New to tinnitus or first time looking for help?

tinnitus

If you have developed a constant ringing, hissing, buzzing or other sound in the ears, you have options.

Where can I go for help?

You can see your doctor, an ENT (ear nose and throat) specialist or a hearing clinic that deals with tinnitus. Who you see may depend on your situation.

  • If your tinnitus has a pulsing quality to it, you should ask your doctor or ENT about it
  • If it has been more than a week, you can see your doctor (especially if there are other symptoms like dizziness) and, in addition, a hearing clinic. Some people live with tinnitus for years before seeking help.

 

  • Do you know how it started?
  • It may have been a noise exposure, or you may have worked in a noisy environment for many years; if so, consider a hearing clinic that provides tinnitus services
  • Some medications have tinnitus as a side effect (either during use or when you stop using it); ask your doctor about this and see what they advise
  • If you were involved in a car accident, had a head or neck injury or an invasive dental procedure right before the noise started, you will want to address these physical issues with your doctor or other healthcare provider involved in your care
  • Other causes can be discussed with your doctor

If you are new to tinnitus, you can also find basic facts and information about it via:

https://www.tinnitus.org.uk

and

https://www.ata.org

 

Our next post will give you some information about the kinds of questions you can ask your doctor or hearing healthcare professional.

Tinnitus and Drug or Pharmaceutical Therapies

Pharmaceutical interventions for tinnitus have been tested over the years. When hearing news about a drug trial it is important to understand the type of tinnitus sufferer on which the clinical trial is focusing. There is a difference between an intervention meant for acute tinnitus or tinnitus that has developed recently due to a noise trauma, versus chronic tinnitus that may have been present for years. To date, there have not been any successful trials of a drug for tinnitus and the FDA has not approved any pharmaceutical intervention for tinnitus of any kind (Zenner et al., 2017). Research is continuing in this direction and there has been more of a focus recently on short-term tinnitus that would have recently developed. Part of this may be because such interventions can target the inner ear as opposed to brain changes. Brain changes that may occur in the hearing brain over months or years are not something that can be easily targeted by a drug. Of course, we are also not discussing potential side effects of such drugs. All of this does not mean however that progress cannot or will not be made in terms of a pharmaceutical intervention. There is continued research in this area.

At times, you may come across treatments involving ginkgo extract in some form or combination. Fortunately, a number of studies have looked at such treatments and compared them with placebo groups. Unfortunately, to date none of the studies showed that using this extract provides meaningful benefits across a tinnitus population (Drew and Davies, 2001; Rejali et al., 2004; Han et al., 2012). In addition, a review of 6000 tinnitus sufferers trying ginkgo biloba reported potential side effects including dizziness, upset stomach and other reactions (Roland and Nergard, 2012). Unfortunately, some of these remedies like gingko extracts continue to be sold to tinnitus sufferers despite a lack of clinical evidence.
One should always consult with their physician before attempting to use any remedies, whether they are pharmaceutical or natural remedies.

 

References:

Eur Arch Otorhinolaryngol. 2017 May;274(5):2079-2091. doi: 10.1007/s00405-016-4401-y. Epub 2016 Dec 19.
A multidisciplinary systematic review of the treatment for chronic idiopathic tinnitus.
Zenner HP1, Delb W2, Kröner-Herwig B3, Jäger B4, Peroz I5, Hesse G6, Mazurek B7, Goebel G8, Gerloff C9, Trollmann R10, Biesinger E11, Seidler H12, Langguth B13.

BMJ. 2001 Jan 13;322(7278):73.
Effectiveness of Ginkgo biloba in treating tinnitus: double blind, placebo controlled trial.
Drew S1, Davies E.

Clin Otolaryngol Allied Sci. 2004 Jun;29(3):226-31.
Ginkgo biloba does not benefit patients with tinnitus: a randomized placebo-controlled double-blind trial and meta-analysis of randomized trials.
Rejali D1, Sivakumar A, Balaji N.

Han SS, Nam EC, Won JY, Lee KU, Choi HK, Levine RA (2012) Clonazepam quiets tinnitus: a randomised crossover study with Ginkgo biloba. J Neurol Neurosurg Psychiatry 83:821–827

Tidsskr Nor Laegeforen. 2012 Apr 30;132(8):956-9. doi: 10.4045/tidsskr.11.0780.
[Ginkgo biloba–effect, adverse events and drug interaction].
[Article in Norwegian]
Roland PD1, Nergård CS.

 

Tinnitus: Sound and Reaction

There is plenty of evidence that it is not just the hearing brain that is involved with tinnitus. There are other parts of the brain called the amygdala (our emotional computer) and the hippocampus (related to memory storage) that seem to be linked to chronic and bothersome tinnitus. 

The amygdala is our emotional computer while memories are dealt with in the hippocampus. Both regions have been shown to be connected to the auditory system in our brain. It is believe that with tinnitus people can learn negative responses to the percept and over time encode it into something related to negative emotions.  All these regions cause a feedback loop that can make tinnitus feel worse or louder for some people.  

For some this circuit can be more active than others which may be why some can experience tinnitus and feel a lot of distress, while someone else with constant tinnitus may learn to ignore it.  More research has to be done on this topic.

However, as most people who have worked with tinnitus sufferers know, it is not just about the sound the person hears, but also their response to it and how much they feel it affects their life and has “always” affected their life.  A treatment approach that provides feelings of control and also addresses the uncertainty can be helpful because we are addressing these other brain regions.

There are two goals for tinnitus sufferers: addressing the reaction to and perception of tinnitus (Jastreboff, 2000). The reaction consists of issues like anxiety, depression and insomnia, whereas the perception is how loud or noticeable the sound is to the person.  It is important for tinnitus sufferers to regain a sense of control while working to manage or reduce their tinnitus.

 

Who Else Hears This Constant Sound?

Tinnitus does not always get the attention it deserves for different reasons. One reason we want to focus on today is the prevalence of tinnitus.  Just how many people have tinnitus and live with it?  We see different numbers put out there:  1-3% of the population all the way to 15% of the population.  But what is the true value?

Really it depends on how you want to define a tinnitus sufferer. If someone has occasionally experienced tinnitus in their life, do they count?  What about those who have recurring tinnitus but not all the time?  Then we can say there are people who always have it but are not bothered, who find it to be inconvenient, or those who have significant impacts on the quality of their life.  Because of this, end up with something of a messy picture of just how widespread tinnitus is.

However, we know that millions suffer because of tinnitus.  In fact, a recent estimate is that 5% of the population in North America has chronic tinnitus that moderately or severely impacts their life.  That is a significant number of people who deal with tinnitus on a daily basis.

Some populations are harder hit than others. For example over 14% of people between 60 and 69 deal with chronic tinnitus (Shargorodsky et al., 2010).  For Veterans Affairs tinnitus is among the most common disability claims. Those who have worked in or been exposed to noisy environments are also obviously more likely to deal with tinnitus.

Going forward, the prevalence of tinnitus is likely to increase due to an aging population.  However, there is a chance to stem the tide if people are proactive about protecting their hearing and dealing with potential causes of tinnitus.  We will speak about this in a future post.

 

 

Prevalence and characteristics of tinnitus among US adults.  Shargorodsky J, Curhan GC, Farwell WR. Am J Med. 2010 Aug;123(8):711-8.

Canadian Audiologist Article

We’ve recently written an article for the Canadian Audiologist talking about tinnitus, the importance of educating others about this condition, and what we are doing to help.

You can read the article here

 

 

Canadian Audiologist is the official publication of the Canadian Academy of Audiology. It publishes articles relevant to hearing and hearing-related conditions every quarter.  You can check out this publication here.

Suffering Musicians

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When you think of a rock star, there are many things that come to mind, but tinnitus is not usually one of them. Unfortunately, many musicians suffer from tinnitus because of years of exposure to loud sounds: concerts, practice, and just listening to music. For some, hearing protection does not feel practical, and for others it is something they think about when it is too late. Because hearing loss is the most common cause of tinnitus, it is easy to see how artists that are exposed to so much noise can develop tinnitus if they do not take precautions. The effect this has on musicians spans generations: from Chris Martin of Coldplay to Neil Young, a whole range of famous artists live with chronic ringing in the ears.

In 2013, various artists got together to work on an album (I Am The One in Ten) to raise awareness for a condition that affects around 10% of the population. Their efforts may not only help with shifting attention to tinnitus, but may also contribute to knowledge of preventative measures (e.g., hearing protection) for tinnitus sufferers.

While most suffering from tinnitus do not have the kind of resources Chris Martin may have, it just goes to show how difficult it has been for tinnitus sufferers to find ways to manage their tinnitus.

Partnering Audiology Clinics

 

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We are excited to inform you that there are several clinics that are working with us or will be starting to work with us in the coming weeks. What this means is that tinnitus sufferers will have the option to come in to a clinic in person to have their hearing and tinnitus assessed and to then obtain our sound therapy from participating audiologists.  If you want to find out more about obtaining your own customized sound therapy through a partnering clinic, you can contact us.  We will also be listing partners and their locations for your convenience.  If you have any other questions about your tinnitus treatment options, please let us know!