TINNITUS
What is Tinnitus?
TINNITUS is the sensation of a sound or noise in the absence of any real external sound stimulation. It is a symptom associated with anything that can go wrong anywhere in the auditory system. In most of our bodily systems pain is the signal that something is amiss but for the hearing mechanism tinnitus is the signal of damage.
Tinnitus appears in a variety of forms and is very prevalent in our modern society. It is estimated that in the U.S. alone there are about 36 million people who have tinnitus in some form and, of that number 20%, or over 7 million, have tinnitus in a severe form. That is, they can never escape from it, it is a constant torment, it is unrelieved and it is always present. Only recently has tinnitus been treatable. The American Tinnitus Association estimates that 12 million Americans are afflicted with severe tinnitus today, and that the numbers are ever increasing. When tinnitus surveys are conducted in other industrialized countries, they reveal about the same prevalence of tinnitus as in the U.S.
Tinnitus is often referred to as "ringing in the ears" which, upon testing, proves to be best matched by a single high frequency tone. High frequency tones are unpleasant and over 83% of tinnitus patients have such tones which lie between 3000 and 12,000 Hz (to orientate you, the highest note on the grand piano is 4000 Hz; common household electricity is 50 Hz).
Patients often have difficulty describing their tinnitus due to the scarcity of adjectives available to describe sounds of any sort. More over, tinnitus patients are also reluctant to admit to their problems since it involves hearing sounds which are not heard by others. Cases of objective tinnitus involve a clicking sound from the pharynx region or the eustachian tube but objective tinnitus is very rare.
Causes of Tinnitus
Tinnitus, which is a symptom of disorder or damage somewhere in the auditory system, can be caused by something as simple as debris on the ear drum to something as severe as a tumor on the VIIIth nerve. Thus, all tinnitus patients should be examined by an otolaryngologist or otologist. The most common cause of tinnitus is exposure to excessively loud sounds; not only the loud sounds of industry and the work place but loud recreational sounds as well. All tinnitus patients are cautioned to avoid or protect against loud sounds, otherwise their tinnitus might be made worse.
Treatment of Tinnitus
As yet there are no cures for tinnitus but due to the large number of investigators now working on tinnitus there is optimism for the future. If a medically treatable cause for tinnitus is discovered then that treatment is the procedure of choice. Unfortunately that is not the case in about 95% of tinnitus patients who must then seek non-medical treatment. The non-medical treatment of choice for tinnitus is masking. Masking is simply arranging an external sound which covers-up the tinnitus and which is readily acceptable to the patient as a substitute for their tinnitus. Before actually trying masking some patients are prone to say; "What advantage is there in trading one sound for another?" The facts are these: an internal sound, such as tinnitus, is very difficult to ignore but all of us have had lots of experience ignoring external sounds which are constant, not too loud and totally monotonous. We consistently ignore sounds of ventilators, fans, air conditioners, traffic rattle, office clatter, etc.
Thus, if the tinnitus is covered up with a sound which will be completely ignored, then the tinnitus is automatically ignored. Additionally, the sounds used for tinnitus masking are aesthetically more acceptable than tinnitus sounds. Recall that most tinnitus is a high pitched tone which is aesthetically much less acceptable than a noise which resembles wind in the trees or the babbling of a brook. Present day maskers are available as in-the-ear or behind-the-ear devices, all of which are visually indistinguishable from hearing aids. No patient with severe tinnitus should reject the idea of masking until they have actually tried it. Everyone can conduct a simple test to determine whether or not masking will work for him or her and, if it is, whether or not it is an acceptable substitute for their tinnitus. One has only to conduct the "faucet test". The faucet test is performed by standing near a water faucet which is turned fully on. If the sound of the tinnitus is not heard over the sound of the running water then it is likely that masking can be effective.
Is Tinnitus always in an ear with impaired hearing?
In a small percentage of cases, about 10%, tinnitus appears in normal hearing ears. In the vast majority of cases, however, tinnitus is accompanied by hearing loss, which is most commonly in the high frequencies. Since tinnitus is also usually in the high frequencies the presence of the hearing loss works against using a relief for tinnitus in damaged ears. In those cases the problem is often solved by use of a tinnitus instrument that is a combination hearing aid and tinnitus masker. The hearing aid, which must be adjusted first, compensates for the hearing loss so that little masking sound is then required to mask the tinnitus. With the combination unit the masking sound does not have to overcome the hearing loss, it has only to overcome the tinnitus.
Can a hearing aid alone provide masking for Tinnitus?
Yes, about 12% of tinnitus patients find that hearing aids alone relieve tinnitus. These are usually cases where the tinnitus is relatively low pitched, that is, below 3000 or 4000 Hz, and the presence of low frequency hearing loss. Since most patients have hearing losses they should try hearing aids before attempting any other form of masking. In some cases the relief of the hearing problem leaves considerably more energy with which to fight the tinnitus which results in sufficient relief.
Do Tinnitus patients wear Tinnitus maskers to bed in order to sleep?
Only in very rare cases. Instead, tinnitus patient are more apt to utilize some form of bedside masking such as FM radio static, a fan, the Marsona TSC-300 sound conditioner or air conditioners, etc. About 68% of patients with severe tinnitus have difficulty sleeping due to their tinnitus. Moreover, these patients often have difficulty finding an efficient tinnitus masker which is effective for sleeping. There are some products that are specifically designed for use while sleeping. See your audiologist for more information.
Information provided by Starkey Laboratories
LINKS
Tinnitus Treatment Centers, Inc.
