Alapa‘i Audiology provides tinnitus assessment and treatment. Tinnitus is the perception of a sound in the ears or the head when no external noise is present. Some describe it as a ringing tone, for others it’s a hissing, buzzing, roaring, or “crickets.” According to the American Tinnitus Association, more than 50 million people in the United States have this condition. Often it is accompanied by hearing loss, but not always. There are many potential causes for tinnitus--noise exposure, drug side effects, hearing loss, or rarely--a tumor. There is much that is not yet known about tinnitus, however research is ongoing. Our present understanding of tinnitus is that it is caused by neurologic changes somewhere in the auditory system--not necessarily the ears, but possibly further up in the sound transmission system, possibly in the brainstem and in the brain itself. These neurologic changes cause the neurons to increase their activity, and we think the brain then inaccurately translates this extra activity as sound. People vary in their response to tinnitus and how they deal with it. Patient “A”, over time, becomes accustomed to it and no longer finds it bothersome. For patient “B”, there may be continued awareness and irritation. Tinnitus treatment may be helpful in his case and may vary from something as simple as turning on other sounds in the room so that he no longer concentrates on the tinnitus, or he may find more relief from devices that are specifically developed to deliver a particular type of sound. The therapy is designed to help his system respond the same way that patient “A” does. The first step in defining the tinnitus is with a diagnostic audiologic evaluation and tinnitus assessment.