Tinnitus Treatment in Wilmington & Southport, NC

Tinnitus — the perception of sound in your ears when no external sound is present — affects millions of Americans. It can sound like ringing, buzzing, hissing, roaring, clicking, or even music. For some, it’s a mild annoyance. For others, it’s relentless and debilitating, interfering with sleep, concentration, work, and quality of life.

The good news: tinnitus can be managed. At Excel Audiology in Wilmington & Southport, NC, Dr. Jason Rickman, Au.D. provides comprehensive tinnitus evaluations and evidence-based treatment strategies to help patients find relief and reclaim their lives.

What Causes Tinnitus?

Tinnitus is not a disease — it’s a symptom. In most cases, it is caused by an underlying condition affecting the auditory system. The most common causes include:

Hearing Loss

Sensorineural hearing loss (from noise exposure, aging, or other causes) is the most common trigger for tinnitus. When the inner ear is damaged, the brain compensates by generating phantom sounds.

Noise-Induced Hearing Damage

Even a single loud event (a gunshot, explosion, concert) can trigger tinnitus.

Earwax Buildup

Impacted earwax pressing against the eardrum can cause or worsen tinnitus.

Middle Ear Conditions

Ear infections, fluid behind the eardrum, or Eustachian tube dysfunction.

Ototoxic Medications

Certain antibiotics, chemotherapy drugs, diuretics, and high-dose aspirin.

Head or Neck Injury

Trauma affecting the inner ear or auditory pathways.

Temporomandibular Joint (TMJ) Disorders

Jaw problems can refer discomfort and noise perception to the ears.

Cardiovascular Conditions

High blood pressure, atherosclerosis, and other conditions can cause pulsatile tinnitus (a rhythmic sound that beats in time with the pulse).

Ménière’s Disease

An inner ear condition causing fluctuating hearing loss, tinnitus, fullness, and vertigo.

Tinnitus Evaluation at Excel Audiology

Before we can treat tinnitus effectively, we need to understand it. Our tinnitus evaluation is a 30–45 minute assessment that includes:

  • A comprehensive hearing test (audiogram) to determine whether hearing loss is present and to what degree
  • Tinnitus pitch matching — identifying the primary frequency of your tinnitus
  • Tinnitus loudness matching — quantifying how loud your tinnitus actually is (most people are surprised to learn it’s quite soft on an objective scale)
  • Minimum masking level — how much sound it takes to mask or cover the tinnitus
  • Tinnitus Handicap Inventory (THI) — a validated questionnaire that measures the emotional, functional, and catastrophic impact of tinnitus on your daily life

This information guides treatment recommendations and allows us to track improvement over time.

Tinnitus Treatment Options

There is currently no universal cure for chronic tinnitus. However, a range of effective strategies can significantly reduce its perceived loudness and the distress it causes.

Hearing Aids

For patients with both hearing loss and tinnitus — which is the majority — hearing aids are often the most effective first treatment. By amplifying environmental sounds, hearing aids reduce the contrast between the tinnitus and the outside world, effectively making the tinnitus less noticeable. Many modern hearing aids also include dedicated tinnitus masking or therapy programs that provide soothing background sounds.

Sound Therapy / Masking

Sound therapy uses external sounds to partially or fully cover the tinnitus signal. Options include:

  • Hearing aid tinnitus programs (white noise, nature sounds, notched audio therapy)
  • Bedside sound machines for sleep
  • Smartphone apps designed for tinnitus management

Tinnitus Retraining Therapy (TRT)

TRT combines sound therapy with directive counseling designed to retrain the brain to reclassify tinnitus as a neutral, non-threatening signal — reducing the emotional and attentional response to it over time. The goal is habituation: reaching a point where the tinnitus no longer impacts daily life.

Cognitive Behavioral Therapy (CBT)

CBT is a psychological approach shown to be one of the most evidence-based treatments for reducing tinnitus-related distress. It doesn’t eliminate the sound, but it changes the way you think about and react to it. We can provide referrals to mental health professionals experienced in tinnitus management when CBT is appropriate.

Lifestyle Modifications

Certain lifestyle factors can worsen tinnitus, including:

  • Caffeine (in some individuals)
  • Alcohol
  • Stress and anxiety
  • Sleep deprivation
  • Loud noise exposure without protection

We will counsel you on managing these factors as part of your overall tinnitus care plan.

When Tinnitus Is a Medical Emergency

In most cases, tinnitus is a chronic condition that develops gradually. However, there are situations where tinnitus warrants urgent medical evaluation:

  • Sudden tinnitus in one ear — especially if accompanied by sudden hearing loss (a medical emergency — seek care immediately)
  • Pulsatile tinnitus — tinnitus that beats in rhythm with your heartbeat (may indicate a vascular condition)
  • Tinnitus with severe vertigo or dizziness
  • Tinnitus only in one ear (unilateral) — should always be evaluated to rule out acoustic neuroma or other structural causes

You Don’t Have to Just “Live With It”

Patients are often told by their doctors that “there’s nothing you can do about tinnitus.” That is not true. While a cure may not yet exist, evidence-based management strategies can dramatically reduce tinnitus severity and the toll it takes on your daily life. Many of our patients experience meaningful relief.

The first step is a proper evaluation. Let us help you understand your tinnitus and build a personalized management plan.

Tinnitus Care in Wilmington & Southport, NC

Excel Audiology provides expert tinnitus evaluation and management for patients throughout coastal North Carolina. Dr. Jason Rickman takes tinnitus seriously and works with every patient to find a strategy that genuinely helps.

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Frequently Asked Questions

There is currently no cure for most forms of chronic tinnitus. However, it can be effectively managed. Many patients find that with the right treatment plan, their tinnitus becomes significantly less bothersome or barely noticeable.

Not always, but the two are closely connected. The majority of people with tinnitus have some degree of hearing loss, even if it hasn’t been formally diagnosed. A hearing test is an essential part of any tinnitus evaluation.

Yes — for patients with hearing loss and tinnitus, hearing aids are often the most effective treatment. They amplify ambient sounds, which reduces the brain’s focus on the tinnitus signal. Many modern hearing aids also include dedicated tinnitus masking programs.

Tinnitus is often stable once the underlying cause is addressed and a management plan is in place. Continued noise exposure without protection, certain medications, and high stress can worsen it. Protecting your remaining hearing is key.

The THI is a clinically validated questionnaire that measures how much your tinnitus affects your emotional well-being, daily functioning, and overall quality of life. We use it to guide treatment decisions and track your progress over time.