Tinnitus and Treatment

Monday, April 26th 2010

Do you hear ringing in the ears? Whooshing sounds? Phantom bells and whistles? If so it may be time to see a hearing professional, such as an audiologist or an otolaryngologist since you may have a case of tinnitus – the medical term for ringing in the ears. And that non-stop ringing and pinging can drive you totally nuts if you don't do something about it.
A recent study published in Archives of Otolaryngology – Head and Neck Surgery, a subsidiary journal of "JAMA," recently reported on a study conducted on this common health issue:
"Tinnitus, or the perception of sound without an external acoustic stimulus, is a common but poorly understood symptom," the authors [of the report] write as background information in the article. "Although the list of factors associated with tinnitus is long, the causes of tinnitus onset and tinnitus maintenance are far from fully understood, and attempts to develop evidence-based therapies have been thwarted by a poor understanding of the pathophysiology of the condition." Tinnitus has recently been reported to cluster in families, but little is known about the importance of genetic effects in susceptibility to the condition."
Indeed, the problems associated with tinnitus are well documented and they are real. It's not a figment of your imagination, at least in most cases. However, the causes of tinnitus are not well understood and without known causes finding successful treatment options is difficult. In addition it has been unknown if tinnitus is hereditary and if tinnitus can be caused by genetics

Study Results Show Tinnitus Is NOT Inherited

Genes to blame for tinnitus?

Let's crunch the numbers.
Dr. Ellen Kvestad, M.D., Ph. D, who works at the Norwegian Institute of Public Health in Oslo, Norway, and the Akershus University Hospital in Akershus, Norway, along with her colleagues, conducted broad-based research, collecting data from those who have and have not been diagnosed with tinnitus.
The study sample "...analyzed data collected from 12,940 spouses, 27,607 parents and offspring and 11,498 siblings. All participants completed a questionnaire about tinnitus and underwent a hearing examination. A subgroup of 16,186 individuals with some hearing loss and 17,785 controls were sent a second questionnaire requesting more details about tinnitus, to which a total of 28,066 responded."
Approximately 21% of study participants reported definite or probable tinnitus symptoms. "On a scale of negative one to one—where negative one would indicate that offspring always had tinnitus if their parents did not, and one would indicate that both parents and offspring always had tinnitus—correlations for tinnitus ranged from 0.01 to 0.07 for parents and offspring, depending on sex differences. The correlation between siblings ranged from 0.06 to 0.14 and the spouse correlation was 0.04," according to the Norwegian report.
The study did not take in to account different types of tinnitus – some of which may be inherited, but the low correlation of parents, children and siblings indicates that tinnitus is not passed down through the generations.
"This result needs to be replicated with other measures of tinnitus and other types of family data," the authors write in their study results.
"Our results do not necessarily mean that genetic effects are unimportant for all forms of tinnitus, because this symptom can arise from a wide variety of underlying diseases," they [the researchers] conclude. "Considering the heterogeneous origin of tinnitus, rather than searching for the genes responsible for tinnitus in general, future investigators need to identify subgroups of individuals affected by tinnitus with specific causes. Our results do not support the spending of large amounts of time and resources to identify the genes that code for tinnitus in general."

Tinnitus: It's a BIG Problem

The American Tinnitus Association (ATA) estimates that more than 50 million Americans suffer from tinnitus in some form. About 12 million experience tinnitus bothersome enough to seek medical attention. And about 2 million, the ATA estimates, are so seriously debilitated that they cannot function on a day-to-day basis.
Now, not all of those who report symptoms of tinnitus indicate that the condition is bothersome enough to create problems in their lives. But 12 million of us DO have tinnitus to the degree that it has a negative impact on the quality of life – and that's enough people to keep researchers searching for both causes and cures of this condition.
Tinnitus has been shown to cause anxiety, depression and isolation if severe enough and left untreated.

Not a Cure, But At Least Some Help

William Martin, the director of the Oregon Health and Science University Tinnitus Clinic and Tinnitus Research Program, explains, "The complexity of the research makes it very time-consuming and very expensive." Why?
Well, tinnitus isn't caused by one condition. It can be caused by a number of factors. It can also affect quality of life in a variety of ways. Some who experience tinnitus go through life without much difficulty. They hear through the ringing and pinging. In other words, they simply get used to the phantom sounds produced by their ears or by their brains.
"Martin said researchers now understand that, while it may emanate from the ear, tinnitus is, in many ways, a brain issue, like phantom limbs. On the other hand, they're still trying to figure out how to measure the condition, he said."

Addressing the Symptoms of Tinnitus

Okay, we don't know the causes of tinnitus and, in fact, hearing specialists believe there are many causes, from head or ear trauma to over exposure to loud noise over a long period of time.
Because there are so many possible causes of tinnitus (including diseases of the ear and of the body as a whole), finding a cure is probably years away. However, hearing professionals have found tinnitus can be managed in some cases by treating the underlying cause (if identified) or by altering the response to the tinnitus. Treatments outcomes vary greatly among individuals; however, the following are a few of the treatments being used today.

Hearing Aids

Tinnitus is often accompanied by hearing loss. When hearing aids are used to treat the hearing loss the increase in amplification and awareness of sound within the environment often leads to the decrease in perception of the tinnitus. The introduction of sound and noise essentially mask out the tinnitus when the hearing aids are worn.
Even when hearing loss isn't present, the use of hearing aids is sometimes the recommended course of action. Hearing aids boost natural sounds, masking the tinnitus and lessen how noticeable it is throughout the day. This in turns helps the brain to stop focusing on the sound and focus on other sounds within the environment.

Noise Makers

Simple devices designed to mask the ringing sound through the production of everything from soft "white noise," to soft, soothing sounds to repetitive music – just enough stimuli to block out that ringing while still concentrating on balancing your checkbook. It's a treatment option that is relatively easy to implement and inexpensive.
Noise generators can be purchases at many different types of stores and websites and produce a wide variety of noise so one can choose what they not only prefer but one they feel best masks their tinnitus. In fact iPhone users can even download a noise maker app so they have an option for when they travel.

Boring Music

A University of Virginia )UV) team has employed a new tactic in the battle to address the symptoms of tinnitus – boring music. UV researchers are using a product, produced by Neuromonics, to help train the brains of tinnitus sufferers to ignore the ringing and, after listening to "Tie a yellow ribbon..." 50 times, that ringing in your ears may be a welcome relief!
Neuromonics is another form of masking tinnitus. This technology combines a neural (brain) stimulus and that couples with unobtrusive music to mask the ringing sounds. Neuromonics retrains the brain to focus on important or relevant sound while hearing "through" the ringing produced by the tinnitus. Think of neuromonics as masking with a resetting of the brain NOT to hear the ringing.
The thinking is pretty simple. IF tinnitus is a brain condition, and not an ear problem, occupying a small part of the brain with boring music serves as a distraction from the ringing sound that is SO distracting to tinnitus sufferers. However, that repetitive, boring music doesn't consume enough attention to distract you from your workday routine but it DOES distract you from the ringing in your ears.
Of course, the trade off is boring music all day, but ask any tinnitus sufferer which they'd prefer and they'll take accordion music over ringing in the ears any time. Using boring music, played repeatedly, occupies enough of the hearing centers of the brain to mask the ringing caused by tinnitus.
Not a cure but certainly a means of addressing the symptoms – and that's plenty good enough for those who have to live with this sometimes maddening condition. Fact is, 12% of us experience tinnitus to the degree that it interferes with daily life. In the most severe cases, those who experience tinnitus are unable to work. Hearing routine sounds becomes a problem and, frankly, the problem can drive sufferers to extremes.

TRT (Tinnitus Retraining Therapy)

TRT involves a series of treatments and regular "brain" work to teach the brain to ignore the ringing in the ears. Unlike neuromonics, TRT employs a different approach – one in which the tinnitus patient simply ignores the ringing.
When you have a toothache, all you think about is that stupid toothache. Tinnitus is the same way. Once you recognize it, it's all you think about. TRT trains the brain to ignore the ringing sound so the individual hears past it or through it. It no longer presents impediments to living a good life.

Hope for the future

At this time there is no cure for tinnitus but hundreds of researchers and organizations such as ATA are fighting to find a cure. The Norwegian study does eliminate heredity as a source of tinnitus.
However, those 50 million Americans who report some degree of tinnitus have hope. There are numerous options to manage the symptoms of tinnitus so you can get on with your life and reduce the negative affects tinnitus has on your well being.
If you have noticed tinnitus, the best first step is to have a full hearing evaluation. Hearing loss often does accompany tinnitus; however, even if the hearing is normal other tests performed during the hearing evaluation may assist the physician in determining an underlying cause.

Fuente Heathy Hearing