Tinnitus Treatment Detective

Coping with Tinnitus

Sun, 19 Sep 2010 17:23:00 GMT

For the millions of tinnitus sufferers in the world, the reality is that the cures available are possibly not really cures or are either experimental, only work part of the time or are simply too dangerous to be considered most of the time. Especially for suffers of subjective tinnitus, where there is nothing physically wrong with the ear, turning off tinnitus is almost impossible. Instead, the best way to deal with tinnitus is to work on coping with it and tricking the brain into ignoring the sounds, even if they started out as a roar.

Using Music to Quell the Noise

Different music therapy approaches are used to help tinnitus sufferers learn to cope or simply help mask the tinnitus so they can function. The approaches vary from simply having music or background noise going all the time to help the person not hear the tinnitus related noises to white noise generators that work more specifically to help mask the problem.

On top of this, there is a very specialized version of music therapy called notch therapy that helps tinnitus suffers by getting their brain to turn off the specific frequency the tinnitus is on. For this therapy, a patient will bring a specially trained audiologist some of their favorite songs that they listen to on a regular basis as well as hearing test results showing which frequency or frequencies are causing the problem. The audiologist takes the music the patient gave them and strips out the frequencies that they hear due to tinnitus and the patient is given a CD of the modified music. Listening to this helps the brain calm the over stimulated nerves causing the tinnitus and helps the brain sort out what frequencies are actually being heard.

Other Technologies to help Coping

There are a couple other ways that people can get help coping with technology. There have been many success stories of hearing aids actually helping with tinnitus. If the rest of the frequency band is being properly represented, the nerves causing the tinnitus often times settle down. In fact, some hearing aids can actually do notch therapy as well now, doubling the value of the hearing aid as a part of coping with tinnitus. There have been other attempts to help eliminate the tinnitus including acoustic stimulation and there has even been success in coping with tinnitus by seeking psychological therapy, especially using cognitive behavioral therapy’s theories of psychotherapy.

Treatment and Cures for Tinnitus

Sun, 19 Sep 2010 17:21:00 GMT

For those suffering from tinnitus, many will never truly get relief from their symptoms due to the type of tinnitus they have. However, there are some tried and true ways of getting rid of tinnitus for those having the issue because of physical problems of the ear, rather than nerve damage of some sort. Some of these methods do show promise for the latter type of tinnitus as well but most of the treatment and cures are for objective tinnitus sufferers or tinnitus where a doctor can identify a physical problem of some sort.

For some, the best solution to their tinnitus problem will be surgical. For those with a physical problem of the ear, including leaking of fluid from the inner to middle ear or a small hole in the ear drum and other common and less than common ear design issues, surgery can provide a quick, safe and most importantly permanent fix for objective tinnitus.

For others, the solution to their tinnitus can be something as simple as a course of antibiotics to clear up an inner or middle ear infection or even just a thorough cleaning of the ears. Lingering infections and fluid buildup can actually cause a plaque to form inside the ear and in extreme cases a surgical removal of that may be needed. However, in most cases antibiotics and possibly a decongestant can be used to remove the inflammation and fluid from inside the ear. For wax buildup, it too can get so dense that it is almost a plaque in the outer ear. Regular hygiene can prevent the buildup in the first place but if left unchecked will require a doctor to safely scrape the ear canal and remove wax buildup inside.

For subjective tinnitus sufferers, proper medical based treatment methods can include small changes in medications a patient is taking to try to eliminate any medications that have tinnitus as a known side effect to changing the patient’s diet to try to see if there is a nutrient deficiency causing the problem. There are some medications that can help with tinnitus but the most common treatments focus more on eliminating things rather than adding things. For example, before giving small doses of anti-psychotics which are known to work to help treat tinnitus, a doctor is going to try having the patient adjust their diet, supplement with key nutrients and avoid common things like caffeine, salt and nicotine first.

What is tinnitus part 2

Sun, 19 Sep 2010 17:20:00 GMT

What Is Tinnitus?

Tinnitus, while considered by many a disease is actually a symptom with many causes. Tinnitus can vary but all Tinnitus suffers will hear some sort of sound when there is none there to hear. The experience of tinnitus varies from individual to individual with some people experiencing only mild noises that are easily ignored to others who can hardly cope both because of the sound and because of the volume. For all who experience tinnitus though, it can be a distraction even when mild.

Causes of Tinnitus

The single biggest cause of tinnitus is due to hearing damage. High sound pressure volumes cause a person’s ears to stop responding as well to sounds and the resulting damage also causes the nerves to produce sounds that are not there. High sound pressures can come from anything from a jet engine to loud music to gun shots and more. Any sound that comes in higher than 90 decibels can cause hearing damage. The higher the decibels, the faster and more dramatic the hearing loss is. Each individual is different in how they might experience tinnitus from hearing damage though. Some may have some short term humming while others may experience constant noise for weeks, months or for the rest of their lives from even one event.

The second most common cause of tinnitus is from a physical problem with the ear. For some experiencing symptoms for this reason the problem can be as simple as wax buildup in the ear. The process is not completely understood but the wax sitting against the eardrum can irritate the nerves nearby causing the perception of sound. Other people will report tinnitus as part of having an ear infection as well. Both middle and inner ear infections can irritate and even potentially damage the nerves responsible for hearing causing the hearing of sound when none is there. For a small percentage of tinnitus suffers there are a couple conditions where the eardrum is not completely sealed or there is some other tiny flaw in the ear that causes the tinnitus symptoms.

The final most common cause of tinnitus is as a side effect from medication. There are many medications where tinnitus symptoms are a known side effect of the medication. In fact, it is a very common side effect, with medications as common as aspirin, some antibiotics and commonly taken anti-malaria drugs all having tinnitus listed as a known side effect.

What is Tinnitus part 1?

Sun, 19 Sep 2010 17:18:00 GMT

Tinnitus is not a disease but actually a symptom that can have many different causes. The symptom which is tinnitus is hearing sound when there is no external source for the sound. The actual sound can be difficult to categorize and specific sounds do not necessarily point to a cause. On top of this, because there is no external stimulation, testing to verify tinnitus is virtually impossible. The only thing that can be done is categorize how bad the sound is based on how much it affects the person and their daily life.

What Causes Tinnitus

Most cases of Tinnitus are subjective tinnitus, where there is no clinical test for the symptoms. The causes of this type of tinnitus vary but the most common is noise-induced hearing loss. For example, virtually everyone will have ringing in their ears for a few days after a loud concert. Another common cause is actually impacted earwax in the ear canals. Ear infections and middle effusion can also cause Tinnitus.

Another common cause of tinnitus is the aging process. Aging causes hearing loss and hearing loss can sometimes lead to tinnitus. Tinnitus is also a common symptom of lead and mercury poisoning but can also be caused by a number of medications, including aspirin, some antibiotics, some diuretics, anti-depressants, quinine and other medications as well.

The final cause of tinnitus is those that cause the much more rare objective tinnitus. In these cases, a doctor can actually hear sound coming from the ears of the patient. This type of tinnitus can be caused by altered blood flow around the ear that causes the person to be able to hear their pulse or blood flowing. Occasionally, this type of tinnitus can be the symptom that leads to diagnosis of serious and dangerous conditions such as aneurysm and dissection of the carotid artery or vasculitis.

What Does Tinnitus Sound Like?

Tinnitus sounds different from everyone, even if two people have the same cause of their tinnitus. It can happen in just one ear or both and is most commonly described as a ringing noise. However, it can sound like a buzz, hum, whistle, click, crickets, music and many more different sounds. The sound can be constant or can be one that just pops up then goes away later. Certain tinnitus suffers find they can set it off by moving part of their body, typically their head, tongue, jaw or eyes. The intensity can vary from only noticeable in quiet surroundings to a howl that cannot be ignored.

iPods and Tinnitus

Tue, 13 Jul 2010 17:06:00 GMT

Ironically, the iPod is both a cause of tinnitus and potentially a way to help alleviate tinnitus sufferer’s symptoms. For the average person with an iPod though, it is far more likely to be a cause than a way to alleviate the symptoms. Some of the treatments that utilize an iPod to treat tinnitus are utilizing the most advanced research to help alleviate tinnitus symptoms.

iPod’s Roles in Causing Tinnitus

The iPod and many other MP3 players cause tinnitus in two different ways. First of all, they produce output that is the equivalent to a jet engine. While not the blanket roar of the jet, the music piped through a set of headphones can easily hit decibel levels that can cause permanent hearing damage. Hearing damage is the single most likely cause of tinnitus symptoms and iPods and MP3 players lack even basic protection to keep the output from exceeding the threshold for permanent hearing damage.

The second and less talked about way that an iPod can potentially cause tinnitus is through infection. The person who wears the ear bud style headphones, especially the most modern renditions that boast noise blocking silicone rubber ear pieces, can cause infection if left in for too long. Bacteria love dark, moist environments and an ear sealed up with a silicon ear bud is a great environment for bacteria growth. The bacteria begin taking hold and a middle or outer ear infection settles in which can cause tinnitus as well. Most of the time, treating the infection will make the tinnitus go away; however, the root cause is often ignored.

In both cases, using speakers for an iPod or MP3 player rather than earphones as much as possible will reduce or eliminate both of these potential iPod related tinnitus causes. However, for many, earphones are the only option. In this case, being sure to keep the volume as low as possible and using open ear headphones rather than ear buds will help in both preventing hearing loss as well as inhibiting infection potentials.

iPods to Treat Tinnitus

The most common treatment for most tinnitus is to produce white noise or play music which masks the tinnitus sounds for the person suffering. This allows them to function during the day and fall asleep without being distracted by the tinnitus noises. An iPod can either play white noise MP3’s or there are programs that are designed to produce more random white noise rather than looping an MP3 of the same white noise.

On top of this, there are special treatments that utilize an iPod to play specially modified songs that have tinnitus frequencies blocked. This helps the brain turn off the sensitivity to those frequencies making the symptoms less or go away completely.

Future Developments for Tinnitus Cures

Tue, 13 Jul 2010 17:05:00 GMT

While not typically debilitating, many people suffer from the effects of tinnitus. For some of them, tinnitus makes falling asleep more difficult or at times causes their work to suffer when they have a period where the tinnitus is loud. Because tinnitus affects so many people, it is very well researched and methods for alleviating tinnitus symptoms have come a long way in the past few years. Going forward, there is research into many different ways of getting rid of tinnitus and some of these will soon be available to the general public.

Basics of Tinnitus

Tinnitus is actually a symptom, not an actual disease. It has many causes, from hearing loss to impacted ear wax to being a symptom of heavy metal poisoning to being a side effect of many different types of medication. However, the single most common cause of tinnitus is hearing loss and most attempts to help correct tinnitus sufferers focus on this cause and the resulting tinnitus.

Newest Treatment Options

Two of the newest treatment options available are tinnitus retraining therapy and additive destimulation therapy. Tinnitus retraining therapy is a two pronged approach to dealing with tinnitus. The first part is through the use of a sound generator to help alleviate the distraction of tinnitus. The second part of this therapy is specialized counseling which helps retrain the brain and ear of the tinnitus sufferer to either make the sound less noticeable or to teach the person how to ignore it.

Additive destimulation therapy is the latest and greatest though and uses a far more technological approach to helping with tinnitus. In this therapy, the audiologist identifies the frequency or frequencies that the tinnitus sufferer hears and then modifies songs that the sufferer likes to listen to take out those frequencies. By removing these frequencies, the brain becomes less sensitive to them and over time, hearing the tinnitus frequencies is no longer an issue because they can be more easily ignored.

The Next Round

On the horizon are techniques that utilize electricity to achieve tinnitus relief. The auditory nerve is the target of one such treatment, called nerve stimulation. In this procedure, an electrode is attached to the auditory nerve and helps reset the receptors in the brain. Because it is fairly drastic and experimental, it is reserved for only the most severe tinnitus sufferers.

The last procedure is called repetitive transcranial magnetic stimulation. It involves using magnets to stimulate specific spots in the brain. In research trials it shows promise in turning off tinnitus with very few side effects and should be approved for bigger trials soon.

Current Treatment Options for Tinnitus

Tue, 13 Jul 2010 16:40:00 GMT

For the tinnitus sufferer, making the tinnitus go away or even just lessening it from severe to mild is important for them to be able to have productive days and restful nights. One of the most common complaints of the tinnitus sufferer is that they have difficulty falling asleep because of the sounds. Treating tinnitus is often a two pronged approach. While working to treat the symptom, which is tinnitus, the sufferer and their medical professional should be looking to assess what is causing the tinnitus.

Treating the Symptom of Tinnitus

Common treatments for subjective tinnitus work to alleviate symptoms. For many tinnitus sufferers who have trouble falling asleep, the most common method of treatment is to create white noise in the room. This white noise can be a fan or a specifically designed white noise generator that sits beside the bed. More recent white noise generators work with iPods and other MP3 players to provide music or constant white noise such as wind or wave sounds. More advanced auditory stimulation includes music therapy and notched music therapy where the tinnitus frequencies are taken out of the patient’s favorite music. This causes the brain to stop being stimulated on those frequencies making the tinnitus more tolerable.

Other common methods of treating tinnitus include reducing or eliminating stimulants and salt. Caffeine and nicotine reduction can help some tinnitus sufferers, however, in some it can make it worse so it is something to evaluate. Alcohol consumption, likewise, can cause tinnitus to get better or worse and can be used, in moderation, if it helps. Zinc supplements, as well as herbal formulas with zinc have been shown to help some sufferers of tinnitus as well because a zinc deficiency can actually be a cause of tinnitus symptoms. Certain medications can be used, including anticonvulsants, tricyclics and benzodiazepines, however, the side effects of these medications can be more detrimental than the tinnitus itself.

Treating Tinnitus Causes

For some, especially those with objective Tinnitus, there are treatments that actually work to fix the cause of the problem. One of the most common is impacted ear wax. A quick visit to a general practitioner or ENT can remove impacted earwax and provide immediate relief should this be the cause. There are other surgical procedures available to objective tinnitus sufferers depending on the cause. For some cases, a quick Botox injection can take care of the problem and for others a detailed surgery where the cochlea is shielded by a Teflon implant is needed.

Cognitive Behavioural Therapy for Tinnitus

Thu, 22 Oct 2009 23:38:00 GMT

Cognitive Behavioral Therapy (CBT) is a widely-practised psychological treatment designed to restructure the thoughts and behavior of patients who have lifestyle and emotional difficulties. Patients are asked to question their outlook on their life, and to restructure negative associations they make towards themselves, their environment or a particular ailment from which they suffer.

A large body of evidence shows that CBT is effective in anxiety and depression management. As well as the obvious benefits this produces for tinnitus sufferers, CBT can also be successful in altering the negative feelings that are evoked by someone’s tinnitus. This form of ‘cognitive restructuring’ can reduce heightened awareness of tinnitus, which in turn paves the way towards habituation.

CBT does not consist of only one form of treatment, but includes behavioral modification, environmental and situation change, relaxation, hypnotherapy and thought-controlling exercises [[i]].

A Swedish report in 2004 demonstrated that CBT delivered via emails from therapist to patient resulted in clinically significant reduction of distress as measured for 27.4% of patients. A three-month follow-up demonstrated that the improvements had been maintained, but there was a high drop-out rate of 30% from the treatment. Although this is a cost-effective and labor-saving form of CBT, the majority did not benefit. CBT may be best administered one-to-one or in a group setting [[ii]].

A study which reviewed a large amount of clinical data on CBT, showed that there was no significant reduction in subjective tinnitus loudness or associated depression. But they did conclude that CBT significantly improved quality of life which led to positive management of tinnitus.

Overall, although CBT may not be conclusively proven to reduce tinnitus intensity, it is generally considered as an effective means of managing the distress provoked by tinnitus. It is also believed that CBT facilitates acceptance and alleviation of negative thoughts towards the tinnitus, which improves quality of life by reducing associated fear, anxiety and depression [[iii]].

[i] Shulman A, Goldstein B. Subjective idiopathic tinnitus and palliative care: a plan for diagnosis and treatment. Otolaryngol Clin North Am. 2009 Feb;42(1):15-37, vii

[ii] Kaldo V et al. Internet versus group cognitive-behavioral treatment of distress associated with tinnitus: a randomized controlled trial. Behav Ther. 2008 Dec;39(4):348-59. Epub 2008 Apr 20.

[iii] Hesser H et al. Clients' in-session acceptance and cognitive defusion behaviors in acceptance-based treatment of tinnitus distress. Behav Res Ther. 2009 Jun;47(6):523-8. Epub 2009 Feb 10

Tinnitus Vitamin: do they work?

Sat, 24 Oct 2009 00:46:00 GMT

Vitamins A, C and E

Noise-induced acoustic trauma is closely associated with free radical formation and reduced cochlear blood flow 7-10 days after noise exposure.

Animal trials have found that NIHL was preventable when the anti-oxidants Vitamin A, C and E were used with magnesium 1 hour before damaging noise exposure. Interestingly, vitamins or magnesium alone were not able to prevent NIHL or sensory cell death, but together they had a combined synergistic effect. These are encouraging results and it would be interesting to see how they translate to human NIHL trials [[i]].

Other vitamins for tinnitus

ZInc
Magnesium
B12

Companies supplying Tinnitus Vitamins

Arches
T-gone

[i] Le Prell CG et al. Free radical scavengers vitamins A, C, and E plus magnesium reduce noise trauma. Free Radic Biol Med. 2007 May 1;42(9):1454-63. Epub 2007 Feb 20

Banish Tinnitus: The Truth

Sat, 24 Oct 2009 00:47:00 GMT

‘Banish Tinnitus’ is a very well known tinnitus which often advertises in the paid adverts section of most Google searches into tinnitus or related searches.

The creator of the site, Paul Carrington offers a book which he claims reveals three natural steps that will cure your tinnitus, using no drugs or vitamins. There are probably no reliable cures for tinnitus, and so someone who suggests that there are may be making an unsubstantiated claim.

The language of the website is orientated towards “hard selling” making a number of claims that do not appear to be logical.

He alludes to the idea that doctors and the entire pharmaceutical industry are potentially involved in a conspiracy to profit from unfounded medication, while withholding critical information about natural remedies which work just as well. All this serves to do is fuel distrust of the medical community and gain the trust of tinnitus sufferers, some of whom may believe Paul Carrington has the answer. Below is an excerpt from the Banish Tinnitus website:

“Whether or not you like it the drug industry (and that includes doctors) are in it to make money. And while you're health is a large priority, the fat cats in the industry and even the doctors themselves hope and prey that you will never discover this information. What's more, they do everything in their power to make sure information like this never sees the light of day! They'd rather keep selling you and me half-ass solutions that deliver severely lacking results...if any...so that you have no choice but to keep coming back to them.”

Doctors are sometimes not the best people to provide advice on tinnitus as some are unaware of the large number of treatment options available, but to accuse of them of deliberately causing harm to patients by withholding information is simply untrue and dangerous.

There are a number of supposed review sites evaluating whether the ‘Banish Tinnitus’ formula is a scam or a reputable form of treatment. Although, they all give Banish Tinnitus a glowing review, it is possible that these review sites might have been written by the company behind Banish Tinnitus or their affiliates.

Respected Books on Tinnitus

There are a number of other books on the market claiming they can cure your tinnitus. Again to re-iterate, to date, there is no scientifically-based cure for tinnitus, but if you are looking to learn more about tinnitus, it is advisable that you buy a book written by a well-respected scientist in the field of tinnitus. Two recommend books are:

Tinnitus Retraining Therapy: Implementing the Neurophysiological Model by Pawel J. Jastreboff and Jonathan W. P. Hazell.

And

Tinnitus: Questions and Answers by Jack A. Vernon and Barbara Tabachnick Sanders.

Arches Formula Review

Thu, 22 Oct 2009 23:03:00 GMT

The company Arches Formula specialise in providing vitamin and mineral supplement pills. They sell 3 different 90-day-supply packs:

1. Relief Formula: Contains zinc, ginkgo biloba extract and deodorized garlic.

2. Stress Formula: contains niacin, riboflavin, folic acid, as well as a number of other compounds advertised as a potent treatment to ‘alleviate the anxiety and frustration due to the effects of stress caused by tinnitus’.

3. Tinnitus B12 formula: contains high levels of folic acid and Vitamin B12.

The reasoning behind the Relief formula supplements are scientifically sound but they are expensive. Each bottle is priced at $34.95 for 90 pills. In addition, there is no conclusive evidence that ginkgo biloba is an effective therapeutic for tinnitus, and taking it unnecessarily is to be discouraged as it carries side effects (see gingko biloba section).

The Tinnitus B12 formula contains only folic acid and Vitamin B12 but is priced at a staggering $34.95. In addition, each pill contains 1mg of Vitamin B12, which is 10 times the Recommended Daily Allowance (RDA) which does not equate to ten times the therapeutic benefit.

Arches Formula also promote a stress relief supplement package, which may cause some surprise. Although diet can play an important part in stress management, true stress reduction can only be achieved by support, counseling, and education.

There are many multi-vitamin retailers often providing the same dosage of vitamins and minerals for much lower prices.

T-Gone Review

Thu, 22 Oct 2009 23:07:00 GMT

T-gone is one of the largest tinnitus therapy companies in the world and similarly to Arches Formula, it’s flagship products are multivitamins including zinc, magnesium, ginkgo biloba, vitamin A, B12, C, E and melatonin. However, this is priced at $34 for a 30 day supply. As previously mentioned there is some evidence that these compounds are beneficial for tinnitus reduction, but there are many cheaper multivitamin packages available.

T-gone additionally advertise they their products boost the immune system which has a direct effect on reducing tinnitus severity. However, to the best of the author’s knowledge there is no conclusive scientific evidence to validate this claim.

Tinnitus Masking: How can it help reduce Tinnitus

Sat, 24 Oct 2009 00:49:00 GMT

Tinnitus masking is perhaps the most common form of tinnitus therapy. A masker produces a sound which is matched to the tinnitus signal, resulting in the suppression of the ringing, buzzing sound. A tinnitus masker can provide instant relief by substituting the tinnitus sound with one that is less intrusive, helping patients get to sleep or relax when they would otherwise be distracted.

It is believed that tinnitus masking can lead to long-term changes in the brain, reducing tinnitus intensity and awareness. This process has been termed habituation and is covered in more detail in the Tinnitus Retraining Therapy section.

Development of Tinnitus Maskers

Commercial tinnitus masker devices have been available since the mid-1970s and their development is largely attributed to the work of Dr Jack Vernon, who is one of the founders the American Tinnitus Association and a leading figure in tinnitus research. Being a physician who suffered with tinnitus, he found that when standing in one location near a water fountain, his tinnitus disappeared. He synthesised the sound of falling water and found it to be an effective masker of tinnitus. Before this breakthrough, researchers had neglected the idea that an external sound could mask an internal sound such as tinnitus.

Since Dr Jack Vernon’s early forays into tinnitus masking technology, today tinnitus maskers range from CDs, MP3s and bedside noise generators to wearable devices, hearing aids, and custom-made electronic devices.

Wearable maskers

Around 1974, the first white noise generator was added to hearing aids so that tinnitus masking could occur at the same time as external sound amplification for those that were hard of hearing. These are often known as combination devices or wearable sound generators (WSG).

These WSGs are commonly used by tinnitus sufferers who require masking at all times. A study conducted in 2006 found that patients who used WSGs for 18 months showed significant improvement in self-rated tinnitus loudness when compared to patients who did not use hearing aids or WSGs in the same period [[i]]. However, another study reports that only 30% of tinnitus patients found wearable maskers helpful for tinnitus [[ii]]. Not everyone will benefit from this type of masking, but the 35 to 40% who do benefit, appear to show significant improvement [[iii]].

It is believed that WSGs are ineffective for most tinnitus sufferers, as they cannot reproduce high frequencies essential for masking tinnitus. Most tinnitus sufferers report their tinnitus tone to be above 6kHz, but the small speakers in the device are physically incapable of producing these frequencies. There is an obvious need for improving the high-frequency output of wearable hearing aid devices to improve effectiveness for tinnitus masking [[iv]].

Other wearable maskers include the devices used in Neuromonics, TRT and Tinnitus Phase-Out. These are explored in separate sections.

Tinnitus CDs and noise generators

These are often the most cost-effective and immediate way to get the benefits of tinnitus masking without the need for WSG fitting. They often use one or more sounds described below.

White Noise

White noise is historically the most common sound used for tinnitus masking purposes. White noise is analogous to white light in that it contains all the frequencies of sound in equal proportions. White noise is a great masker and many people find it a relaxing sound to listen to. It is commonly used by people to block out distracting noise and improve concentration. However, some people do find the presence of the highest frequencies harsh on the ear.

There are other shades of noise which are not as harsh that are becoming increasingly popular amongst tinnitus sufferers.

Pink Noise

Pink noise is considered a more natural masking sound to listen to for extended periods. It is similar to white noise, but the highest frequencies have been filtered out, rendering it effective for masking while being comfortable on the ear.

Brown Noise

A sound with a much lower frequency content than pink and white noise, most effective for masking lower tinnitus sounds such as rumbles and roars rather than pure tone ringing. Brown noise is similar to the distant sound of the sea.

Noise Generators

There are numerous desktop/bedside noise generators on the market. The better ones have a range of noise and nature sounds and can normally be timed to turn off. But these devices have one main problem in that their often poorly-produced speaker cannot reproduce the highest frequencies. If you cannot match the frequency of high-pitched tinnitus tones due to ineffective high frequency output, efficient masking will not occur. High frequencies have been demonstrated to be necessary for successful tinnitus masking [[v]].

Your personal “hi-fi” will probably have better speakers than a bedside noise generator, and so a tinnitus masker CD may be a more efficient masking solution. Otherwise, ensure the bedside noise generator can be connected to other playback equipment.

Masking tapes are uncommon today and are inadvisable as the high frequency output of most cassette players is usually about 16kHz, while CD which have sampling rates of 44.1kHZ can reach 20kHz.

Nature Sounds

Most people find the sounds of nature enjoyable and relaxing. The sound of water is particularly popular and well-tolerated. White, pink and brown noise can be thought of as simpler synthetic-sound versions of water as they are similar in frequency characteristics. If you periodically increase and decrease the volume of pure noise, it can sound almost identical to the waves of the sea.

There are a wide variety of nature sound CDs and some of these will lack the high-frequency content essential for masking high pitched tinnitus. In addition, be aware that some nature sounds contain distracting sounds such as bird calls, which although they can add to the overall ambience, can be more distracting than relaxing, especially when trying to sleep.

Music, Radios and TVs

All music and speech evokes a subconscious reaction at a time when the nervous system should be in the absence of acoustic stimulation. Therefore, it is advisable that they are not used for tinnitus masking. Some tinnitus sufferers are told that using a radio tuned just-off station is an appropriate masker. However, Professor Martin Lenhardt of the Otolaryngology Department of Virginia Commonwealth University says that:

‘while the mistuned radio advice has often been offered to tinnitus sufferers, its general utility and long-term acceptance is low’. [[vi]]

[i] Folmer RL, Carroll JR. Long-term effectiveness of ear-level devices for tinnitus. Otolaryngol Head Neck Surg. 2006 Jan;134(1):132-13

[ii] Vernon et al. Clinical measurement. Otolaryngol Clin North Am 36(2):293-305, 2003

[iii] Johnson, R. The masking of tinnitus. In J Vernon (Ed). Tinnitus: Treatment and relief Allyn & Bacon, Needham Heights, MA. 1998. Pp. 164-173

[iv] Vernon et al.. Attributes of tinnitus and the acceptance of masking. Am J Otolaryngol 11(1):44-50. 1990.

[v] Shulman A, Strashun A. Descending auditory system/cerebellum/tinnitus. Int

Tinnitus J 1999, 5(1), 92–106.

[vi] Tinnitus Devices, Encyclopaedia of Biomedical Engineering and Biomaterials, 2004. Martin L. Lenhardt, Professor of Biomedical Engineering, Otolaryngology and Emergency Medicine. Medical College of Virginia, Virginia Commonwealth University.

Tinnitus Phase Out Review

Sat, 24 Oct 2009 00:50:00 GMT

Tinnitus Phasing is novel compared to all of the other audio treatments for tinnitus currently available, utilising the same concept behind noise-cancelling headphones (described later). This concept holds that every sound has an opposing sound which can completely neutralise it. This is known as phasing.

Essentially, if you know the exact amplitude and pitch of someone’s tinnitus, you can create a special phased wave which cancels out the tinnitus sound. Sound cancellation and phasing has been utilised in many devices from special ‘quiet’ headphones for helicopter pilots to effects-pedals for guitarists.

The company Tinnitus Phase-Out has created a device which delivers phase-shifted sounds specific to a sufferer’s tinnitus tone, resulting in tinnitus sound cancellation. There have been a number of encouraging scientific reports conducted into the Tinnitus Phase-Out device. The creator of the company, Dr Daniel Choy MD designed the first experiment.

Clinical Trials

He found that of 35 patients given a sham tinnitus tone with no phasing three times weekly for 10 minutes at a time, only 24% showed improvement in tinnitus when. However, when those same patients were given phase out treatment for the same length of time, 82% reported an improvement in tinnitus. These improvements are equated as a 6db reduction in tinnitus which approximately equates to a halving in tinnitus volume [[i]]. Similar results have been described in several independent reports:

A study by the Lake Erie College of Osteopathic Medicine demonstrated that 57% of patients had improvement in tinnitus reduction using the phase out device. They also stated that ‘46% of patients reported periods of complete residual inhibition (CRI) averaging two days’. Residual Inhibition is a term for the complete suppression of tinnitus sensation [[ii]].

The Department of Otorhinolaryngology, University of Antwerp, found that after only three sessions of using tinnitus phase out, 21 of 35 patients had a significant improvement in tinnitus loudness and quality of life [[iii]].

Below you will find a link to a free copy of the study.

http://tinnituscare.net/pdf/Antwerp_Study.pdf

Prior to the use of the device, patients require a psychoacoustic profile to determine the frequency and amplitude of tinnitus and afterwards they require a check-up twice a year to ensure the treatment is working. A major drawback of this treatment is that it is only for sufferers of predominantly pure tone tinnitus who experience the tinnitus noise as a single pitch. It is unclear what percentage of tinnitus sufferers perceive pure tone tinnitus, although a study in 2003 showed that 75% of tinnitus sufferers can match their tinnitus to a specific frequency or tone [[iv]].

Below is a link to a Youtube video of the device being promoted on British television: http://www.youtube.com/watch?v=LrIO3K6bgDs

The UK company www.tinnituscare.net charges approximately $1550 USD, which includes a $420 three-session consultation and $1130 for the device. You can rent the device instead of purchasing but I am unaware of the concession this offer provides.

In conclusion, the independent evidence that Tinnitus Phase-Out works is quite strong. Its founder Dr Choy is a well-respected scientist and has the support of other high-profile tinnitus experts, including Dr Jack Vernon. However, larger studies are needed to identify the long term therapeutic benefits of Tinnitus Phase-Out when compared to other therapies or placebo alone. It’s also not the cheapest of therapies but is considerably cheaper than Neuromonics and other custom-sound therapy devices. In most respects Tinnitus Phase-Out appears to be an encouraging new form of sound therapy for sufferers of pure tone tinnitus.

[i] www.tinnitusphase-out.com

[ii] Lipman RI et al. Phase-shift treatment for predominant tone tinnitus. Otolaryngol Head Neck Surg. 2007 May;136(5):763-8.

[iii] Vermeire K et al. Phase-shift tinnitus treatment: an open prospective clinical trial. B-ENT. 2007;3 Suppl 7:65-9

[iv] Vernon JA, Meikle MB. Masking devices and alprazolam treatment for tinnitus. Otolaryngol Clin North Am. 2003 Apr;36(2):307-20, vii

Tinnitus Tumor: Surgical Treatment

Thu, 22 Oct 2009 22:49:00 GMT

Vestibular Schwannoma (VS), also known as acoustic neuroma is a benign, slow-growing tumor that originates from the vestibular and auditory nerves which sense balance and hearing. Hearing loss, episodes of vertigo and tinnitus are common symptoms of the tumor.

Surgery to remove the tumor has been shown to alleviate tinnitus. In a retrospective study involving 171 VS patients, 70% of patients complained of tinnitus before surgery. After surgical removal of the tumor the tinnitus disappeared in 25%, and improved in 33%, but worsened in 9% of patients [[i]].

[i] Kameda K et al. Effect of tumor removal on tinnitus in patients with vestibular schwannoma. J Neurosurg. 2009 May 29