Talk:Tinnitus

Tinnitus and depression, bidirectional relationship ?

It is well known that patients with tinnitus will be, as a consequence of their tinnitus, more likely to suffer from depression ; just like one developing a chronic disease is also more likely to fall into depression. But can depression be the origin of a permanent tinnitus ? Can depression permanently worsen the tinnitus (i.e. make it louder, with more frequencies) ?

Researchers who have used psychoacoustical characterizations of tinnitus (intensity, frequency, annoyance, and disturbance levels, etc) have found no relationship between a patient's level of tinnitus and his level of annoyance or disturbance. So how could anxiety permanently increase tinnitus loudness and frequency-range ?

I have the feeling that studies claiming there is a bidirectional relationship (such as this one) lost track of this fact. Tinnitus patients suffering from depression may report being more annoyed by (-and more focused on) their tinnitus during anxiety peak; but does their anxiety permanently worsen their tinnitus ? For sure, noise induced hearing loss and presbycusis can !

Galeop (talk) 17:59, 26 July 2015 (UTC)

References

Problem with source stating depression as a cause

The cited article Diagnostic approach to tinnitus does not say anywhere else than in the abstract and the figures that depression may be a cause. It does not even cite a source stating this.

References

It does not need to. This also mentioned depression as a risk factor [1] Doc James (talk · contribs · email) 01:30, 29 July 2015 (UTC)

Link to Sound Therapy actually links to Music Therapy

The link to Sound Therapy links to only Music Therapy, which in no way appears to address Sound Therapy as might relate to tinnitus. There is currently no Sound Therapy page in Wikipedia, so perhaps it was deleted, or never written?

original research?

I can't bother to scour for sources but after one loud noise incident years ago, I've had tinnitus of the comes and goes variety of varying frequencies (mostly mid-freq sinewave like) in both ears, varying from none to bothering in intensity, mostly mild. Through experimenting and research, in my case, I have found that when the tinnitus is mild (only audible when going to sleep), this mild intensity tinnitus can go to more audible/bothering quickly with each of : 1) salt/natrium/sodium intake (possibly connected to amount of water drank) 2) continual lack of proper amount of sleep or waking up before 8 hours of sleep is had 3) changes in air pressure may change the intensity if the tube from mouth to ear becomes blocked. I read about a theory that salt in the system causes water to accumulate in the ear which could block the tube which can be very tiny. After I had this condition, simply the air pressure from riding a bike with nothing covering the ears started the worst tinnitus (this was of low rumbling type) I had had to date on the right ear, which then changed to low frequency hearing loss in the ear. It took maybe a month of minimal salt diet and this slowly resolved but some kind of "pressure" was still felt in the ear for couple months after the hearing loss resolved. — Preceding unsigned comment added by 2001:14B8:100:2A9:0:0:0:2 (talk) 22:16, 12 September 2013 (UTC)

For some type of subjective tinnitus vitamin combination of 500 mg C & 400+ IU D3 + 500 mg calcium may help

I already noticed mention of one proprietary vitamin combination in the article but it seem to have lot of components which makes it hard to determine what is the helping component, so here's what I found to work for one particular very mild level of tinnitus sound.

I've tried this combination (and only some parts of it rather than everything) on and off over past 6 months and I would say it takes approx 1-2 weeks of the mentioned dosage to start helping if it will help. It takes approx 2-4 days from stopping dosage for the particular type of sound to come back. The sound is like two alternating medium pitch sines in a single ear. The particular tinnitus started when I was sleep deprived and had a stressful and loud event happen but I can't rule vitamin deficiency entirely out of the picture as a facilitator of the possible damage, so for Tinnitus Prevention I would add: Avoid sleep interruptions, ensure proper nutrition. Also I can't recommend use of ear plugs at night every night. I tried this since it also helps with this same particular tinnitus but it also caused ear irritation.

Another poster below had the "brainwave theory". Interesting but I think it's always important to mention that there can be multiple causes of tinnitus. After all if there was a single cause, then my example of what helped with one instance of my own tinnitus would have surely had some effect on the other instances as well. (I've got 1 from very loud music (they sold ear plugs at the event! should've got em!), 2nd&3rd that came over time and come and go and the alternating one I described above)

Some cases of tinnitus are medically unexplained.[3][not in citation given]

Added verification tag because the review does not mention the symptom being medically unexplained, and nothing about the classification Medically unexplained symptoms. There might be a reference out there that verifies the material, but this source doesn't. Ward20 (talk) 18:30, 18 August 2009 (UTC)

For the record, the editor tagged this line in the intro as being unsupported by the reference: "Some cases of tinnitus are medically unexplained." If not resolved soon, any editor should remove the line. 5Q5 (talk) 18:18, 2 October 2009 (UTC)

MUPS failed verification tag removed

This edit removed tag but the source never talks about medically unexplained or medically unexplained symptoms.[2] Ward20 (talk) 03:36, 30 October 2009 (UTC)

Feedback

I wonder whether some tinnitus may be a case of audio feedback or sensory feedback. See Talk:Audio feedback for details. 68.83.179.156 (talk) 06:49, 3 November 2009 (UTC)

I also wonder whether vibrations other than sound cause or affect tinnitus. 68.83.179.156 (talk) 21:08, 26 November 2009 (UTC)

Champagne bubbles

Gentleman, my description of tinnitus: like hearing 1000 effervescent carbonated beverage bubbles popping in the distance. Jidanni (talk) 20:23, 2 February 2010 (UTC)

Please differentiate between tinnitus and actual high frequency sounds

The writers of the tinnitus page have not mentioned the fact that sometimes a patient who hears high frequency sound is misdiagnosed as having tinnitus. The home or building this occurs in might need to be tested (by other knowledgeable persons)with sound gauges and meters for high frequency transmission signals, or modern wiring which can cause very high pitched sounds. this might be the case if the sound usually occurs only in certain "quiet" settings but not usually in other types of quiet settings, especially where the same transmissions and/ or wiring do not exist. Electromagnetic frequencies are known to be the culprit in many cases that were misdiagnosed. there are remedies for these kinds of signals and electromagnetic frequencies that don't involve drugs but rather, altering the environment they are found in. Here's a page that you might get info from on this subject: [[3]] Of course this is a whole different ballgame which most physicians might not even be aware of, since it is far from your particular discipline and you might have NO education regarding it. But it is very important that anyone concerned with tinnitus be made aware of this other distinct possibility that exists for many. I am not affiliated with the linked page in any way, i simply suffered from electromagnetic noise and found them as a resource. Meat Eating Orchid (talk) 06:16, 21 February 2010 (UTC) People suffer greatly when misdiagnosed, which happens often with "tinnitus", so i needed to shed some light by referring to this fact. I added a good academic link to the info i previously added in the article. —Preceding unsigned comment added by Meat Eating Orchid (talk • contribs) 19:06, 19 May 2010 (UTC)

Isn't this easy to test? If you hear the noises after putting your finder on the outer flap of the ear and gently holding the flap pressed against the ear channel, this blocks outside noises very effectively. Then just walk around and if the noise intensity stays the same, it's tinnitus for sure. — Preceding unsigned comment added by 2001:14B8:100:2A9:0:0:0:2 (talk) 22:21, 12 September 2013 (UTC)

Suggested Improvement of readability of bulleted outline style.

The Causes of subjective tinnitus is a good example of how large outlines can pose readability issues. The only deliminator for outline sub levels is indentation, which becomes quite difficult to follow when there are a large number of subjects under a given topic.

I suggest adding different bullets for each level, and/or having vertical guidelines for each of the levels (run regedit.exe and check the folder hierarchy, you'll see exactly what I mean if you use Windows).

I do not know how to edit Wikipedia articles, and I assume if I learned how I would only find out that this is the only bulleted list style available.

97.73.64.152 (talk) 16:42, 18 May 2010 (UTC)

My thoughts on tinnitus, in direct accordance with talk guidelines.

I suggest that the article on Tinnitus is not verifiable, except by secondary and tertiary documents of such poor quality they don't count as valid for inclusion within Wikipedia. The entire sum of these appear to be based on incorrect, confusing, misleading or misinterpreted primary material. Therefore, I suggest the primary body of material that makes up the article on Tinnitus is unreliable. As there is no body of reliable secondary and tertiary material, I provide this section only as a direct copy of the only published tertiary material containing the correct description of tinnitus. I welcome and encourage editors to check my statements of claimed verifiability, and of unreliability themselves, and to subsequently edit first this talk page, and subsequently, the entire article, appropriately, and in line with Wikipedia policy.

Source:- http://en.wikipedia.org/wiki/User_talk:Xenek

Content:-

(subject) Wikipedia FAILS as a reference and learning tool because it doesn't provide or guide users to share or view original research and places too much value on historically false tertiary & second sources.

(content) My subject explains the problem.

Presently, Wikipedia is nothing more than a slowly developing weak reference source of occasionally false facts, furthering pseudoscience where this is the case. This can be resolved by a simple interface change.

The article on tinnitus is a classic example.

There was once in this article a single line someone posted saying something like (not word for word correct)-

"tinnitus may be the sound of the nervous system itself".

This has since been removed, by a well meaning individual.

Removing lines like this (containing key words like 'may' or 'might') because they are as yet unsubstantiated by primary or secondary research, stifles human development, not improves it. This results in Wikipedia today being just as poor a single general reference as are old version of Encarta, Britannica or Funk & Wagnells.

This original line led me to studying myself for a few years.

I have subsequently confirmed through persistent scientific observation that my tinnitus IS the sound of my brainwaves, specifically, areas of my neocortex. I haven't proven this in a laboratory - yet. For me, it isn't a sound in my 'ear' as the current painfully incorrect Wikipedia article falsely asserts. Yet I can confirm I experience identical symptoms as most other 'sufferers' described in the article. The term is the correct one to define my learned ability. The article is simply poor because it tries to abide by severely limiting policy.

My next paragraph is a statement of my thoughts after careful observation. This paragraph demonstrates and describes in the form of a concrete example, why it is so important to me to be able to (according to policy) reinsert a more accurate line "Tinnitus may be the sound of the nervous system itself, and is believed by some individuals to be the sound of the neocortex, and is completely unconnected to hearing loss apart from being more noticeable in the event of." into the current article on tinnitus.

Balancing and controlling left and right hemispherical activity and analyzing your brain by observing tinnitus is an ability that should be taught at preschool level for it probably takes decades to develop in the average person. I have been well aware of it since early primary school but never met a Doctor or Audiologist intelligent or knowledgeable enough to explain it clearly. Most people don't study their tinnitus closely enough, or for long enough, to be able to hear the different pitch or timbre of each distinct brain region at the different loudness levels. They probably won't either if they continue to be told it is a disorder, so tinnitus might never become the tool that it is - a very well connected and capable brainwave monitor able to be used for biofeedback of neurological features and functions. Biofeedback is the future of self-regulating individual brain management, which if harnessed correctly and taught may allow each individual to manage enabling or disabling superior mental abilities in self-chosen specific areas. Having tinnitus is a gift, claiming to be suffering from it is little different than to be claiming to be suffering because we can see.

I can't post a single line of my thoughts and conclusions on this original research in the Wikipedia article on tinnitus, because it would violate policy. This is terrible, because the present article has much pseudoscience written and believed by representatives of or individuals who are products of the established medical and educational institutions that, in this good example, demonstrates their propensity to continue supporting false and misleading secondary documentation that vaguely tries to explain something that is in hindsight obviously incorrect but hasn't yet been recognized as such.

To put this politely, in my opinion the present knowledge described in the article on tinnitus is a steaming pile of self supporting rubbish, that is far from scientific, even though it has been developed out of the combined work of a massive number of incredibly capable individuals. They misled themselves from the start, so all their work is in the wrong direction. Wikipedia only furthers this problem.

To resolve this issue so I can reward both Wikipedia, the writer of that single line, and the global community of humans with something tremendously important, all you need is a single additional tab across the top of the tinnitus tab, to the right of the article and discussion tabs. For this explanation I propose it be called 'Possibilities'. I expect someone can come up with a better appropriate term.

This tab would provide people with the ability to contribute their own original research to a secondary persistent article containing information that would inspire and encourage independent thought, through publishing and supporting developing knowledge and new directly relevant and key associated ideas. It need not be academic or institutionally supported, but does need to be clear and must contain words that accurately describe the content as 'possible not factual'. It would follow most or all of the usual article rules, apart from additionally violating the pillar of 'no original research'. It doesn't deserve or want to be in a separate wiki, for it really needs to be in article form 'side by side' the old article, for comparison reasons and so that a cohesive summary of new information is made immediately available to the editors of the primary article as written according to the three pillars policy, and to readers of the primary article that is assumed to be completely factual.

My own concerns of deliberately false or misleading data appearing in this tab, or of organizations using the content of this tab as proof of fact are valid, but insubstantial. All entries in the Possibilities tab would be removed (or persistently marked up as such) if they could be proven to be false, or had been proven false in a variety of possibly incorrect or inadequate studies, while simultaneously claiming to be factual. This tab would contain the key points of the original article with additionally simply described memes of a 'different viewpoint', 'supposed', 'developing' or of a 'only possibly correct' nature organized much as the original article. To repeat - all content on this tab would need to always be clearly worded as 'possible' using terms such as 'may' - as I use in my proposed single line above.

Without enabling a second tab containing a revised article supporting new possibilities, Wikipedia actively restricts allowing capable people to assist with improving the quality of existing human knowledge and instead frequently further reinforces or supports sometimes false or misleading knowledge. This is a fact which makes Wikipedia very dangerous, in my opinion.

If my conclusions are wrong, or this interface feature and policy already exists in an obvious form, with regards to this article then please correct me by editing my post as per guidelines, leaving only the verifiable material. Thank you.

Xenek (talk) 22:53, 13 June 2010 (UTC)

By your own admission, the addition of this content is original research, and not substantiated by any reliable sources. Please remember that "The threshold for inclusion in Wikipedia is verifiability, not truth". --- Barek (talk • contribs) - 00:00, 14 June 2010 (UTC)

I believe there was a recent report in New Scientist corroborating the idea that tinnitus is the background noise of the auditory system in that as has been scientifically proven (according to the report) the brain needs a background pattern to compare with in order to detect sensory input. Being profoundly deaf with a Cochlear Implant and tinnitus I find this fits very well with my own experience. I beleive the line is now a correct statement ans should stay.

My thoughts on tinnitus, in direct accordance with talk guidelines.

I agree with the words of Xenek (talk) 22:53, 13 June 2010 (UTC) which I am quoting, "I suggest that the article on Tinnitus is not verifiable, except by secondary and tertiary documents of such poor quality they don't count as valid for inclusion within Wikipedia." The entry on tinnitus as currently written is misleading or unsubstantiated to the extent that it would be better to not have an entry for tinnitus at all. This article has enough misinformation that a warning should be made that that content may actually contain false or misleading istatements due to conflicting views among experts and the fact that studies cited have in many cases been contradicted by other research. Statements have citations they refer to sources that are contradicted by other sources which not cited. I cannot give a full account of the conflicts because it would take more words than contained in the Wikipedia tinnitus entry itself itself. Just to give one single example of how the public might be harmed by this article is the listing of amitriptyline as a substance that could ameliorate tinnitus when it is known that amitriptyline may cause tinnitus. There is content which contradicts itself. Just sticking with amitriptyline as an example because it is impossible to be comprehensive here, the article states this antidepressant can be beneficial yet in another part of the text is lists antidepressants as a possible cause of tinnitus. It is irresponsible to make statements which may lead a person with tinnitus to use a substance that might cause that person harm. Tomandzeke (talk) 06:01, 13 March 2012 (UTC)

Can we clean this page up?

The "Causes" section is disorganized and sounds like a news article, and it has 0 references. Bluefist (talk) 04:22, 27 November 2010 (UTC)

I do not see hypertension listed as a cause. Did I miss it?? — Preceding unsigned comment added by 98.82.133.45 (talk) 17:28, 7 October 2011 (UTC)

The section on treatments needs to be grouped more logically, either by type of tinnitus or by type of treatment. Even better would be a table that covered both of those and had other attributes of the treatment methods, such as invasiveness, where performed, etc. DCDuring (talk) 06:22, 25 March 2012 (UTC)

What Language is this ?

"In-ear headphones via sound entered directly into the ear canal itself, without any opportunity to be deflected or absorbed elsewhere are a popular cause of Tinnitus with volume set beyond modest or moderate levels". For goodness sake ! Just think about what you want to say, then write it down in simple sentences. This is apalling ! 'Popular' ???? Cannot Wikki find a competent writer of English among its numbers ? —Preceding unsigned comment added by 82.32.49.157 (talk) 08:36, 17 December 2010 (UTC)

I was disturbed to see the tinnitus article without mention of the inner sound; what Eckankar calls the ECK or audible life current and what other religions would call Aum or Om. Surely this would be a richer article for their inclusion, wouldn’t it? brent56@telus.net —Preceding unsigned comment added by 154.5.46.184 (talk) 06:49, 12 March 2011 (UTC)

Uloric for High Uric Acid may cause Tinnitus

I have high Uric acid, which results in Gout attacks. I recently switched from Alopurinol to Uloric. The latter claims to have fewer side effects. Th ringing in my ears started about two months after the change over.. My doctor thinks it may be the Uloric. I have gone back to the Alopurinol. I will follow up on this posting in a month or two. Has anyone else experienced this from this new drug Uloric? (KLF) — Preceding unsigned comment added by 99.245.164.239 (talk) 19:04, 29 August 2011 (UTC)

Thermal noise

Just a question...

I'm writing this here b/c Wikipedians have a good overview.

Could Tinnitus be jonson noise or thermal noise caused by brownian motion? Notpayingthepsychiatrist (talk) 18:15, 13 January 2012 (UTC)

Should we separate /* Notable individuals */ into a separate list article?

I think it would be beneficial to separate the Notable individuals section into a "List of persons with tinnitus" or "List of people with tinnitus". The current article is growing large enough that it is becoming painful to wait for the loading in edit & preview mode, & there is enough individuals that I think that it would make a effective list, especially with the extensive footnotes in this section.

Any thoughts? Peaceray (talk) 07:11, 2 November 2012 (UTC)

Picture

The reference picture is not encyclopedic. Also, it seems like it's a stock image or an "instagrammed" photo with no encyclopedic value. I recommend we remove it and add a scientific picture of the inner ear. --164.58.59.60 (talk) 06:09, 8 November 2012 (UTC)

I placed the subjective image of someone with tinnitus holding her or his ears & the picture of books on tinnitus just a few days ago. Before then, there were no illustrations. These two images are among the three located in the tinnitus category at Wikicommons, so there were not a lot from which to choose, especially since the third image in that category was in German. It would be great if someone added additional images related to tinnitus to this category.

I am not sure how replacing one stock image with another would improve the article. When I performed a Google image search for tinnitus, nine of the first forty images, or 22.5%, had people holding their hand(s) over their ear(s). Another had a similar pose in which the subject was grimacing & pointing his fingers at his temples. I had never have had permanent or debilitating tinnitus, but I have had a minor manifestation off & on. I suspect that the subjective image with the hands of the ears may well visually express what it is like to have the severe form of the affliction. Indeed, some with the debilitating form of tinnitus contemplate suicide.

Perhaps someone who has a more severe form of tinnitus can weigh in here.

I for one, welcome additional images that illustrate this condition, objectively or subjectively. However, I do not think that a stock diagram or picture of the inner ear would necessarily be a good replacement for the current image. After all, who can say that all forms of tinnitus occur in the inner ear? Is it not possible that the condition could also arise in the aural processing parts of the brain?

Peaceray (talk) 04:15, 9 November 2012 (UTC)

No image would be better than the image that is currently used. The photo being used has been unnecessarily stylistically edited, and if one could argue a photo or illustration of an ear or inner ear isn't the most accurate representation of tinnitus, it could also be argued that someone covering their ears is equally as inaccurate. After all, no one with tinnitus would cover their ears in an attempt to relieve the ringing… that would be tremendously counterproductive.

That said, the current photo is uncharacteristic of a suitable image for encyclopedic content. I will remove it if a better image cannot be agreed upon in a reasonable time frame. ⚓ nbmatt 21:36, 25 November 2012 (UTC)

Characteristics

"This has led to the suggestion that one cause of tinnitus might be a homeostatic response of central dorsal cochlear nucleus auditory neurons that makes them hyperactive in compensation to auditory input loss."

Any chance someone can simplify this so the author doesn't seem like too much of a douche? Pongley (talk) 02:15, 14 January 2013 (UTC)

Removed form Notable individuals list

I've removed Bono form the list of Notable individuals. The only reference to this fact has "gone away" - and that without a valid reference, this entry was a clear breach of WP:BLP. It should be removed until a reliable source can be found. Thank you. Miss Bono ^[zootalk] 17:44, 5 September 2013 (UTC)

Protected

This is a high-visibility WP:MEDICINE-scope article, it's been seeing some poor edits from IPs removing well-sourced info and questionable changes, so semi-protected for 1 week, please use the article Talk page. Zad68 18:02, 5 January 2014 (UTC)

On 4 January Jmh649 substantially rewrote the whole of the tinnitus article and in particular the Management/Treatment section. New research about the role of Clonazepam in reducing tinnitus sound was removed even though it is from a 2012 article in the highly respected journal J Neurol Neurosurg Psychiatry. This appears seriously to be censorship of research that one author may disagree with. The role of sound therapy was also downgraded with the sentence "poorly supported by evidence". This is in fact a distortion of the 2013 Lancet article Jmh649 cites which states that "the evidence base is strongest for a combination of sound therapy and CBT-based counselling". The role of CBT is given unqualified approval - again a distortion of recent evidence -no mention is made of the fact that though it may have a role in reducing tinnitus-related stress, there is no evidence that is has a reductive effect on tinnitus loudness.

Such an unbalanced and distorted rewriting by Jmh649 can only call into question good faith and possible financial motivations. So I have a very simple question for Jmh649 - do you derive an income from offering CBT to tinnitus patients? — Preceding unsigned comment added by 78.147.175.249 (talk) 10:42, 6 January 2014 (UTC)

Suspected bad faith in editing of Tinnitus management/treatments section

On 4 January Jmh649 substantially rewrote the whole of the tinnitus article and in particular the Management/Treatment section. New research about the role of Clonazepam in reducing tinnitus sound was removed even though it is from a 2012 article in the highly respected journal J Neurol Neurosurg Psychiatry. This appears seriously to be censorship of research that one author may disagree with. The role of sound therapy was also downgraded with the sentence "poorly supported by evidence". This is in fact a distortion of the 2013 Lancet article Jmh649 cites which states that "the evidence base is strongest for a combination of sound therapy and CBT-based counselling". The role of CBT is given unqualified approval - again a distortion of recent evidence -no mention is made of the fact that though it may have a role in reducing tinnitus-related stress, there is no evidence that is has a reductive effect on tinnitus loudness.

Such an unbalanced and distorted rewriting by Jmh649 can only call into question good faith and possible financial motivations. So I have a very simple question for Jmh649 - do you derive an income from offering CBT to tinnitus patients? Please note if you do not reply it will be assumed that you do have undeclared conflicts of interest.Recent examples of financially-motivated editing of entries by contributors makes the need for all conflicts of interest to be declared essential - this is at the heart of the integrity of Wikipedia as a project. — Preceding unsigned comment added by 78.147.175.249 (talk) 10:42, 6 January 2014 (UTC) — Preceding unsigned comment added by 92.26.172.212 (talk)

I do not receive any money or income from doing CBT for tinnitus patients. In fact I have never done CBT for tinnitus patients or referred them to CBT.

Now please read WP:MEDRS. It says we do not use primary sources to refute secondary ones. This is a 2013 Lancet review [4] Sources do not get much better than that. Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:03, 12 January 2014 (UTC)

We state for CBT " It decreases the amount of stress those with tinnitus feel" Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:03, 12 January 2014 (UTC)

My comment is that your own editing was a distortion of the Lancet 2013 article which I have read. The Lancet article argues for a combination of therapies - especially sound therapy and CBT therapy.It also points out that though CBT may reduce patient anxiety as a result of tinnitus it does not have any effect on the tinnitus sound level - an important point that needs to be included. Moreover, one of the main points of the Lancet article is that the evidence base supporting any therapy for tinnitus is very limited - no therapy has been shown to have anything more than very limited effectiveness. — Preceding unsigned comment added by 78.147.163.81 (talk) 13:48, 15 January 2014 (UTC)

Per "not have any effect on the tinnitus sound level" Yes we already say this. CBT is recommended first line as it is safe. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:16, 24 January 2014 (UTC)

JMH649 said Per "not have any effect on the tinnitus sound level" Yes we already say this" This is simply untrue - perhaps you would like to substantiate your comment by referring to the section of CBT Therapy discussion where this is stated?? I'm afraid that this is yet another example of lies, distortion and bias by JMH649 - your continual distortion of the Tinnitus Wiki page for financial gain will not be allowed to stand.

Sorry let me clarify, we say " It decreases the amount of stress those with tinnitus feel." We do not state it decreases tinnitus. The Lancet paper says " In a large randomised clinical trial, a multidisciplinary stepped-care approach involving counselling and elements of cognitive-behavioural therapy and tinnitus retraining therapy showed significant benefit in tinnitus severity, tinnitus impairment, and health-related quality of life compared with usual treatment." So a program involving CBT may decrease tinnitus.

This bit "Results of a meta-analysis in which eight controlled trials involving 468 participants were assessed showed clear evidence for an improvement in quality of life and reduction of depression scores after therapy, when cognitive-behavioural therapy was compared with no treatment or another intervention, even if cognitive-behavioural therapy did not reduce tinnitus volume." says CBT is useful even when it does not decrease tinnitus. Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:14, 24 January 2014 (UTC)

Your "clarification" actually clarifies nothing because what you are quoting from is not the tinnitus wiki article but other source material. So you have failed to substantiate your claim that the fact CBT does not reduce tinnitus volume is discussed in the section on CBT in the "Management Section". Additionally the Lancet article you cite argues for a combination of therapies including CBT, TRT and sound therapy. The Management Section of the tinnitus wiki effectively (as rewritten by you) dismisses TRT and sound therapy, arguing for CBT alone.

So Doc James, your misrepresentation of other sources - not to mention simple misrepresentation of what is included in the Tinnitus Wiki article itself - again raises the question of why you are so explicitly promoting CBT. Let's try again: do you earn any income either directly from CBT or indirectly from referring patients to CBT?? Have you allowed Wikipedia to independently verify that you do not financially profit from CBT either directly or indirectly? — Preceding unsigned comment added by 92.24.169.28 (talk) 16:06, 26 January 2014 (UTC)

If you wish to suggest a change to the article we can discuss it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:34, 27 January 2014 (UTC)

We didn't get an answer to the question whether Doc James had allowed Wikipedia to independently verify that he does not financially profit from CBT either directly or indirectly. The failure to respond by Doc James to that question in itself speaks volumes about the agenda that's really been behind the rewriting of the tinnitus wiki.

Issues with these edits

[5]

1. We do not use primary sources to refute secondary ones such as "Recent research has indicated that Clonazepam may have a reductive effect on tinnitus loudness, though more research is required.<ref>Clonazepam quiets tinnitus: a randomised crossover study with Ginkgo biloba.[jour]=J Neurol Neurosurg Psychiatry. 2012 Aug;83(8):821-7. doi: 10.1136.</ref>"

1. Not sure why the 2013 Lancet review was removed
2. We do not capitalize cognitive in CBT.

Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:05, 24 January 2014 (UTC)

To the user in question see WP:MEDRS CFCF (talk) 13:13, 24 January 2014 (UTC)

We didn't get an answer to the question whether Doc James had allowed Wikipedia to independently verify that he does not financially profit from CBT either directly or indirectly. The failure to respond by Doc James to that question in itself speaks volumes about the agenda that's really been behind the rewriting of the tinnitus wiki — Preceding unsigned comment added by 2.96.233.118 (talk) 19:19, 20 March 2014 (UTC)

But notice that YOU didn't respond to his points. So are YOU also 'not responsive'? -- Charles Edwin Shipp (talk) 17:52, 8 May 2014 (UTC)

"Wikipedia" does not have the ability to "verify" stuff. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:25, 8 May 2014 (UTC)

"Wikipedia" does not have the ability to "verify" stuff. Yes that is indeed one of Wikipedia's big problems and has allowed people to promote particular products or services from which they derive financial benefits - as you have with CBT. I think recent scandals have highlighted the problems for Wikipedia - the "assumption of good faith" is being flagrantly abused and simply isn't working. In time some kind of requirement of testing of special interests. will be introduced. Until then we're stuck with people like you using the site to promote their own interests. — Preceding unsigned comment added by 88.106.84.66 (talk) 19:01, 12 May 2014 (UTC)

There is a major problem with the CBT section - at the moment it doesn't seem to reflect the sources. For one thing, where exactly does it say in Hesser that CBT does not affect sound volume? I know it says this in the Lancet review, but they are referencing Hesser and I don't see any mention there. Also please stop harassing editors asking if they have a WP:COI. --sciencewatcher (talk) 22:20, 28 June 2014 (UTC)

The Lancet review states "even if cognitive-behavioural therapy did not reduce tinnitus volume". We do not need to check to see if the Lancet did a good job or not and can simply repeat its conclusions. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:50, 29 June 2014 (UTC)

That's not what this article says. The wording in the Lancet is a bit ambiguous, but if you look at their source you'll see it doesn't have the same meaning as we have in the article. Also I don't think it says in the reviews that CBT just reduces stress - that implies that it isn't really effective, which is misrepresenting the sources. Overall the article seems to be downplaying the effectiveness of CBT. I think we need to more closely say what the reviews say, i.e. that it is a moderately effective treatment, and the effects last until followup. Currently we say the the effects wear off after treatment, which seems to be completely made up (at least it's not in the source given). The whole section looks like it needs to be rewritten from scratch. --sciencewatcher (talk) 04:29, 29 June 2014 (UTC)

Yes excellent points. Will adjust. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:56, 29 June 2014 (UTC)

Thanks. Figured it out. The issue occured with this edit [6] which was then hidden by a bot shortly after such that I missed it. This is one reason why I hate this bot.Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:01, 29 June 2014 (UTC)

Why protection?

As far as I can see there haven't been any edits from new/ip users about a month, so why suddenly protect the page? --sciencewatcher (talk) 04:17, 30 June 2014 (UTC)

Look back at the history. There is a many many month effort to add poor quality content to this article and remove well supported content. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:44, 30 June 2014 (UTC)

Agreed, but I was just surprised that it's suddenly been protected now. I thought perhaps I had missed something. Anyway, thanks for taking the time to improve the article, Doc James. --sciencewatcher (talk) 14:30, 30 June 2014 (UTC)

First paragraph - is it correct?

The opening paragraph of the article reads:

"is the perception of sound within the human ear (ringing of the ears) when no actual sound is present."

...whereas the National Health Service describes Tinnitus as:

"Tinnitus is a term that describes any sound a person can hear from inside their body rather than from an outside source."

Does the former suggest that the noise must be iside the ear? Perhaps this is correct - I'm thinking outloud :)

Also, I think the former is slightly inaccurate as the noise is not always a 'ringing', it could be any of the following:

buzzing, humming, grinding, hissing, whistling, sizzling

Thanks! PJone (talk) 10:12, 30 July 2014 (UTC)

10:11, 30 July 2014 (UTC)

Thanks. Good point. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:15, 31 July 2014 (UTC)

Visual Snow

I have noticed that no one has mentioned visual snow yet. Many visual snow sufferers also experience Tinnitus, and it is thought that the two are connected somehow. As a sufferer of VS myself, I would appreciate it if someone mentioned this somehow in the article. Mycroft1893 (talk) 01:06, 10 October 2014 (UTC)

REf needed Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:04, 10 October 2014 (UTC)

Aspirin

When aspirin is a cause of tinnitus, it would be good if the article explained in detail the mechanism.

"Aspirin’s potential effect on hearing was first reported soon after the drug was synthesized more than a century ago. In fact, tinnitus and hearing loss are among the side effects sometimes listed in tiny print on the label. It’s believed that salicylic acid, the active ingredient, can cause a variety of detrimental changes in the cochlea in the inner ear."

-71.174.175.150 (talk) 16:03, 24 November 2014 (UTC)

What is a ringing

The link in the first paragraph goes to Ringing (medicine), which redirects to tinnitus. I've removed that link as it is useless, is a definition of ringing required? crh23 (talk) 13:12, 4 March 2015 (UTC)

Probably not. Doc James (talk · contribs · email) 10:29, 22 May 2015 (UTC)

Mine is a constant whistling sound at multiple pitches, mostly in the range 3.2kHz-4kHz. Guy (Help!) 13:11, 22 May 2015 (UTC)

Semi-protected edit request on 6 March 2015

There is medical treatment that works in some people, the prescription tri-cyclic anti-depressant Nortriptyline. I have a severe case of subjective, non-relenting tinnitus. Dr. Jeffrey P. Harris of UCSD (Univ. Calif. S Diego) put me on nortrip, 25 mg x 3 daily, and my condition is much better. I can lead a near normal life. No xanax, no valium, no hearing re-training devices. Nortrip restores some of the electro/chem balance in the auditory cortex, and some of the neurons that are making the noise, are un-stressed and return to normal working order. That is the best I can explain. The doctors are not good at explaining exactly how or why nortip works, but it works in many cases.

Donrparty (talk) 05:57, 6 March 2015 (UTC)

We need high quality refs for Wikipedia. Best Doc James (talk · contribs · email) 06:23, 6 March 2015 (UTC)

Not done for now: all requests need to be backed up by reliable verifiable sources, without which no information should be added to, or changed in, any article.
The standard of proof for medical articles is even higher - please see Wikipedia:Identifying reliable sources (medicine) - Arjayay (talk) 08:54, 6 March 2015 (UTC)

Semi-protected edit request on 10 April 2015

The pronunciation should include the alternative pronunciation /ˈtɪnɪtəs/ see Collins English Dictionary - Complete & Unabridged 2012 Digital Edition et al.

122.106.177.188 (talk) 23:03, 9 April 2015 (UTC)

Done Alakzi (talk) 00:00, 10 April 2015 (UTC)

Missing space and full stop

This: "and should be evaluated for bruitsSome people experience" should be "and should be evaluated for bruits. Some people experience". Why is the article not editable? 86.132.221.215 (talk) 20:35, 5 December 2015 (UTC)

Fixed. Someone was trying to promote benzos as a treatment a while ago. Doc James (talk · contribs · email) 08:51, 6 December 2015 (UTC)

Semi-protected edit request on 25 January 2016

Please add citation needed in place of citation 69 here:

Prolonged exposure to sound or noise levels as low as 70 dB can result in damage to hearing (see noise health effects). This can lead to tinnitus.[69] Ear plugs or other measures can help with prevention.

Nowhere does the linked citation mentions that claim. Nucleo22 (talk) 22:22, 25 January 2016 (UTC)

Ref says "In addition, individuals with a history of loud noise exposure from firearm usage or occupational or leisure activities have a higher prevalence of tinnitus"

Adjusted Doc James (talk · contribs · email) 06:29, 26 January 2016 (UTC)

Semi-protected edit request on 28 March 2016

Please delete the first sentence of the following section:

Alternative medicine

Ginkgo biloba does not appear to be effective.[81]

With:

Alternative medicine

An extract of Ginko biloba showed statistically significant superiority over placebo in eight randomized, placebo-controlled trials of the standardized Ginkgo biloba extract EGb 761®.

Here is the citation:

Neuropsychiatr Dis Treat. 2011; 7: 441–447. Published online 2011 Jul 28. doi: 10.2147/NDT.S22793 PMCID: PMC3157487 Ginkgo biloba extract in the treatment of tinnitus: a systematic review

The reason for this change is because the Neuropsychiatry article refutes the statement currently in the Wikipedia Tinnitus article.

70.124.135.151 (talk) 01:12, 28 March 2016 (UTC)

Not done: The source that is currently cited is a Cochrane review from 2013. 1

Your proposed source is from 2011. Besides being a more up-to-date review, Cochrane reviews are typically thought of as the gold standard. Cannolis (talk) 01:25, 28 March 2016 (UTC)

Semi-protected edit request on 4 April 2016

2602:304:4159:50C0:C646:19FF:FEA3:468C (talk) 19:25, 4 April 2016 (UTC)

 Not done as no edit was proposed. Guy (Help!) 19:31, 4 April 2016 (UTC)

Inappropriate use of a statistic

This article says "In clinical settings, 45% of people seen for tinnitus are found to have had an anxiety disorder in their lifetime.[23]" This clearly implicates anxiety disorder as a causal factor, with the implicit assertion that there is a statistical relationship between the two disorders. But no base rate is stated in this article: what proportion of the same populations have experienced anxiety disorders at some point in their lifetimes? We should not leave such a dangling datum and treat it as evidentiary. The full paper is behind paywall.If its authors found a statistically significant correlation in their meta-analysis of papers, the details should be included, or all mention of the statistic should be removed. In the article on anxiety disorder, a different paper gives a 29% incidence in the US population for having anxiety disorder at some point in the life, but it is improper to compare numbers from disparate populations. My objection is that this denigrates people who have tinnitus resulting from exposure to loud noises, and whose inner ear produces ringing noises of various degree and type, and implies they merely have a psychiatric disorder rather than an auditory disorder. Edison (talk) 19:08, 12 July 2016 (UTC)

I agree that this is an entirely inappropriate and misleading use of a statistic which bears no causal relationship to tinnitus. Reify-tech (talk) 21:28, 12 July 2016 (UTC)

An association yes but which is causing which is not clear. Doc James (talk · contribs · email) 18:21, 13 July 2016 (UTC)

Statistically, a "one cell experiment" is what this amounts to. It is a meaningless statement on its own. There is an implicit assumption that the lifetime incidence of anxiety disorder is zero or at least significantly lower in those not complaining of tinnitus. Fire a shotgun a few times, fight a war, work as a boilermaker or rock musician, or play in a marching band and you may have significant hearing loss along with tinnitus. It is then insulting and unscientific to dismiss it as a mental disorder without an auditory disorder. Edison (talk) 02:00, 14 July 2016 (UTC)

It was never stated to be a mental disorder? Doc James (talk · contribs · email) 03:22, 14 July 2016 (UTC)

Proposed change to Alt. Medicine section

I was adding in a sentence from a new 2016 cochrane review on zinc supplements, and I noticed that there are primary articles used to indicate melatonin and zinc supplements as potential therapeutic treatments. In light of this, I propose to make the following changes to the alternative medicine section:

remove:"Tentative evidence supports zinc supplementation[84] and in those with sleep problems, melatonin.[85]"

Modify and Insert:

The American Academy of Otolaryngology recommends against taking melatonin or zinc supplements to relieve symptoms of tinnitus.[70] In addition, a 2016 Cochrane Review concluded that evidence is not sufficient to support taking zinc supplements to reduce symptoms associated with tinnitus. (http://www.cochrane.org/CD009832/ENT_zinc-supplements-tinnitus)

Thanks. JenOttawa (talk) 18:07, 25 November 2016 (UTC)

Sure. Doc James (talk · contribs · email) 23:11, 25 November 2016 (UTC)

Text

"The most common form of an objective tinnitus, however, are spontaneous otoacoustic emissions (SOAEs), which are faint high-frequency tones that are produced in normal healthy inner ears. They can routinely be measured with a sensitive microphone in the ear canal, and a small minority of persons producing them do hear them themselves and describe them as tinnitus. "

A few things: 1) A source from 1991 is a little old. 2) Tinnitus requires the person hearing a sound. 3) Not sure where this ref supports that text

Doc James (talk · contribs · email) 18:55, 13 September 2017 (UTC)

SOAEs that are not heard by the persons whose ears produce them are not called tinnitus. This is only done in the rare cases where the producers do hear then. The source on OAE is not too old for this particular question, because knowledge on the relation of SOAEs and tinnitus has not changed since them. The matter was settled already in those days. --Saidmann (talk) 20:33, 13 September 2017 (UTC)

Which text from the source in question says "The most common form of an objective tinnitus are SOAEs"? Doc James (talk · contribs · email) 22:01, 13 September 2017 (UTC)

The basic data make it obvious. The source is the best review on the subject of OAEs that exists. The prevalence of SOAEs in the general population is about 50%. The frequency among these 50% who hear one of their own SOAEs and describe it as tinnitus is estimated - based on several studies - to be 4%. This means that about 2% of the general population have SOAE-based, objective tinnitus. This figure is far higher than all other forms of objective tinnitus, which is generally (!) reported to be very rare. To be on the safe side, I will add another secondary source: PMID 16411806. --Saidmann (talk) 16:30, 14 September 2017 (UTC)

Okay so you are saying the source does not directly support the text in question?

The second newer ref says "The discovery of spontaneous otoacoustic emissions (SOAEs) generated by outer hair cells led to the logical speculation that they might prove to be an objective correlate of some forms of tinnitus (Kemp, 1979). A number of studies that attempted to link SOAEs with tinnitus found that they were generally independent events (Prieve & Fitzgerald, 2002). It does appear, however, that some patients have tinnitus caused by SOAEs. Penner (1990), for example, observed that the prevalence of tinnitus caused by SOAEs was 4%."

So about 4% of tinnitus is due to SOAEs which is a minority of cases. Doc James (talk · contribs · email) 00:26, 15 September 2017 (UTC)

No, no, I did not say this at all. A minority of cases (4%) within the group of SOAE-producers hear an SOAE as tinnitus. But a majority of cases within the group of patients with objective tinnitus has SOAE-based tinnitus. All other forms of objective tinnitus only appeared as very rare singular cases that could never be counted for a statistical evaluation. And the other source does directly support the text in question because it presents the facts on SOAEs and on the relation SOAE-tinnitus. --Saidmann (talk) 10:42, 15 September 2017 (UTC)

Okay where does the ref say "a majority of cases within the group of patients with objective tinnitus has SOAE-based tinnitus". Carotid stenosis fairly commonly results in tinnitus. Doc James (talk · contribs · email) 00:41, 16 September 2017 (UTC)

As I wrote above, "about 2% of the general population have SOAE-based, objective tinnitus". All other forms of objective tinnitus are far below this figure, including carotid stenosis: PMID 10703157 (and according to this source it is only 0.4 % in the general population). --Saidmann (talk) 18:16, 16 September 2017 (UTC)

The ref does not appear to say "about 2% of the general population have SOAE-based, objective tinnitus"

Sources say 12.5% have tinnitus and 4% of those may have SOAE related tinnitus. So that would be 0.5% have SOAR tinnitus maybe. Doc James (talk · contribs · email) 18:27, 16 September 2017 (UTC)

Yes, only slightly above the 0.4 % with blood noise. PMID 2340968, however gives 6 to 12 % for the Tinnitus-SOAE relation, which supports the view that SOAE-based tinnitus is the most common type within the group of objective tinnitus. --Saidmann (talk) 22:37, 16 September 2017 (UTC)

We do not generally do independent math and make claims based on it. That is also a primary source. Doc James (talk · contribs · email) 03:34, 18 September 2017 (UTC)

Agreed. Flyer22 Reborn (talk) 03:36, 18 September 2017 (UTC)

I now suggest that "The most common form" be replaced by "Another form" (and deleting "however"). In this particular case any kind of prevalence ranking is not of foremost interest for many readers. So we can just as well leave it out here. --Saidmann (talk) 12:04, 18 September 2017 (UTC)

Updated to based on more recent source[7] Doc James (talk · contribs · email) 17:59, 18 September 2017 (UTC)

"Reddit Cure"

As shown in the reddit post https://np.reddit.com/r/WTF/comments/3l3uri/these_guys_lighting_a_mortar_shell_in_their_garage/cv3474n/ there is a "cure for tinnitus", this works for some and doesn't for others; and for some only works for a small period of time (such as myself). Even though this isn't an official cure that has 100% success rate, it is worth it to let people know through the wikipedia article that it exists. If someone is diagnosed with tinnitus, one of the first things they will likely do is look on wikipedia for a cure. Would it not be better to say that there is a unreliable but safe cure that can be done anywhere, rather than that there is no cure?

Please see WP:MEDRS Doc James (talk · contribs · email) 01:58, 20 September 2017 (UTC)

This is a mess

Why is there so much discussion on this talk page about what tinnitus is? That is explicitly and exactly what talk page discussions are NOT for? And what doyou mean by discussing alternate methods to inform the article. That's not how Wikipedia works, period. If there's a dearth of reliable information, we keep the article short, based on what there is. NO EXCEPTIONS. And the article is even worse, a hodgepodge of dubious claims, far too many of which have gone from being unsourced to sourced with extremely dubious material; the Lancet article, for example, is written by 2 PhDs and a surgeon, with no MD providing input. — Preceding unsigned comment added by 2601:197:A7F:D239:88D7:C92:503C:672B (talk) 21:06, 1 January 2018 (UTC)

I fail to see how the Lancet article can possibly be described as 'extremely dubious'. PriceDL (talk) 22:28, 1 January 2018 (UTC)

Auditory-somatosensory bimodal stimulation

I recently added the following paragraph concerning a promising new treatment:

Research published in 2018 found that a combination of sound and mild electrical pulses delivered to the face and neck helped the majority of patients with somatic (craniocervical) tinnitus. Treatment was 30 minutes a day for 28 days. Most decrease in loudness occurred in the final week of the treatment. There were also improvements in terms of a decrease in the harshness or obtrusiveness of the tinnitus. In two of the 20 patients, symptoms disappeared entirely towards the end of the treatment period. Benefits ceased at the end of the treatment or within a couple weeks. There was no benefit without the electrical pulses.

This was reverted by Doc James, and he edited my user page implying that Science Translational Medicine is not a reliable source. Here is the continuation of our discussion:

@Doc James: Speaking of references, what are you referring to? What was my sin? Eric Kvaalen (talk) 06:05, 13 January 2018 (UTC)

Primary source http://stm.sciencemag.org/content/10/422/eaal3175.full rather than review or major textbook Doc James (talk · contribs · email) 15:51, 13 January 2018 (UTC)

@Doc James: It could be years before that research gets into major textbooks or reviews! The researchers found a treatment that gives good results for sufferers of "somatic" tinnitus. Do you not trust the results of this study, published in Science? Eric Kvaalen (talk) 06:30, 14 January 2018 (UTC)

Was not in Science but Science Translational Medicine. It is a single trial of 20 people. So yes would want to see it repeated and would want to see the totality of the evidence discussed in a review. Doc James (talk · contribs · email) 17:32, 14 January 2018 (UTC)

@Doc James: Yes, I know it was Science Translational Medicine -- I was just abbreviating. (It's the same outfit isn't it?) The article says

"Eleven participants noted subjective changes in volume, pitch, or quality that resulted in their tinnitus becoming less “harsh” or “piercing” and more “mellow.” Even participants who did not experience a complete elimination of their tinnitus reported anecdotally that their tinnitus was noticeably less obtrusive and easier to ignore."

It's not entirely clear to me whether that means all 20 participants, or all of the eleven. But that's not too important. The point is, it gave significant benefit to the majority of the subjects. Do you think this was just due to chance? Remember, there was a sham treatment as control, so it's not just psychological.

Eric Kvaalen (talk) 06:47, 15 January 2018 (UTC)

References

Semi-protected edit request on 19 January 2018

Add British Tinnitus Association to external resources https://www.tinnitus.org.uk/ Catherineseow (talk) 16:02, 19 January 2018 (UTC)

Done Spintendo ᔦᔭ 18:06, 19 January 2018 (UTC)

Proposed changes from expert

I am an expert on tinnitus [the first reference of the current article is a chapter I wrote]. I have run a tinnitus clinic in Boston [Harvard] for 25 years and the last 6 years in Israel at the Tel Aviv Medical center. There are 2 major points that need to be made in the article that are missing. (1) a type of tinnitus known as "typewriter tinnitus" always responds to specific medication [carbamazepine and similar drugs] <Levine, R. A. (2006). "Typewriter tinnitus: a carbamazepine-responsive syndrome related to auditory nerve vascular compression." ORL J Otorhinolaryngol Relat Spec 68(1): 43-46; discussion 46-47. Brantberg, K. (2010). "Paroxysmal staccato tinnitus: a carbamazepine responsive hyperactivity dysfunction symptom of the eighth cranial nerve." J Neurol Neurosurg Psychiatry 81(4): 451-455. Sunwoo, W., Y. J. Jeon, Y. J. Bae, J. H. Jang, J. W. Koo and J. J. Song (2017). "Typewriter tinnitus revisited: The typical symptoms and the initial response to carbamazepine are the most reliable diagnostic clues." Sci Rep 7(1): 10615. ></ref> (2) there is a type of pulsatile [cardiac synchronous] tinnitus that never has a detectable abnormality of blood flow by any kind od exam or imaging. All evidence points to it being related to jaw or neck muscle strain.<Levine, R. A., et al. (2008). "Somatosensory pulsatile tinnitus syndrome: somatic testing identifies a pulsatile tinnitus subtype that implicates the somatosensory system." Trends Amplif 12(3): 242-253.></ref> Let me know how I can add these points to the current article Thank you ObbyRAL (talk) 18:10, 30 January 2018 (UTC)

Here is one of the places I would make a change [there are several others, but this is but one example] Prevention involves avoiding loud noise.[2] If there is an underlying cause, treating it may lead to improvements.[3] Otherwise, typically, management involves talk therapy.[5] Sound generators or hearing aids may help some.[2] As of 2013, there were no effective medications WITH THE EXCEPTION OF CARBAMAZEPINE FOR TYPEWRITER TINNITUS(Levine 2006, Brantberg 2010, Sunwoo, Jeon et al. 2017).[3] Tinnitus is common, affecting about 10–15% of people.[5] Most, however, tolerate it well, and it is a significant problem in only 1–2% of people.[5] The word tinnitus is from the Latin tinnīre which means "to ring".[3]ObbyRAL (talk) 06:44, 31 January 2018 (UTC)

Here is a recent email I received regarding one of the things I would like to add to the current article, so that it will be better known: "January 31 2018 Shalom Dr Levine I found your article on the web and I believe it describes my somatic pulsitile tinnitus :) "Somatosensory Pulsatile Tinnitus Syndrome: Somatic Testing Identifies a Pulsatile Tinnitus Subtype That Implicates the Somatosensory System" Attached is my detailed PDF along with notes from UCSF Dr YYYY, etc. Might you review my PDF and see it you have any ideas? If so we can talk? Many thanks. XXXXXX"77.127.94.159 (talk) 20:39, 4 February 2018 (UTC)

copy/pastes of emails are not reliable sources anywhere in Wikipedia. It also doesn't matter who you say are, or what you say you know. What matters is what reliable sources say. Please see WP:MEDRS for sources for content about health, and WP:RS for anything else. Content also must comply with the content policies and guidelines, see especially WP:NPOV. Jytdog (talk) 20:55, 4 February 2018 (UTC)

of the refs cited above, each of PMID 16514262 and PMID 19778910 and PMID 28878303 and PMID 18632767 is each a primary source and not OK per MEDRS. I appreciate that you would like to improve this article but we look for recent literure reviews or statements by major medical/scientific bodies for sources. This high standard does mean that WP is not cutting edge, but we are able to prevent addition of all kinds of bad content by keeping to it consistently. Our mission is provide the public with "accepted knowledge", and the kinds of refs I just mentioned are where we find it. Jytdog (talk) 21:01, 4 February 2018 (UTC)

Dear Jytdog - thank you for clarifying for me how wikipedia selects its medical content I understand that "Ideal sources for biomedical information include: review articles (especially systematic reviews) published in reputable medical journals; academic and professional books written by experts in the relevant fields and from respected publishers."

This is currently the first reference in the wiki tinnitus article. Levine, RA; Oron, Y (2015). "Tinnitus". Handbook of clinical neurology. 129. pp. 409–31. doi:10.1016/B978-0-444-62630-1.00023-8. PMID 25726282.

All the edits I would like to make are based upon the information contained within this chapter I wrote.

I think you will agree that this chapter I authored is (a) a systematic review article, (b) published in an academic and professional book [Handbook of Clinical Neurology] written by experts in the relevant fields and (c) is from a respected publisher [Elsevier] . As such it meets the WP:MEDRS criteria for sources for content about health. There is nothing controversial about any of the edits I would like to make, so the edits are consistent with Wikipedia:Neutral point of view. Shall I be more specific about the edits that I feel should be made? 77.126.120.220 (talk) 19:36, 10 February 2018 (UTC)

Still awaiting response for my request to make edits based upon the chapter I authored which meets WP:MEDRS criteria for sources for content about health. It is almost a month since I made the request. Kindly respond ObbyRAL (talk) 18:54, 7 March 2018 (UTC)

Semi-protected edit request on 19 February 2018

In Management Section

Medication :

Add : Caroverine drug show good success rate in treating subjective tinnitus of inner ear.

Ref : Denk DM, Heinzl H, Franz P, Ehrenberger K (Nov 1997). "Caroverine in tinnitus treatment. A placebo-controlled blind study". Acta Oto-Laryngologica. 117: 825–30. doi:10.3109/00016489709114208. PMID 9442821. Amitdwivedi11 (talk) 10:24, 19 February 2018 (UTC)

 Not done for now: Per WP:MEDRS. This source and similar caroverine tinnitus studies can best be described as preliminary or investigational. Although apparently sold for that purpose in some countries, it is not an approved drug by the US FDA or the European Medicines Agency and the current Clinical Practice Guideline from the American Academy of Otolaryngology recommends against any medication therapy. Eggishorn (talk) (contrib) 19:33, 20 February 2018 (UTC)

Ototoxic Drugs

I find reference 31 is not a strong reference and I was wondering if the author could find a better list of 'ototoxic' medications or medications with potential hearing loss side-effects. I am not an expert in this field, but I find that the medications listed in reference 31 are often misspelled, and don't see quite correct in other cases. I tried to find a better reference myself, but was not able. Maybe there is a list somewhere for general practitioners?RodentsRodentsRodents (talk) 12:41, 19 February 2018 (UTC)

NEJM

doi:10.1056/NEJMcp1506631 JFW | T@lk 07:14, 29 March 2018 (UTC)

Image

2010-07-20 Black windup alarm clock face

Wondering what image we should use to illustrate this article if some do not like this one? Doc James (talk · contribs · email) 13:13, 9 May 2018 (UTC)

None, it's better without an image. Sources call it a ringing, but none equates it to an alarm clock. The image is completely uncalled for. TarkusAB^talk 17:42, 9 May 2018 (UTC)

In Medication Header add

In Medication Section add" Caroverine has been demonstrated to have a high rate of efficacy in the treatment of cochlear-synaptic tinnitus. Reference: Denk DM, Heinzl H, Franz P, Ehrenberger K (Nov 1997). "Caroverine in tinnitus treatment. A placebo-controlled blind study". Acta Oto-Laryngologica. 117: 825–30. doi:10.3109/00016489709114208. PMID 9442821. Topical Administration of Caroverine in Somatic Tinnitus Treatment: Proof-of-Concept Study Klaus Ehrenberger Department of Otorhinolaryngology, Medical University of Vienna, Austria A clinical study on role of caroverine in the management of tinnitus Abha Kumari, Sandeep Kumar Amitdwivedi11 (talk) 08:29, 15 June 2018 (UTC)