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Tinnitus & Hyperacusis

Tinnitus is the perception of sound when no actual external noise is present. While it is commonly referred to as “ringing in the ears,” tinnitus can manifest many different perceptions of sound, including buzzing, hissing, whistling, swooshing, and clicking. In some rare cases, tinnitus patients report hearing music. Tinnitus can be both an acute (temporary) condition or a chronic (ongoing) health malady. The word tinnitus is of Latin origin, meaning “to ring or tinkle.” Tinnitus has two different pronunciations, both of which are correct and interchangeable:

  • ti-NIGHT-us :: typically used by patients and laypeople
  • TINN-a-tus :: typically used by clinicians and researchers

Millions of Americans experience tinnitus, often to a debilitating degree, making it one of the most common health conditions in the country. The U.S. Centers for Disease Control estimates that nearly 15% of the general public — over 45 million Americans — experience some form of tinnitus. Roughly 20 million people struggle with burdensome chronic tinnitus, while 2 million have extreme and debilitating cases. Tinnitus is not a disease in-and-of-itself, but rather a symptom of an underlying health issue. While tinnitus is a symptom of a wide range of conditions, it is most frequently the result of some level of hearing loss.

In general, there are two types of tinnitus:

Subjective Tinnitus: Head or ear noises that are perceivable only to the specific patient. Subjective tinnitus is usually traceable to auditory and neurological reactions to hearing loss, but can also be caused by an array of other catalysts. More than 99% of all tinnitus reported tinnitus cases are of the subjective variety.

Objective Tinnitus: Head or ear noises that are audible to other people, as well as the patient. These sounds are usually produced by internal functions in the body’s circulatory (blood flow) and somatic (musculo-skeletal movement) systems. Objective tinnitus is very rare, representing less than 1% of total tinnitus cases

Most patients develop tinnitus as a symptom of hearing loss, caused either by age, long-term hearing damage, or acute trauma to the auditory system. According to the general scientific consensus, hearing loss causes less external sound stimuli to reach the brain. In response, the brain undergoes neuroplastic changes in how it processes different sound frequencies. Tinnitus is the product of these maladaptive neuroplastic changes. Patients with hearing loss and tinnitus may find relief from the use of hearing aids and other sound amplification devices.

Do not waste money on the pills sold online as they are not effective for tinnitus!

Hyperacusis

Hyperacusis is the condition in which ordinary sounds seem unpleasantly loud or painful. Often associated with tinnitus, hyperacusis can be experienced by itself. In both cases, the cause may be an excessive responsiveness of the central auditory system. Hyperacusis can be equally disruptive in day to day functioning. It can affect both children and adults. Exposure to loud noises such as rock concerts, gunfire, loud work environments, fireworks and air bag deployment in cars can all be causes of hyperacusis. Often the same non-medical treatments that are conducted for tinnitus apply to the treatment of hyeracusis

If you or someone close to you struggles with tinnitus, contact us for a consultation. Dr Robert Traynor has been successfully treating tinnitus patients since 1978.

Apps and Sound Devices

In our clinic the next level of tinnitus treatment is to consider smart phones applications that especially designed for tinnitus and specially made devices. Most of these products are relatively
inexpensive and some often assist greatly with the tinnitus. For either Apple or android systems you can go to the applications store and obtain tinnitus applications. Simply go to the Apple Applications store, or the Play Store and put in a search for the term “tinnitus” and the various tinnitus applications will come up. Most of these apps are designed to used with the headphones that came with your phone. Follow the directions for the app or set up a counseling session in the clinic and we can assist you through the process. There are also devices that work with tinnitus as well that are available either online or in stores. For example, there is a sound pillows that either generates a noise or relaxing music can be downloaded. Other products for tinnitus can be obtained to accommodate to the the tinnitus. 

 

Hearing Aids

When there is hearing loss, hearing aids have been shown to be among the most effective means of reducing the perception of tinnitus. Hearing aids do not eliminate tinnitus, however most patients report a decrease in the loudness or disturbing quality of the tinnitus perception. Clinical evidence shows that the use of hearing aids in tinnitus patients provides two benefits: it makes the patient less aware of the tinnitus and it improves communication by reducing the annoying sensation that sounds and voices are masked by the tinnitus. Hearing loss reduces stimulation from external sounds resulting in increased awareness of tinnitus and deprivation of input may change the function of structures of the auditory pathways. Tinnitus is often caused by expression of neural plasticity evoked by deprivation of auditory input. With hearing aid amplification, external sounds can provide sufficient activation of the auditory nervous system to reduce the tinnitus perception and it may elicit expression of neural plasticity that can reprogram the auditory nervous system and thereby have a long-term beneficial effect on tinnitus by restoring neural function. To obtain the best results, hearing aids should be fitted to both ears, use an open ear aid with the widest amplification band, and disabled noise reducing controls. In some cases a combination device would be preferable. Most manufacturers have now included a tinnitus program in their products as part of the newest generation of hearing devices that simply is there and available if we choose to use it. The conditions required in order to obtain good results include not only the use of devices, but above all, their adaptation to the needs of the single patient, by counseling and customization. Wearing the hearing aid must become second nature to the patient even though it is only one element of the therapy.

Neuromonics

Neuromonics is a treatment program that is based upon an Australian audiology dissertation from the early 1990s. It consists of a two step process used for severe tinnitus that uses a small, lightweight Oasis™ device with headphones delivers spectral modified, precisely designed music embedded with an acoustic neural stimulus. These sounds, customized for each patient’s audiological and tinnitus profile, stimulate the auditory pathway to promote neural plastic changes. Over time, new connections train the brain to filter out tinnitus disturbance, providing long-term relief from symptoms. There are 5 simple steps over approximately 6 months to the Neuromonics process:

  1. Personal Assessment – An assessment of the hearing and the tinnitus. A discussion of the treatment program.
  2. Fitting of the Oasis Device – Based on your audiological and tinnitus profile, your Oasis™ device will be customized with your individual prescription.
  3. Stage 1 Treatment: Relieving the Symptoms – Stage one usually lasts for about 2 months. This stage helps relieve symptoms so that you can begin to experience control over your tinnitus while continuing treatment. The device is worn for at least two hours per day (or longer, if preferred or needed) during daily activities like reading, preparing meals or at the office.
  4. Stage 2 Treatment: Breaking the Cycle – The goal of Stage Two is to help the brain develop new neural connections that allow it to filter out tinnitus sounds. When this happens, relief continues even without regular use of the Oasis™ device. In this stage, the device is used for at least two hours per day initially. Treatment times are then gradually reduced as tinnitus disturbance lessens. This stage of treatment typically lasts about four months.
  5. Maintenance – At the completion of a successful treatment program, your audiologist will work with you to develop a maintenance program you can use to continue to control your tinnitus on your own. Many people may not feel the need to use the device after treatment. Those who do typically use it for short periods of time (two to four hours per week) to help them maintain the benefits achieved.

If you or a loved one experiences tinnitus or hyperacusis, contact Dr. Traynor today at 970-352-2881 or toll free 877-499-HEAR (4327).