Ringing, Headaches, and No Clear Answers: Laura’s Tinnitus Case
A comprehensive tinnitus and audiological evaluation identified previously unrecognized hearing loss and led to a treatment plan addressing both tinnitus impact and auditory needs.
Meet Laura
After more than 10 years of ringing and buzzing, Laura came to Sound Relief looking for answers. Watch her describe the evaluation, sound therapy, and changes she experienced in daily life.
Clinical Case Summary
Laura, age 40 · Treating clinician: Dr. Megan Read, Au.D., CH-TM
Patient
Laura, age 40
Primary concerns
Chronic ringing/buzzing tinnitus and recurring headaches described by Laura as migraines. Difficulty hearing in noisy environments on occasion.
Tinnitus history
High-pitched tinnitus, worse on the left, present for more than 10 years and progressively more intrusive.
Prior care
The patient reports multiple ENT visits over an extended period, with discussions of steroids and possible sinus surgery.
Baseline tinnitus impact
January 17, 2025, TFI: 76.8 (very severe range). Broad functional impact was documented, including emotional distress, quality-of-life impact, and anxiety related to tinnitus.
Audiological findings
Otoscopy clear, AU. Type A tympanometry, AU. Mild sensorineural hearing loss with a sloping/trough-shaped configuration; tinnitus pitch match at 8 kHz. Excellent word recognition at a slightly elevated level. SNR normal on QuickSIN.
Management plan
Widex Moment bilateral hearing aids with amplification and Zen sound therapy programs. Avoid silence for at least 12 months; ToneLink app for control of programs; TRT counseling and ongoing follow-up for adjustments and monitoring.
Early patient-reported response
Laura reported that the headaches she had been experiencing stopped within several days of beginning care; tinnitus and hearing-related function also improved.
6-month outcome
August 15, 2025, TFI: 22.4 (mild range), a 54.4-point reduction from baseline. Follow-up documentation notes headaches were better within two weeks of beginning sound therapy; tinnitus was described as relieved and non-impactful. Sound therapy was increased one step on the right for balance.
12-month outcome
The annual hearing test documented a slight decrease on the right. The dome was changed and gain increased. The annual note describes tinnitus and headaches as alleviated.
Presenting Concerns: Years of Searching for Answers
Laura did not describe a single dramatic onset. Instead, she gradually became aware of buzzing, ringing, and sounds that seemed to appear without an external source. As the tinnitus became more intrusive, she began searching for an explanation and relief.
“I just started noticing a lot of buzzing and ringing and just sounds that were kind of coming out of nowhere. I don’t know why, but it started getting really bad.”
Clinical history documented at evaluation: high-pitched tinnitus, worse on the left, present for more than 10 years and progressively affecting daily activities and communication. Laura also reported intermittent tinnitus flare-ups and difficulty hearing conversations, especially in noisy environments. Her history included chronic allergies/sinus congestion, sinus infections, and prior steroid treatment.
Laura’s first step was to seek ENT care. According to her recollection, she saw multiple ENT specialists and came away feeling that she still did not understand why the tinnitus was affecting her so strongly or what options remained. She recalls discussions about steroid treatment and possible sinus surgery.
“I was on a journey trying to figure out what was going on with me; going to all these ENTs and getting nowhere, getting no answers.”
When Tinnitus Began Affecting More Than Hearing
As the tinnitus intensified, Laura also experienced recurring headaches that she describes as migraines. At the time, she believed the two might be related, but she couldn’t explain why. The uncertainty increased her fear that long-term medication or surgery might be her only remaining options.
“The migraines were a huge thing for me. Thinking that I was going to have to live with that for the rest of my life was really scary.”
Headache history: Laura’s record describes migraine symptoms in the setting of chronic allergies and sinus congestion.
A Different Kind of Tinnitus Evaluation
Laura recalls that her first visit to Sound Relief differed from her previous appointments because the conversation focused not only on the presence of tinnitus, but also on what it was doing to her daily life. The clinician asked about quiet environments, listening demands, headaches, and overall quality of life.
“She actually took her time and listened to me. She asked me about the tinnitus symptoms and then what my daily life was like. What’s it like being in a quiet room?”
Treating clinician: Dr. Megan Read, Au.D., CH-TM
Diagnostic Evaluation
The purpose of the evaluation was not to assume that Laura’s tinnitus meant she had hearing loss. Rather, the goal was to characterize the tinnitus, identify relevant auditory findings, assess its functional impact, and determine whether any findings required additional medical referral or changed the management plan.
Tinnitus history
High-pitched buzzing tinnitus present for more than 10 years, worse on the left. Documentation includes both “constant tinnitus” and “fluctuating/flare-ups”; history of migraines.
Validated outcome measure
TFI 76.8 - very severe tinnitus impact, with severe and pervasive effects across multiple areas of life.
Otoscopy
Clear bilaterally.
Pure-tone audiometry
Mild sensorineural hearing loss bilaterally with a sloping/trough-shaped configuration.
Speech testing
Speech-in-noise testing documented normal signal-to-noise ratio (SNR) loss bilaterally and excellent word recognition testing at a slightly elevated level, AU.
Middle-ear assessment
Type A tympanograms bilaterally; middle-ear function within normal limits.
Tinnitus-specific measures
Tinnitus pitch match at 8 kHz, 2 dB sensation level (SL).
Medical red-flag review
No medical red flags documented in the materials provided.
Clinical Findings: Tinnitus Plus Previously Unrecognized Hearing Loss
The tinnitus evaluation identified hearing loss Laura had not recognized. The ringing and buzzing had dominated her attention, and she had not interpreted subtle communication changes in her daily life as signs of reduced hearing.
“I didn’t really even notice that I had much hearing loss. I just thought it was the ringing and the buzzing.”
Audiological diagnosis: Mild sensorineural hearing loss with a sloping/trough-shaped configuration; tinnitus pitch match at 8 kHz with a 2 dB sensation level.
Clinical Interpretation
Published research has identified an association between migraine, tinnitus, and hearing loss, but the relationship is not sufficient to establish a single causal mechanism in Laura’s case. Prescription hearing aids with amplification and sound therapy for tinnitus could successfully mitigate symptoms.
Treatment Plan and Rationale
Laura was fit bilaterally with Widex Moment hearing aids that provided amplification and access to Zen sound therapy programs for tinnitus management. The plan addressed both her documented hearing findings and her tinnitus-related functional impact rather than treating the ringing as an isolated symptom.
Device
Widex Moment 220 RIC 10
Fitting
Bilateral fitting on January 17, 2025
Amplification goal
Address documented hearing needs and communication difficulty while supporting tinnitus management.
Tinnitus sound program
Widex Zen fractal-tone therapy mixed with ocean sound; set to a soothing and calming level. Monitor and adjust over time.
Counseling
Patient was counseled on expectations for tinnitus retraining therapy (TRT) and the role of ongoing sound-based tinnitus management.
Recommended use
Full-time use during waking hours was recommended.
Follow-up plan
Follow-up planned at 1 month, 3 months, 6 months, and 12 months, followed by semi-annual check-ins.
During the initial experience with the devices, Laura recalls sitting in a quiet room and noticing an immediate difference in how she experienced the tinnitus.
“She let me wear them, I think, for maybe ten minutes. I think she even walked out because she wanted it to be really quiet. And I just, I think that was my moment.”
Early Patient-Reported Response
Laura reported that the headaches she had been experiencing stopped within several days of beginning treatment. The clinical follow-up record separately notes that her headaches improved within two weeks of starting sound therapy.
“Right when I came here, I would say it was maybe within a few days the migraines went away. It was pretty shocking to me.”
At the annual follow-up, the chart continued to describe both tinnitus and headaches as alleviated.
Functional Changes Laura Reported
Laura described improved clarity rather than simply increased loudness. She also began to recognize small compensatory behaviors she had been using before treatment, such as turning her head to hear conversation more easily.
“It’s not making everything just louder, but it’s making it more clear. That’s what’s been huge for me, and I didn’t even realize it till I got them.”
She also connected those auditory changes with broader improvements in everyday function. Meetings that had made her anxious became more manageable, and she reported feeling more confident in conversations and relationships.
“Now I can go in, I have my sound on, I can focus, I don’t have to worry about not hearing anything.”
Longitudinal Outcomes
Tinnitus Functional Index (TFI): 76.8 at baseline to 22.4 at follow-up — a 54.4-point reduction (70.8%).
TFI total
Baseline: 76.8 (Jan. 17, 2025)
Follow-up: 22.4 (Aug. 15, 2025)
54.4-point reduction (70.8% decrease from baseline) by the 6-month follow-up.
Tinnitus patient report
Baseline: Very severe tinnitus impact; severe, pervasive disruption across multiple areas of life.
Follow-up: 6 months: mild tinnitus; relieved/non-impactful. Annual: tinnitus documented as alleviated.
Marked reduction in tinnitus-related functional burden, supported by both TFI change and follow-up documentation.
Headache/migraine status
Baseline: Recurring migraine symptoms associated in the record with chronic allergies/sinus congestion;
Follow-up: Interview: headaches stopped within days. Clinical follow-up: headaches better within 2 weeks. Annual note: headaches alleviated.
Sustained patient-reported and chart-documented improvement;
Hearing/communication
Baseline: Difficulty hearing conversations, especially in noise, was reported but hearing loss had not been fully recognized by Laura.
Follow-up: Laura reported clearer hearing and improved communication. Annual hearing test showed a slight decrease on the right; dome changed and gain increased.
Subjective communication improved, while annual testing prompted a programming/fit adjustment on the right.
Why This Case Matters Clinically
Laura’s case illustrates why tinnitus evaluations should go beyond asking whether a patient hears ringing. A structured assessment can identify hearing findings a patient may not recognize, quantify how tinnitus affects daily life, screen for features that warrant medical referral, and create a baseline for measuring change over time. It can also distinguish documented clinical findings from patient-reported associations that require careful interpretation.
For Laura, the most important clinical story is not that one test “found the cause.” Instead, a broader tinnitus-focused evaluation identified previously unrecognized hearing loss, supported an individualized management plan, and produced outcomes that can be followed over time with both validated measures and the patient’s own report of functional change.
Patient Perspective
“I just want people to know they need to come to a place like this, no matter what you might think or what preconceived notions you might have, or what you’ve heard — just give it a shot.”
“The money that I have spent at ENTs and other doctors, it’s just been ridiculous compared to coming over here and just doing it. It’s money well spent. It’s worth it. And I would do it again and again and again because it’s truly life-changing.”
Limitations of This Case
This report describes the experience of one patient and should not be interpreted as evidence that the same intervention will produce identical outcomes for others. Tinnitus is heterogeneous, and treatment recommendations depend on the individual’s hearing status, tinnitus characteristics, medical history, functional impact, and treatment goals. Although Laura reported that her headaches improved shortly after treatment began, this temporal relationship does not establish that tinnitus treatment alone caused the headaches to resolve.
Clinical Takeaway
Laura’s experience demonstrates the value of documenting tinnitus as a functional clinical problem rather than a sound complaint alone. Her evaluation identified mild sensorineural hearing loss that she had not fully recognized and established a baseline TFI of 76.8. At follow-up, her TFI had fallen to 22.4, a 54.4-point reduction, while the chart described tinnitus as relieved and non-impactful. Her headache symptoms also improved over time after treatment and remained alleviated at the annual visit, although this case cannot establish causation. Together, the audiological findings, validated outcome measure, and longitudinal patient report provide a substantially stronger clinical record than a testimonial alone.
Clinical references
VA/DoD. Clinical Practice Guideline for Tinnitus. 2024. Evidence-based framework for tinnitus evaluation, management, therapeutic sound, and outcome monitoring.
National Institute for Health and Care Excellence (NICE). Tinnitus: assessment and management (NG155). Recommends audiological assessment for people with tinnitus and considers the Tinnitus Functional Index for adults.
Meikle MB, Henry JA, Griest SE, et al. The Tinnitus Functional Index: development of a new clinical measure for chronic, intrusive tinnitus. Ear Hear. 2012;33(2):153-176. DOI: 10.1097/AUD.0b013e31822f67c0.
Henry JA, Thielman EJ, Zaugg T, Griest S, Stewart BJ. Assessing Meaningful Improvement: Focus on the Tinnitus Functional Index. Ear Hear. 2024;45(3):537-549. DOI: 10.1097/AUD.0000000000001456. Supports interpreting TFI score change together with the patient’s own impression of benefit.
Campello CP, Lemos CAA, de Andrade WTL, et al. Migraine associated with tinnitus and hearing loss in adults: a systematic review. Int J Audiol. 2024;63(1):1-7. DOI: 10.1080/14992027.2022.2151943.
CARE Case Report Guidelines. Structural framework for timeline, clinical findings, therapeutic intervention, follow-up/outcomes, patient perspective, limitations, and informed consent.
Clinical Review
Clinically reviewed by Dr. Julie Prutsman, Au.D., CH-TM, Founder of Sound Relief Tinnitus & Hearing Center
Reviewed: October 15, 2026
