Patients with intractable tinnitus as a primary complaint represent a complex enigma to the otolaryngologist. Once the symptom has been determined to be caused by benign factors, the otolaryngologist usually offers simple reassurance1 and informs the patient that nothing can be done about it, as it is something that one just has to learn to live with. This advice is often met with bitter resistance from patients who interpret it as being callous and insensitive. After all, if the symptom was something patients were able to "learn to live with," they may not have sought professional help in the first place.
In addition to the frustration of knowing that medical and surgical treatment probably will not help alleviate the symptom, the physician may have difficulty justifying an outside referral, since so many of the nonmedical treatments described in the literature in the past several years have not provided consistent
Counseling the Patient With Tinnitus. Arch Otolaryngol. 1985;111(5):283–284. doi:10.1001/archotol.1985.00800070035001
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