By the time Stephen came to my office complaining of painful spasms and ringing in both ears, he had already been to several physicians about his problem. He had been given an array of diagnoses; most doctors said he had acute outer or middle ear infections and prescribed oral antibiotics or ear drops. These measures had not helped, though. He was 21 years old and had suffered with this pain for nearly a year.
Like many people with ear or head sounds—which we lump into one word, tinnitus—Stephen was distraught. Knowing that there is no magic drug for ringing, I mentally prepared my usual sermonette: Avoid noise, aspirin, and methylxanthines (stimulants of the central nervous system, such as caffeine). And embrace the tried-andtrue helper, sound substitution, or “masking.” This technique, in my experience, is a remedy for almost every patient with tinnitus.
