Frequently a person will come into my office because they are hearing sounds in their ears that have become bothersome. They’ll tell me about how it is loudest when they are in a quiet room and while trying to lay down to sleep. They’ll report that there can be good days and bad days. Sometimes the sounds are so loud that it is distracting and keeps them from being able to concentrate at home and at work. Their difficulty sleeping can make their overall body feel run down and their mood is poor due to their tinnitus.
Tinnitus can be defined as “anything you hear that does not have an external stimulus”. Some studies are showing that the tinnitus is a perception of sounds from the brain. Most people perceive the sounds coming from the center of the head, but some people hear it in only one ear. If you have tinnitus, it should be evaluated by an audiologist for testing to rule out causes that may need a referral to an Ear, Nose, and Throat surgeon.
These sounds, or we will call them “tinnitus”, can be unique to each person. Some people hear crickets, cicadas, static, wind, or a high-pitched ring. Many people I have worked with report good days and bad days. Researches at University of California Irvine found that no matter if a subject reported a good or bad day, the volume and pitch of the tinnitus did not change. This solidifies the belief that tinnitus is a perception of the brain. Our brain also chooses our perception of a good or bad day.
The limbic system, also known as the brain’s “fright or flight” mechanism, can be linked to the perception of tinnitus. If a person hears a sound, then becomes upset by it, which causes them to perceive that the sound/tinnitus is louder. It becomes a negative cycle. We need to break this cycle.
Where does it come from? No one truly knows. There are specific events, such as a traumatic sound event where a blast of sound occurred too close to someone’s ears, that can be the initial cause for the tinnitus. In this case, there was damage to the outer hair cells of the inner ear causes the ear to create their own sounds. There are some medications that have tinnitus as a side effect. Some people hear tinnitus when their blood pressure rises and the more stress, the greater the tinnitus.
What can be done? No studies have been able to prove a cure for tinnitus. Some vitamins or herbal supplements will advertise that they will eliminate tinnitus. There are some eastern medicine techniques that say they can help too, such as acupuncture. But there is no known cure. Many of the above options may have helped some people, but no studies have found a definite answer to eliminating tinnitus.
There are programs that can be offered to people to help them minimize their perception of the tinnitus, manage it, and move forward with their lives. Approximately 80% of all people who are seen in our office simply needed to be evaluated and counseled on their specific hearing and tinnitus, including a description of the anatomy and physiology of the ear. After this visit, they feel as though they have enough knowledge to no longer be bothered by the sounds they hear. We offer many strategies to help reduce the perceived sounds while in quiet as well.
Some patients need a device with a tinnitus masker embedded in it to help them break the negative cycle between hearing the tinnitus. There are different programs that can use these maskers to improve patient’s outcomes and give not only relief, but also control over their tinnitus. Lately, there are even free apps that can be downloaded to smartphones that many of our patients have found very helpful.
As stated before, a large portion of people noticing tinnitus have an untreated hearing loss. In June 2013, the FDA allowed hearing aids to include tinnitus maskers. This allows the audiologist to program soothing sounds to help the patient. However, a large number of patients who have tinnitus, but also a hearing loss notice that the tinnitus is no longer present while wearing hearing aids. The correction in hearing can allow the patient to hear more environmental sounds and less of the tinnitus from the inner ear.
Dr. Pawel Jastreboff of the University of Maryland and Emory University has conducted research and reported studies on tinnitus retraining therapy. They have an excellent analogy regarding tinnitus. They liken tinnitus to a birthday candle in a dark room. If you have nothing else to look at, the candle becomes bothersome, especially if it were the only thing to look at for days, weeks, months, etc. If you could turn on the lights and allow the eyes and brain to see and process other things in the room, the candle no longer seems to bright. Therefore, if a person has a hearing loss in as little as one region of the sound spectrum, they may hear sounds from their ears without competition from sounds from the outside world.
If you have tinnitus, feel free to call us for an initial consultation. We will evaluate not only your hearing abilities, but also your perception of tinnitus.
Dawn Heiman, AuD is an Audiologist in Oak Brook, IL. 
For questions about hearing loss and hearing aids, contact Dr. Heiman at dheiman@helpingyourhearing.com and get your questions answered before you make a costly mistake. www.chicagoaudiologyandhearingaids.com .
