What is tinnitus?

Considered one of the most prevalent medical conditions in the world, tinnitus refers to the perception of sound in the ear(s) or head when there is no external source for the sound. Many people with tinnitus describe their experience as ear-ringing or head noise. Derived from Latin "tinnire," the word means "to tinkle or ring like a bell."

Tinnitus can involve a variety of different sounds besides ringing. People often report a hissing or roaring in the ears or the head, and there may be tinnitus present where there is no hearing loss. This condition can cause fear, frustration and even emotional devastation if severe cases are left untreated. Other side effects of the condition may include tension in the head or neck, poor concentration and feelings of panic.

The condition is NOT a psychiatric phenomenon, but often involves emotional implications. Usually associated with conditions of the ear, the central nervous system or the vascular system, tinnitus tends to be most significant in individuals who have extremely active limbic systems. Located in the forebrain, these structures play a significant role in reconciling emotional and motivated behavior, as well as memory storage.

Males and females are equally affected by tinnitus, and about 10% of sufferers report that the constant noise severely impacts their lives.

What causes tinnitus?

Hearing loss does not cause tinnitus, nor does the opposite happen. The two conditions often exist simultaneously, but tinnitus stems from any of a number of other causes, such as:

• exposure to excessively loud sounds
• high blood pressure
• overproduction of ear wax
• ear infections
• acoustic tumors
• disorders of the cervical vertibrae (neck)
• an underactive thyroid
• cardiovascular disease
• allergies
• a tumor on the auditory nerve
• degeneration of the bones in the middle ear
• age-related changes in the inner ear
• use of a prescription drug or other medications (such as high doses of Aspirin)
• systemic disease
• head trauma

What can I do to help myself if I have tinnitus?

First, visit your family doctor and arrange to be examined by an otolaryngologist (an ear, nose and throat specialist) to find out whether there's a medical condition that is causing your tinnitus. If there seems to be no pathological cause of the tinnitus, you should also obtain an evaluation by an audiologist with expertise in the assessment and treatment of tinnitus.

In the meantime, here are some everyday practices that can help:

• Avoid loud noise. Wear ear plugs or muffs when vacuuming, riding motorcycles, using power tools, etc.
• Reduce stress in your life. Many people report that their tinnitus seems lessened when they're relaxed.
• Avoid the use of caffeine, alcohol, nicotine and Aspirin, and eliminate salt from your diet. These substances can increase the level of tinnitus.
• Inform your doctor about your tinnitus before he/she prescribes antibiotics or other drugs. There may be a type or dosage that will not exacerbate your tinnitus. Even aspirin may make your tinnitus worse.
• Pay attention to the circumstances surrounding your tinnitus. Do you have any problems with balance or dizziness? When it began, were you taking a new medication or exposed to an extremely loud noise? Is the noise you hear consistent and in both or only one ear? Have you experienced any hearing loss? Some people with tinnitus keep a diary in order to recognize patterns of behaviour that may trigger the condition's severity.
• Be sure to get enough sleep. People with tinnitus often find that background noise such as FM radio static or the droning of a fan helps them sleep.

Can tinnitus be treated?

Millions of North Americans have tinnitus to some degree, many of whom consider it little more than a nuisance. Others possess this chronic condition to the point where it severely affects their ability to function in day-to-day life through loss of concentration, anxiety and sleep problems. Some seek no help, because they mistakenly believe there is no effective treatment for tinnitus. Millions do, however, explore medical and non-medical help from professionals.

Although there is no "cure" yet for tinnitus, an audiologist can suggest any number of therapies, many of which may help on their own. In some cases, a combination of therapies is most effective.

• TRT: Tinnitus Retraining Therapy is a non-invasive nonmedical treatment that involves a thorough audiological evaluation, a series of directive counselling sessions and the use of sound therapy. This technique retrains the subconscious to ignore the tinnitus sounds.
  • Counselling: Often tinnitus, especially in the early stages, can cause depression or anxiety - which ironically worsens the condition. By explaining what tinnitus is and demystifying the phenomenon, an audiologist can help reduce the accompanying anxiety. Directive Counselling helps to change patients' reactions to their tinnitus and is used as part of TRT.
  • Sound Therapy: Hearing aids and sound generators can help. Sound therapy for tinnitus usually involves a constant low level stimulation of the auditory system that creates habituation of the tinnitus signal.
• Promote Relaxation
  • Biofeedback: Through electronic monitoring, patients can learn to control their breathing, muscle tension, blood pressure and other physiological responses to tinnitus.
  • Hypnosis: This technique may be used to help an audiologist adjust signal and response behaviour when tinnitus is present.
• Orthodontia: If the tinnitus is caused by problems with the tempormandibular jaw joint, therapy may include wearing an appliance or some orthodontia.
• Prescription medications exist that may provide relief for those who have severe debilitating tinnitus.

Upper Canada offers Tinnitus Retraining Therapy (TRT)

Upper Canada Hearing and Speech Centre employs one of the few audiologists in Canada certified to administer TRT, which has a success rate of over 80%. This treatment takes between 18 and 24 months in total, and involves an audiogram and several other painless tests during the evaluation phase. The initial session takes approximately 3 to 4 hours and includes an audiological evaluation and counselling. Even if the tinnitus is not present during the testing phase, the treatment can still be successful.

TRT involves no biofeedback or psychotherapy. Counselling sessions are more educational and informative. Often when people understand tinnitus more, the condition's negative effects lessen.

TRT IS NOT A CURE. It is a treatment that will retrain you to ignore your tinnitus in order to function more fully in everyday life. You may be able to "tune into" your tinnitus if you choose to, but its annoyance will be reduced. Although there is no guarantee with this treatment, over 80% of patients who access TRT report significant improvement.

At Upper Canada, you'll find one of the few audiologists in Canada trained in this method of treating tinnitus. The initial session takes approximately 3 to 4 hours and includes a thorough tinnitus evaluation and counselling.

More information on Tinnitus Retraining Therapy (TRT) by Pawel J. Jastreboff

For more information on tinnitus, contact the Tinnitus Association of Canada, which is a voluntary self-help association of tinnitus patients.

Tinnitus Association of Canada
23 Ellis Park Road
Toronto, ON M6S 2X4

www.hearingandspeechcentre.com

905-895-7399 or 905-780-6687