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New Tinnitus Therapy Offers A Near 80% Habituation Rate
Introduction
Recent research has found retraining therapy over 80% successful
in treating tinnitus, a condition that afflicts one in five adults.
This new therapy, now available at Toronto Hearing Services, employs
a neurophysiological model to retrain brain activity, reduce anxiety
and facilitate habituation. Of those studied, 20% said the ringing
sensation disappeared within 11 days.
Tinnitus (from the Latin tinnire, which means to ring or tinkle)
describes the sensation of sound perceived in the head or ears without
an evident external stimulus. Thought tinnitus is subjective, for
clinical purposes it is classified as subjective or objective, the
latter describing those few incidents in which the sound can be
detected by an observer. A manifestation of a malfunction in the
processing of auditory signals, tinnitus should be differentiated
from auditory hallucinations, which are generally considered a symptom
of psychiatric or neurological disorders.
Research indicates that tinnitus-related ringing is perceived in
the ears (76%) or the head (24%). Due to age-related deterioration
of the nerve fibers, those over 50 are more likely to be affected.
Tinnitus, especially if it is significant, negatively impacts the
sufferer's sense of well-being. In chronic cases, the pattern of
symptoms is similar to that seen in patients with major depression
and can include:
- Insomnia
- Dysphoria
- Decreased
concentration
Ten percent of
elderly tinnitus patients have been found to exhibit these symptoms.
Causes
Tinnitus is a symptom of many diseases and may be triggered anywhere
along the auditory pathway. The ringing sensation may be associated
with any form of sensorineural hearing impairment. In studies
by the Danavox Foundation, hearing loss was identified as the
major determinant of tinnitus, followed by aging and noise exposure.
With age-related sensorineural hearing loss, tinnitus may be attributed
to deterioration of hair cells in the cochlea. Deterioration of
the central auditory pathways in the midbrain, temporal lobes
and cerebral cortex also may be blamed. In conductive hearing
loss, middle ear pathology of nasopharyngeal pathology may produce
the ringing sensation.
Temporary tinnitus may be prompted by:
- Wax in the
ear canal
- Otitis media
or Eustachian tube dysfunction
- Drug ingestion
- Emotional
response to stimulus compounded
by stress or depression.
Classification
The following criteria are commonly used to classify tinnitus:
- Normal vs.
pathological
- Type and probable
site of the underlying disorder
- Acute vs.
chronic
- Self-reported
or measured psychoacoustic characteristics
- Grade of severity
or annoyance
Examination
or Measurement
Thorough testing by a licensed audiologist is necessary to identify
the reason for the ringing sensation. Thorough testing includes:
- Audiometry
- Auditory evoked
potentials
- Acoustic reflexes
- Otoacoustic
emissions
- Loudness growth
Questionnaires
are used to assess the level of annoyance the condition provokes.
Tests are used to delve into the perceptual aspects of the ringing
and its psychosocial consequences. Impact on concentration, hearing,
memory, irritability, sleep patterns and overall psychological
well-being also are measured during testing.
Thoroughly measuring this highly treatable condition is important
for diagnostic reasons and to assure the patient that the symptom
is being given careful consideration. An accurate diagnosis is
the first step in designing a successful treatment plan appropriate
to the patient's age, condition and lifestyle.
Latest Treatments
The newest technology and latest treatments yield
relief ranging from 69% to almost 100%. These treatments include:
Tinnitus Retraining - a new neurophysiological approach focusing
on behavioral retraining of the associations induced by the perception
of ringing. The American Tinnitus Association has reported success
rates of over 80% with this treatment. Twenty percent of those
studied said their tinnitus disappeared within only 11 days. This
promising treatment requires special training and expertise and
is currently available at only a handful of clinics in Canada,
including Toronto Hearing Services.
Hearing Aids - when hearing impairment is present, aids
amplify ambient sounds and provide a masking effect. Current research
shows that these devices reduce tinnitus in 69% of patients.
Maskers - generate constant, external sounds to divert
attention away from the ringing. Maskers were effective for 89%
of patients, according to statistics published in the British
Journal of Audiology. Toronto Hearing Services is the Canadian
distributor for the latest masking therapy from Petroff Audio
Technologies of California.
Combination Instruments - a double instrument appropriate
for patients with hearing loss as well as severe tinnitus that
amplification does not mask effectively. Studies report this instrument
to have a habituation rate similar to a masker.
Psychological Methods - such behavioral strategies as relaxation
training and biofeedback help patients cope with tinnitus. When
the cause of the condition is benign, biofeedback may boost concentration
and relaxation, thereby reducing the intensity of the ringing
sensation. Patients have been found to express relief after sessions
as short as 15 minutes.
Tailoring treatment to the patient's individual needs is the cornerstone
of tinnitus management. Undertreatment or overtreatment may lock
the patient in a cycle of annoying symptoms. A neurophysiological
study published in the British Journal of Audiology reported that
adverse professional intervention actually made the symptoms of
tinnitus worse.
Successful habituation begins with an explanation of the basic
psychological mechanisms involved in the perception of ringing
and, for most patients, reassurance as to the benign nature of
their problem.
Conclusion
Today, patients do not have to be told to live
with tinnitus. Research has shown and experts agree that prompt
and appropriate treatment can yield relief from most symptoms.
The key to the best possible outcome is early referral to an experienced
audiologist who is up-to-date on the latest and most effective
treatments available.
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Studies show that adverse professional intervention
exacerbates the symptoms of tinnitus.