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Tinnitus
What is Tinnitus?
Tinnitus is the perception of sound that does not have an external source. If you suffer from tinnitus, you are not alone. Tinnitus, or ringing in the ears, can be a nerve wracking condition that robs a person of life’s simple pleasures. Tinnitus is commonly described as a “hissing, roaring or ringing.” It may be constant, pulsed or intermittent. It may be perceived on one ear, both ears or in the head. Approximately 17% of the general population in the U.S. has tinnitus - that’s 44 million Americans. Most people experience tinnitus in quiet situations, but can “ignore” it when other, more prominent sounds are present. Many people with tinnitus also suffer from hyperacusis, an inability to tolerate even moderate level sounds.
What Causes Tinnitus?
The exact mechanism underlying tinnitus is unknown. It is likely there are many mechanisms. Some potential causes are: Disorders in the outer ear such as ear wax or a foreign body touching the eardrum. Disorders in the middle ear such as infection, otosclerosis, muscle spasms, or estachian tube dysfunction. Disorders in the inner ear such as sensorineural hearing loss, labyrinthitis (inner ear infection), or Meniere’s Disease. Temporary effects of high dosage of medications such as anti-inflammatories, and anti depressants. Systemic disorders such as high or low blood pressure, anemia, diabetes, thyroid dysfunction, vascular disorders, and hormonal disorders. While the majority of tinnitus sufferers also have hearing loss, the presence of tinnitus does not necessarily mean that one is losing hearing.
How do you treat tinnitus?
Our treatment is called Tinnitus Retraining Therapy, but other names such as habituation-oriented
therapy, tinnitus treatment based on a neuropsychological model, and “Dr. Jastreboff’s treatment” are used as well. It involves an extensive audiological evaluation, several counseling sessions, the use of external sound, and frequently the use sound devices. It does not involve any surgery or drugs.
What does retraining therapy mean?
We try to retrain the subconscious parts of the brain to ignore the sound of your tinnitus and to achieve the stage in which you are not aware of and/or annoyed by your tinnitus.
Are there any side effects of the treatment?
There are no side effects.
What kind of audiological tests are performed? Will it hurt my ears? What if I don’t have tinnitus when I am tested?
The tests include an audiogram and several specific tests, which will allow us to evaluate whether you have tinnitus and/or hyperacusis, and to what degree. The tests begin with low levels of sound and gradually get louder, therefore, none of the tests will be painful. It your tinnitus is not present on the day of the testing, it will NOT influence the possibility of success with the treatment.
I recently had audiological tests done. Do they have to be repeated?
We prefer to have the tests performed in our Center. There are very specific measurements we
perform which are not routinely provided in other clinics.
Is the counseling a form of psychotherapy or biofeedback?
No, the counseling will provide you with information about the causes and factors involved in your
tinnitus /hyperacusis, explain to you how the retraining therapy works, and teach you how to control your tinnitus. The counseling session is a fundamental part of the treatment process.
What is the role of external sound?
External sound from radios, TVs, stereos, etc. is used at low level in order to bring the changes in your subconscious hearing system, and to cover (mask) your tinnitus. It reduces the contrast between your tinnitus and complete silence, and slightly distracts you from the sound of your tinnitus.
What are the devices and what do they look like?
The devices used in retraining therapy are called ‘noise generators’. The noise generators are worn in the ear, but not blocking the ear canal as it is the case for many hearing aids. They do not interfere with your daily activities, such as work or talking on the telephone.
Can I just buy the devices?
The devices are used to help speed up the process of retraining, but what is important is how they are used. The manner in which the devices are used depends on each patient’s individual need. If you just buy and wear the devices you most probably will not achieve improvement, and in some cases you may even hurt yourself. We will teach you how to use them effectively.
Do I need to have the devices?
Not everybody needs the devices. After the medical and audiological evaluation we will give you our recommendations and you choose your treatment.
I am using hearing aids; how can I use other devices?
Depending on the type of hearing aids, it is possible that we can work with your hearing aids and you will not need any other devices.
I was using maskers without effect. What is the difference between masking and these devices?
Although in some cases masking can provide tinnitus relief, this approach is aimed at making tinnitus inaudible. When the device is removed, however the tinnitus returns. In addition, the level of sound required to mask the tinnitus may be uncomfortable. We use the devices to generate noise, not to cover the sound of tinnitus. The goal of retraining therapy is to retrain the brain so that it eventually does not pick up the tinnitus sound, and in order to do this, the tinnitus sound cannot be covered. Generating sound that mixes with your tinnitus will help you feel more comfortable and remove the emotional response to tinnitus. At this point, tinnitus no longer bothers you even when it is perceived.
My mother is deaf and she has tinnitus. Can she benefit from Tinnitus Retraining Therapy?
This therapy uses sound as a part of the protocol. So if your mother is completely deaf and does not have a cochlear implant, she would not be able to benefit from this therapy. However, the use of electrical stimulation of the ear (through cochlear implant or external stimulation) combined with Tinnitus Retraining Therapy my help. If she can hear sound, even if she cannot recognize speech, we can try to help her.
I am taking some medication. Will I be able to continue?
Our medical evaluation will provide the answer. In general, if you are taking medication for any other reason than tinnitus, you will be able to continue taking the medication.