Depending on your specific symptoms and examination findings, Dr. Cohen may recommend further tests such as tympanometry (evaluating middle ear function), acoustic reflex testing, or imaging studies.
What to Expect During Treatment
Tinnitus treatment is highly individualized and may include several therapeutic approaches:
For Medically Treatable Tinnitus
Earwax Removal
For tinnitus related to cerumen impaction, Dr. Cohen performs gentle, microscopic removal of excess earwax, which can provide immediate relief in some cases.
Medication Adjustment
If your tinnitus appears related to certain medications, Dr. Cohen will consult with your prescribing physician about potential alternatives or dosage adjustments.
Treatment of Underlying Conditions
Addressing conditions such as high blood pressure, ear infections, TMJ disorders, or other identifiable causes may significantly reduce or eliminate tinnitus.
For Chronic Primary Tinnitus
Hearing Aid Fitting
If hearing loss is present, Dr. Cohen works with audiologists to prescribe appropriate hearing aids, which often provide significant tinnitus relief by enhancing external sounds and reducing listening strain.
Sound Therapy Implementation
Various sound-generating devices may be recommended, from simple tabletop sound machines to wearable devices that deliver customized sound therapy to help mask and manage tinnitus.
Tinnitus Retraining Therapy
This structured approach combines sound therapy with educational counseling sessions to help you habituate to tinnitus perception and reduce its impact on your life.
Cognitive Behavioral Therapy Referral
For patients with significant psychological distress related to tinnitus, Dr. Cohen may recommend CBT, which helps modify negative thought patterns and develop effective coping strategies.
Supportive Care
Dr. Cohen provides ongoing support, monitoring, and adjustment of your treatment plan as needed, recognizing that tinnitus management often requires a long-term approach.
Frequently Asked Questions About Tinnitus
While there is currently no definitive cure for most cases of tinnitus, many underlying causes can be treated, and various management strategies can significantly reduce tinnitus perception and its impact on quality of life. For some patients, particularly those with tinnitus due to treatable medical conditions, symptoms may resolve completely with appropriate intervention.
For most people, tinnitus doesn’t progressively worsen. Many patients report that their tinnitus seems most severe when first noticed and may become less bothersome as they adjust to it. However, significant changes in tinnitus warrant medical evaluation to rule out new underlying causes.
While hearing loss is the most common condition associated with tinnitus, not everyone with tinnitus has measurable hearing loss. However, some degree of damage to the auditory system is thought to underlie most cases of tinnitus, even when hearing tests appear normal.
Some patients report that certain dietary factors like caffeine, alcohol, or salt intake can influence their tinnitus perception. While research hasn’t conclusively established these connections, Dr. Cohen may recommend monitoring your diet and its potential effects on your symptoms.
The most effective prevention strategy is protecting your hearing from excessive noise exposure using appropriate hearing protection. Maintaining cardiovascular health, avoiding ototoxic medications when possible, and promptly treating ear infections may also help reduce tinnitus risk.
Although various supplements are marketed for tinnitus relief, scientific evidence supporting their effectiveness is limited. Dr. Cohen can discuss current research regarding supplements and help you make informed decisions about their potential role in your tinnitus management.
Why Choose Dr. Michael Cohen for Tinnitus Treatment
When selecting a physician for tinnitus evaluation and treatment, specialized expertise offers significant advantages:
- Board-certified otolaryngologist with over 25 years of experience diagnosing and treating complex ear conditions
- Comprehensive approach that addresses both the tinnitus itself and its impact on quality of life
- Advanced diagnostic capabilities to identify underlying causes of tinnitus
- Experience with the full range of tinnitus management strategies, from medical interventions to sound therapy
- Collaboration with skilled audiologists for precise hearing evaluation and hearing aid fitting when appropriate
- Recognition as a Top Doctor by NY Top Docs for 25 consecutive years
- Current affiliation with prestigious institutions including NYU Langone Health and Northwell Health
Dr. Cohen’s patients particularly value his thorough approach to tinnitus evaluation and his commitment to finding effective management strategies for this often challenging condition.
Expert Tinnitus Care Throughout Nassau and Suffolk County
Don’t let the persistent sounds of tinnitus diminish your quality of life. While tinnitus cannot always be eliminated completely, proper evaluation and management can significantly reduce its impact, helping you regain comfort and focus in your daily activities.
With convenient locations in Syosset and Port Jefferson Station, expert tinnitus care is accessible to residents throughout Nassau and Suffolk County. Contact our office today to schedule your consultation with Dr. Cohen and take the first step toward effective tinnitus management.