Tinnitus Q&A

Tinnitus is a serious condition that affects hearing and quality of life for nearly one in five people in the United States. Here are some of the most common questions we've encountered in our experience with the diagnosis and treatment of tinnitus, along with answers provided by our professional hearing and audiology experts.

What is tinnitus?

Tinnitus is not a disease, but a symptom that can result from a wide range of underlying causes: prolonged exposure to abnormally loud sounds in the ear canal, ear infections, foreign objects in the ear, nasal allergies that prevent (or induce) fluid drain, or wax build-up. Tinnitus can also be noticed as part of the natural aging process, as a side effect of some medications, and as a side effect of genetic (congenital) hearing loss. However, the most common cause is noise-induced hearing loss. Back to Top

What are the effects of tinnitus?

The effects of tinnitus can be devastating in severe cases. Sleep deprivation and disrupted concentration make performing the most basic day-to-day tasks difficult. Work, recreation and social interactions can become unmanageable. When a person is struggling to find a cure for their annoying tinnitus, their quality of life can quickly deteriorate. Back to Top

What causes tinnitus?

The leading cause of tinnitus is exposure to noise. Other causes of tinnitus include some medications, head trauma, heredity factors and catastrophic events (i.e., the death of a family member). Back to Top

What hearing tests help diagnose & treat tinnitus?

Hearing assessments are used to determine whether there is any hearing loss, which is a common cause of tinnitus. If your practitioner suspects you have tinnitus, further evaluations such as otoacoustic emissions, auditory brainstem response and tinnitus pitch and loudness matching are necessary. The results of these tests are used to provide the patient with a customized treatment plan.

OTOACOUSTIC EMISSIONS TESTING
Otoacoustic emissions (OAE) testing helps verify the health of the cochlea. In OAE testing, the audiologist places a small foam probe in the ear. The person relaxes while listening to a series of sounds; no response on the part of the person is required. A computer analyzes the recordings made from the ear and determines whether they are normal. U

sed with other test results, OAE results help determine whether a person's tinnitus might a result of a damaged cochlea. These results are also used to isolate possible sources of a person's hearing loss or dizziness.

AUDITORY BRAINSTEM RESPONSE
Auditory brainstem response (ABR) testing helps verify the healthy functioning of the auditory system, including the cochlea, auditory nerve, and brainstem. The test records neural activity in response to sounds. The audiologist places electrodes on or near the ears. The patient is instructed to relax while listening to a series of clicks or other sounds played through earphones. A computer records the auditory system's electrical responses to the clicks. The audiologist analyzes these responses to determine whether the auditory system is functioning normally.

The ABR results are used along with the results from other tests to determine the source of a person's tinnitus, hearing loss, or dizziness, and to decide on an appropriate treatment program. This test is used to rule out the possibility of tumors or other growths that may be impinging on the auditory or vestibular nerves.

TINNITUS PITCH AND LOUDNESS MATCHING
For these tests, the clinician will present a series of sounds and ask the patient which sounds most resemble their tinnitus. The loudness of the tinnitus is evaluated. The results of these tests are used to provide the patient with a customized treatment plan. Back to Top

Are there effective tinnitus treatments available?

There are several treatment methods for tinnitus. After performing any necessary diagnostic testing to create a customized treatment plan, the following treatment options may be considered.

TINNITUS RETRAINING THERAPY (TRT)
Tinnitus Retraining Therapy (TRT) involves retraining the brain to ignore the annoying sound of tinnitus. Compared to other treatment options, TRT has a tremendous success rate with over 80% of patients showing significant improvement of symptoms.

We all know the auditory system provides the signal (tinnitus) but the problem is created when this signal is processed by the brain as something threatening, resulting in a negative reaction. This reaction is of a conditioned reflex type, and as such, cannot be changed by conscious will.

Fortunately, the brain has the remarkable ability to habituate to any positive reaction sensory signal. Thus, the purpose of TRT is to remove the negative reaction. Through the use of directive counseling and sound therapy, the brain is distracted from the tinnitus (negative reaction) and can therefore start the habituation process.

MASKERS
Another treatment approach is the use of sound generators (or maskers). Maskers look similar to hearing instruments, but only produce "white noise" or an ocean-type sound in order to mask the tinnitus. Although this type of treatment has been around for a number of years, it is not the preferred treatment for tinnitus. Maskers provide temporary relief of tinnitus and do not allow for the habituation process necessary for rehabilitation.

Those suffering from chronic tinnitus often have substantial hearing loss. After assessing the hearing loss and determining the pitch and loudness of the tinnitus, hearing instruments provide relief through amplification of environmental sounds that fall within the same range of the patient's tinnitus.

In some cases, a person may have a substantial hearing loss and annoying tinnitus that falls within a different pitch range. These persons require a combination hearing instrument - masker device that not only amplifies the sounds they need to hear better, but also generates the "white noise" necessary to begin the habituation process.

OTHER TINNITUS TREATMENTS
Other behavioral treatments of tinnitus may include cognitive training, sleep facilitation, relaxation techniques and biofeedback therapy. In most cases, these are used in conjunction with Tinnitus Retraining Therapy according to the needs of the patient.

Overall, the best course of treatment for the relief of tinnitus can only be determined by careful diagnostic testing and consultation by a healthcare professional specifically trained to treat patients with this disorder. Back to Top

Is there a self test for tinnitus?

It’s best to visit an audiologist for diagnosis and a customized treatment plan if you suspect you have tinnitus. However, this self test may be helpful in determining your treatment options. If you answer "yes" to any of these questions, you may be a candidate for Tinnitus Retraining Therapy (TRT).

• Because of your tinnitus, is it difficult for you to concentrate?
• Does the loudness of your tinnitus make it difficult for you to hear people?
• Because of your tinnitus, do you have trouble falling asleep?
• Does your tinnitus interfere with your ability to enjoy social activities?
• Does your tinnitus get worse when you are under stress?
• Because of your tinnitus, do you find that you are often irritable?
• Do you find it difficult to focus your attention away from your tinnitus and on other things?
• Because of your tinnitus, do you feel you have a terrible disease?

What tips can you offer for living with tinnitus?

Tinnitus is a serious condition. Patients suffering from tinnitus find that it affects almost every area of their lives. However, in our years of working with tinnitus patients, we’ve found the following advice to be helpful.

• Avoid silence
• Purchase an environmental sound generating device and use it regularly in quiet settings
• Protect your ears from dangerous loud sounds
• Reduce sodium intake
• Drink plenty of water each day
• Exercise regularly
• Be HOPEFUL! There are a variety of treatment approaches for tinnitus

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