Tinnitus, commonly referred to as “ringing in the ears”, occurs in approximately 10% of the population on a regular basis. Of those affected, 1% report tinnitus is severe enough to interfere with daily activities and only 3-5% of those affected have clinical treatable tinnitus.
Tinnitus can range from intermittent episodes that are not very bothersome to constant tinnitus. It can occur a few times a month or many times in one day. It can last for a few moments or several hours. It can even be constant without relief while sleeping. For some individuals tinnitus has a pulsating or repetitive pattern. It can also be described as ringing, chirping, or clicking.
Tinnitus has three defining characteristics. First, tinnitus is a perception of sound and therefore it must be audible to the person. Second, it is involuntary and cannot be produced intentionally. Lastly, it must originate in the head.
There are several neurophysiological theories regarding tinnitus. No one theory has been definitive proven. In addition to neurophysiological factors, there almost always psychological influences play a significant role in the perception of tinnitus.
A well-accepted neurophysiological model is that of spontaneous activity in the auditory system in the absence of auditory stimulation. This theory states that damage to hair cells in the cochlea can contribute to the perception of tinnitus.
Furthermore, as people experience tinnitus they may or may not give it high priority. In a case where it is assigned a high priority, tinnitus can increasingly become a focal point for the patient. If this continues for an extended period of time, the brain will learn to focus on the tinnitus even when other background sounds are present.
Tinnitus can cause anxiety and stress in many people.
Treatment of Tinnitus
There are a number of treatment options available for tinnitus.
- Hearing aids are an effective treatment for people that suffer from tinnitus and also have a hearing loss. By wearing hearing aids the patient hears more of what is going on in the environment and the tinnitus becomes less noticeable to them.
- Resound has developed a new hearing aid like device that delivers sound to the ear in order to mask the tinnitus. This new device has a number of automatic features that allow the user to focus less attention on the device and get on with daily activities. One such feature automatically increases the volume when the user is in a quiet location (when the tinnitus is more likely to be noticed). This device is also suitable for users who also suffer from a hearing loss.
One well established treatment is Sound Therapy, where a tinnitus sound generator (TSG) is used to provide relief from tinnitus. A TSG can take the form of sound pillows, radios, television, or it can be a device that is worn in the ear.
With Sound Therapy the device is often set to a therapeutic level designed to allow patients to habituate to their tinnitus over time. This helps reduce the perceived strength of the tinnitus by introducing background noise, which makes it more difficult to separate the tinnitus from the background noise level. Over time, less importance and priority is placed on the tinnitus and relief is achieved.
- Another well-known treatment strategy is Tinnitus retraining therapy. The emphasis is placed on educating patients on the neurophysiological foundations of tinnitus as previously described. The goal is to give patients more control over their tinnitus. Ultimately, placing less importance and priority on the tinnitus will allow them to cope.
- In addition there are also psychological models of treatment, such as behavioral treatment, existential treatment and many more.