Thomas Jefferson UniversitySidney Kimmel Medical College

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Tinnitus

Did you know that 12 million Americans have tinnitus? While it is a very commonly reported symptom, it is not always a cause for concern. It is true that many individuals who have ear problems will list tinnitus among their symptoms. This is why it is a smart idea to have your concerns checked out by your audiologist and otolaryngologist.

Tinnitus is usually described according to location, duration, quality, pitch, and loudness. There are an estimated 40 million Americans (one out of every seven Americans) who seek physician consultation for tinnitus each year. For those people who do see a physician, 6% report that they are severely debilitated by their tinnitus.

As living organisms we all have a certain amount of internal "noise". Have you ever been in a quiet room and been more aware of your heartbeat, digestive track sounds, or breathing? Tinnitus is a sound that is generated inside of the body, just like a rumbling from the stomach. The biggest difference is that most of the time, others cannot hear the same sound. It can be confusing and scary to hear a noise that others do not. Some people's brains tune into these sounds and pay more attention to them. During the course of the day we are exposed to external sounds that stimulate the auditory pathway and often divert attention away from those internal sounds. That is why even though tinnitus is very common, not everyone is deeply disturbed by it.

When tinnitus becomes bothersome, it is important to understand what is happening. Hearing scientists are still studying the ear and parts of the brain that are linked to hearing. Over time with advances in science we are currently treating tinnitus using the neurophysiolocial model. Through the use of tests such as an MRI, scientists have been able to see changes in the brain in patients with tinnitus. With advances in understanding where and how the brain is processing tinnitus, effective treatments are occurring.

Once tinnitus has been identified and measured, the audiologist will meet with you for an in depth tinnitus evaluation.  During this time, you will learn about your hearing test results and discuss particular problems related to the tinnitus.  The audiologist will design a treatment plan that may include recommendations regarding lifestyle modifications, referrals to other specialists (if needed), aural rehabilitation to address communication difficulties related to hearing loss or a more structured therapy. 

The Neuromonics tinnitus treatment is a treatment approach that combines the use of an acoustic stimulus with a structured program of counseling and support by a clinician trained in tinnitus management.  The individually customized acoustic stimulus was designed to provide stimulation to auditory pathways deprived by hearing loss.  Engage positively with the limbic system, and allow intermittent, momentary tinnitus perception within a pleasant and relaxing auditory sensation, thereby facilitating desensitization to the tinnitus perception.

the Oasis

The Oasis™ device, (pictured to the left) by which the Neuromonics Tinnitus Treatment is delivered, is a patented, precision medical instrument. It is available only by a prescription and from a Neuromonics-trained, medical professional.

It is not: a masking device, a noise or sound generator, or a hearing aid. And it’s not an MP3 player — though it’s designed to look as inconspicuous as one to the casual observer.

The high-fidelity earphones accompanying the Oasis device provide the acoustic clarity and fidelity required for the treatment across a wide frequency range. Lightweight, flexible and unobtrusive, they allow users to go easily about their day-to-day activities with little awareness of their treatment.

Links with Hearing Loss

Tinnitus and hearing loss are often seen together in patients.  While the hearing loss may not be impacting a person’s communication abilities, it may often be found during specialized hearing testing.  The tinnitus is not causing the hearing loss; rather it is a symptom of the inner ear damage.  Often when the brain is deprived of auditory stimulation due to hearing loss, the brain starts searching for sound.  Many people have had the experience of attending a concert or working with power tools and then experiencing a temporary hearing loss, or temporary threshold shift.  They may also complain of a ringing or buzzing in the ears that subsides as the hearing returns to normal.  Our brains are constantly monitoring and sorting out the sounds that we hear.  When there is a change in the amount of information coming into the system, then the brain may begin focusing on internal sounds, such as tinnitus.

Tinnitus Testing

At the Jefferson Balance and Hearing Center we provide a medically-based assessment for individuals who are suffering from tinnitus.  A team consisting of an audiologist, an otolaryngologist, and other health care professionals work together to diagnose tinnitus and work with the patient towards an individualized treatment plan for tinnitus management.

The first step on the journey is scheduling an appointment for a hearing test and to see one of our specialized otolaryngologists (a neurotologist).During this appointment you will have a diagnostic hearing test, as well as some measurements taken to identify at what pitch the tinnitus is, how loud it is, and your general tolerance of sound.  The neurotologist will perform a thorough medical evaluation to check for any cause of the tinnitus that can be managed medically. 

After you have consulted with the physician, you will receive an informational packet for review.  Included in this packet are questionnaires relating to tinnitus, and other forms that must be completed prior to the next appointment.  Once this information is completed and sent back to the audiologist, you will be contacted to schedule an Individual Tinnitus Evaluation Appointment.  During that visit, you and the audiologist will discuss the test results and have the opportunity to further understand the nature of your tinnitus.  Time will be spent with counseling and developing an individualized tinnitus management plan.

Stress & Tinnitus

Steps

It is very common to worry about tinnitus, which may cause increased stress or tension.  Tension and worry can make the tinnitus worse, creating a negative feedback cycle. The tinnitus increases anxiety and the anxiety increases the perception of the tinnitus.  Learning how to relax is a large part of the relief process.