There are multiple causes for Tinnitus, and determining which one it is, no easy task, can help in determining therapy - at the easiest level to deal with is blood pressure related causes, such as sudden standing or exertion, and these resolve on their own or with medicines to lower blood pressure.
Positional Tinnitus is next, and can have to do with either the otoliths (earstones) or various neck, shoulder or cranial displacements or tensions - hence the reason Paula O2's positive experience with a chiropractor, although I would tend to want to see an Osteopath for that, since the former works the bone placements, but the latter works the muscles and nerves that are causing the displacement.
We come then to "learned" Tinnitus - where there was some sort of Tinnitus for a short time, and the Brain adapted, learning to hear it as a normal aspect of hearing, and so kept it up. Here the best way is hearing retraining, of which various methods abound. I have a fondness for the Tomatis Method, but it has no strong basis in science, as of yet - however it does work with some of my patients. I caution here that the reason may be the therapist and not the therapy per se.
Then we get into the area of hearing damage related Tinnitus, caused by the death or damage to the tiny hairs in the cochlea that transmit sound to the auditory nerve. This is by far the most common and do date there is little to do about it - a sudden loss of hearing followed by Tinnitus is usually related, and can be a forerunner of Morbus Meniere (or not - often Sudden Loss of Hearing resolves itself, and is a coping mechanism in the ear to a sudden change of the condition of the cochlear health). For these there is little or nothing one can do to help except develop coping mechanisms. Some success has been found with "buzzers" that mimic the noise of the tinnitus and help the brain to learn the frequency and mask it out. In most cases this is noise or drug damage. Sometime traumatic accidents can be the cause of this, as it can for Positional Tinnitus.
Next is damage to the auditory nerve, usually caused by antibiotics or certain catastrophic illnesses. No help there at all.
The last and saddest is when it is somewhere in the brain's hearing region itself. For this there is nothing that can be done, and I bring this one up especially for a point. Because it is so difficult to diagnose the exact cause of Tinnitus, and there can be multiple causes, resorting to extreme therapy, such as surgery, is very dangerous and unwise. Let me relate to you a case that I am very familiar with (full disclosure, I have had in the past a close association with the umbrella organisation for the Hard of Hearing in Switzerland): One particular patient was so driven to distraction by his Tinnitus that he elected to have his auditory nerve cut completely, rendering him deaf, which he felt was a better solution than hearing the constant Tinnitus. The operation was a success, he was no completely deaf, he could hear nothing. Except his Tinnitus, because the source of the Tinnitus was in his brain and not his hearing organ or the auditory nerve. So anyone considering drastic surgery of any sort to deal with this, beware - this man now hears, night and day, without letup or any way to distract it, a constant Tinnitus, and now, alas, nothing else.
Finding the exact cause of the Tinnitus, as you can see is no easy matter. The fault of determining wrongly where the tinnitus originated was not the fault of the doctor's, but the fault of the extreme difficulty in determining where it was coming from, and in some cases, such as the brain related Tinnitus, how easily it mimics Tinnitus from other causes.
There is no known effect of PAP therapy on Tinnitus, however the forced pressure of the PAP device can, especially during a swallow or a yawn, go up through the Eustachian Tubes and raise the air pressure in Middle Ear, which may cause discomfort or auditory distortion.
(This post was last modified: 09-21-2013 06:10 AM by DocWils.)