Although the low level laser therapy against tinnitus is known for more than 20 years, it is still a rather controversial treatment (and therefore usually not covered by health insurances). It is based on the theory that tinnitus is caused by damage or deterioration of the hair cells in the inner ear, and that this damage can be repaired by supplying radiative energy to the inner ear by means of the laser (although the laser can not directly reach the inner ear due to the amount of tissue that must be traversed, it is assumed that there is still sufficient energy being supplied to the inner ear). The low level laser therapy is either applied by a practitioner in special tinnitus clinics/practices (of which however there exist only very few) or one can buy or rent corresponding devices for home treatment. Whilst the latter are usually less expensive than a clinical treatment (which has to last for several sessions), they are also less powerful and therefore probably less effective. Whether the above theory of the laser repairing the hair cell damage is correct is at least debatable since in many (if not the majority) of cases there is no reason to assume that the hair cells are damaged at all (the tinnitus is solely caused by by the nervous system). But there are a number of studies which seem to indicate that the low level leaser therapy is effective in at least significantly improving the condition, but these have usually been performed or sponsored by the institutions applying these treatments or selling lasers for home treatments. This is not to say that they should necessarily be questioned, but, as far as I am aware, independent studies have as yet not conclusively confirmed the effectiveness of the low level laser therapy. Nonetheless, I know personally of people who have experienced a substantial improvement of the condition after having had a low level laser therapy treatment, so for anyone looking for a last resort it might still be worth checking out (even though it is a costly option).

Sound therapies in various forms are often being applied in order to alleviate the tinnitus symptoms. The most common form of a sound therapy is a 'tinnitus masker (noiser)' , which is a device that produces 'white noise' in order to distract from the tinnitus noise. In this way it is hoped that the person learns to focus less on the tinnitus and thus push the latter in the background. For some people tinnitus maskers appear to provide some relief in this sense (especially in the early phase), but the drawback is that they make it more difficult to get used to the tinnitus and thus habituate to the latter. So a masker (noiser) could actually lengthen the time required for the tinnitus if not to be cured but then at least be reduced to a level where it does not present any problems anymore (compensated tinnitus). The strategy of fighting fire with fire in this sense may therefore not be the best one for everybody. In fact, it is not rare that maskers worsen the tinnitus (I personally had contact with a couple of people where the noiser actually added a new tinnitus tone to the existing one). Sounds are however not only used to acoustically mask the tinnitus, but also in order to provide relaxation. Relaxation CDs and sound files (especially nature sounds) are very popular and in general helpful for tinnitus sufferers (as relaxation will calm the nerves down and thus reduce the tinnitus noise). Recently there have been some scientific experiments with 'notched' music where certain frequencies (centered around the tinnitus frequency) were filtered out (see for instance this BBC news bulletin. Whether this has the potential for a recognized therapy is still questionable, music CDs treated in this sense are already commercially available. Their prices are unfortunately quite inflated, but with suitable Audio software, one cam actually produce 'notched' recordings oneself without any cost. So whilst sound therapies can be quite useful and effective in improving tinnitus symptoms, one should be aware of its limitations and not expect a full cure from this. One should also take care not to overdo it and cause more harm than good by exposing oneself to too much music and sounds. This holds especially if one uses headphones as these can cause problems with regard to pressure equalization on the ear. In particular, in-ear headphones ('earbuds') should be avoided, but also headphones that completely close around the ears. Better use 'open' headphones that don't prevent ventilation of the ear. Thomas