March 2019 Lock Haven Express

It has been three and a half years since I wrote my last article on “tinnitus” so I decided to update you on the research and development about this pesky problem. There have been great strides in hearing aid technology related to helping with tinnitus. That having been said, there are people whose ringing is so severe that even the most recent features available do not help. Sadly, I just experienced that in my office. Both the patient and I were disappointed that he got no relief from the tinnitus masking support of his new hearing aids. I do, however, have dozens of patients who have been helped. Let’s review by defining tinnitus.

“Tinnitus (TIN-ih-tus) is the perception of noise or ringing in the ears. A common problem, tinnitus affects about 1 in 5 people. Tinnitus isn’t a condition itself — it’s a symptom of an underlying condition, such as age-related hearing loss, ear injury or a circulatory system disorder. Although bothersome, tinnitus usually isn’t a sign of something serious. Although it can worsen with age, for many people, tinnitus can improve with treatment. Treating an identified underlying cause sometimes helps. Other treatments reduce or mask the noise, making tinnitus less noticeable.”(Mayo Clinic)

There are two types of tinnitus. Subjective tinnitus happens in a patient’s hearing and is only audible to the patient. It happens inside the patient’s head. Objective tinnitus can actually be heard from the head of the patient by others. Tinnitus involves the annoying sensation of hearing sound when no external sound is present. Tinnitus symptoms include these types of phantom noises in your ears: ringing, buzzing, roaring, clicking, and hissing. The phantom noise may vary in pitch from a low roar to a high squeal, and you may hear it in one or both ears. In some cases, the sound can be so loud it can interfere with your ability to concentrate or hear actual sound. Tinnitus may be present all the time, or it may come and go.

Tinnitus does not have a cure yet, but treatments that help many people cope better with the condition are available. Most doctors will offer a combination of the treatments below, depending on the severity of your tinnitus and the areas of your life it affects the most. Hearing aids often are helpful for people who have hearing loss along with tinnitus. Using a hearing aid adjusted to carefully control outside sound levels may make it easier for you to hear. The better you hear, the less you may notice your tinnitus. Counselling helps you learn how to live with your tinnitus. Most counselling programs have an educational component to help you understand what goes on in the brain to cause tinnitus. Some counselling programs also will help you change the way you think about and react to your tinnitus. You might learn some things to do on your own to make the noise less noticeable, to help you relax during the day, or to fall asleep at night.

Wearable sound generators are small electronic devices that fit in the ear and use a soft, pleasant sound to help mask the tinnitus. Some people want the masking sound to totally cover up their tinnitus, but most prefer a masking level that is just a bit louder than their tinnitus. The masking sound can be a soft “shhhhhhhhhhh,” random tones, or music. Tabletop sound generators are used as an aid for relaxation or sleep. Placed near your bed, you can program a generator to play pleasant sounds such as waves, waterfalls, rain, or the sounds of a summer night. If your tinnitus is mild, this might be all you need to help you fall asleep.

Acoustic neural stimulation is a relatively new technique for people whose tinnitus is very loud or won’t go away. It uses a palm-sized device and headphones to deliver a broadband acoustic signal embedded in music. The treatment helps stimulate change in the neural circuits in the brain, which eventually desensitises you to the tinnitus. The device has been shown to be effective in reducing or eliminating tinnitus in a significant number of study volunteers.

Cochlear implants are sometimes used in people who have tinnitus along with severe hearing loss. The device brings in outside sounds that help mask tinnitus and stimulate change in the neural circuits.

Antidepressants and antianxiety drugs might be prescribed by your doctor to improve your mood and help you sleep. Other medications may be available at drugstores and on the internet as an alternative remedy for tinnitus, but none of these preparations has been proved effective in clinical trials.

In the past three and a half years since I wrote on this topic, hearing aids have made huge strides in tinnitus masking software capabilities. Previously, we could really only create a white noise to compete with the tinnitus, now mid and top-level technology in hearing aids gives us seven counter noise options, usually three to four broadband noises and three to four nature sounds like the sea shore or a soft babbling brook. This technology distracts the brain away from the annoying tinnitus by giving it something more pleasing to listen to. Obviously, the tinnitus is not masked when a patient takes off their hearing aids at night. About eighty percent of my tinnitus patients gain some relief just by the soft circuit hum that comes with wearing hearing aids. After a few days the brain adjusts to that low-level hum and the tinnitus is not noticed as before. Again, the tinnitus will return when the hearing aids are removed. Hearing industry professionals usually say that not everyone with hearing loss has tinnitus, but generally everyone who has tinnitus has hearing loss.

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