People troubled by persistent ringing in the ears known as tinnitus may find relief with therapy aimed at changing the way they think about the problem. Tinnitus is a common disorder, estimated to affect 36 million Americans. It can arise from a number of causes, from ear wax build-up to medication side effects to hearing loss. For some people, the noise is persistent and bothersome enough to interfere with daily life. Treatment depends on the underlying problem, but one strategy--known as tinnitus retraining therapy (Tinnitus RT)--involves counseling to change the way patients perceive and react to the ear noise. In addition, small "noise generators" that can be worn in the ear are used to provide a low-level sound that competes with the tinnitus and makes it less noticeable. In the new study, 6 months of Tinnitus RT improved both physical and emotional well-being among 32 patients with tinnitus. The patients had been living with the ear ringing for more than 7 years, on average. Dr. Julie A. Berry and colleagues at the University of Maryland Medical System in Baltimore evaluated patients' scores on a standard test of daily functioning and emotional well-being before and after 6 months of Tinnitus RT. After therapy there was an improvement in test scores -- in practical measures such as job performance and concentration, and in the way patients reacted emotionally to their tinnitus. Evidence suggests that the brain can be retrained to remove the negative emotional association given to the tinnitus signal. For its part, the sound-generating ear device may blur the contrast between a patient's tinnitus and everyday noises in the environment, helping to change the way the tinnitus is perceived. Archives of Otolaryngology--Head and Neck Surgery 2002;128:1153-1157. Tinnitus treatment cause of tinnitus pulsatile tinnitus tinnitus relief clear tinnitus acupuncture tinnitus remedy.