Tinnitus (Ringing in the Ears) Treatment in Singapore

What is Tinnitus?

Tinnitus is the perception of sound — typically ringing, buzzing, hissing, or pulsing — without any external source. Globally it affects around 15% of adults; in Singapore the prevalence is similar, with higher rates in elderly patients and former National Servicemen exposed to live firing.

Tinnitus itself is not a disease. It is a symptom that something has changed in the auditory pathway, most often a degree of hearing loss. The good news: there are real, evidence-based treatments that reduce the impact of tinnitus, even when it cannot be eliminated entirely.

Types of Tinnitus Sounds

• Ringing — the most common
• Buzzing, humming, hissing, or clicking
• Pulsatile tinnitus — rhythmic, matching the heartbeat. This requires investigation.
• Unilateral (one ear) versus bilateral (both ears) — unilateral tinnitus needs imaging

What Causes Tinnitus?

• Noise-induced hearing loss — concerts, NS live firing, prolonged earphone use
• Age-related hearing loss
• Ear wax impaction — easily fixable
• Ménière's disease
• TMJ (jaw joint) disorders
• Medications — high-dose aspirin, certain antibiotics, chemotherapy
• Stress and anxiety — these worsen, but rarely originate, tinnitus
• High blood pressure and vascular causes
• Acoustic neuroma — rare, but the reason unilateral tinnitus needs an MRI

When to See an ENT Doctor

• Tinnitus in one ear only
• Pulsatile tinnitus
• Tinnitus accompanied by sudden hearing loss
• Tinnitus that affects sleep or concentration
• Tinnitus lasting more than 2 weeks
• Tinnitus with dizziness or balance problems

Diagnosis

• Detailed history and ear examination
• Pure Tone Audiometry — almost all chronic tinnitus has an associated hearing change
• Tinnitus pitch and loudness matching
• Tympanometry
• Blood tests if a metabolic cause is suspected
• MRI of the internal auditory meatus — for unilateral tinnitus, to rule out acoustic neuroma

Treatment — Effective Options Do Exist

Many patients arrive at the clinic having been told "there is nothing to be done". This is rarely true. Effective management combines several layers.

Treating the Underlying Cause

• Wax removal — sometimes resolves tinnitus immediately
• Hearing aids — amplify ambient sound, which often makes tinnitus less prominent
• Medication review — discontinuing ototoxic drugs where possible
• Treating Ménière's disease, TMJ dysfunction, or vascular causes

Sound Therapy

• White noise machines and bedside sound generators for sleep
• Tinnitus masking apps
• Hearing aids with built-in tinnitus programs

Cognitive Behavioural Therapy (CBT)

CBT has the strongest evidence base for chronic tinnitus. It does not silence the sound, but it changes how the brain reacts to it — moving tinnitus from foreground to background awareness.

Tinnitus Retraining Therapy (TRT)

A structured combination of counselling and sound therapy over 12–24 months, designed to achieve habituation — the brain stops paying attention to the tinnitus signal.

Medication

No medication cures tinnitus, but melatonin can help sleep, and low-dose antidepressants are sometimes used for severe distress. Ginkgo biloba is popular but the evidence is weak.

Why Choose Dr Pang?

• Thorough investigation to identify treatable causes — not "you have to live with it"
• Full audiometric testing in-clinic at Mt Elizabeth
• Collaborative ENT and audiology approach
• Realistic, compassionate counselling for chronic tinnitus

Frequently Asked Questions