Tinnitus

Question 0

What questions can you ask an individual with tinnitus to identify if they are a “tinnitus patient”?

Answer 0

• questions about sleep
• questions about concentration
• questions about mood
• questions about awareness and annoyance
  
  • what percentage of your waking hours are aware of your tinnitus?
  • what percentage of your waking hours are you bothered by your tinnitus?
• what effect does tinnitus have on your life? (0-10)
• tinnitus questionnaire

Question 1

What is tinnitus?

Answer 1

A perception of sound that is involuntary and originates in the head.

It is an electrical signal in the absence of a mechanical vibration, therefore it is a phantom sound.

It is a normal compensation for changes in the auditory system.

Question 2

Why is tinnitus a problem for some people?

Answer 2

It affects sleep, concentration, mood, and hearing (not true that it masks speech)

Question 3

What are tinnitus patients often told?

Answer 3

There is nothing you can do about it.

This is what they hear because it is a way to say that there is no surgery or medication to “cure” you. There are however good behavioral procedures that help a lot of people

Question 4

How do we help tinnitus patients?

Answer 4

Medical evaluation –> Audiological evaluation –> Tinnitus education –> Individual consultation and treatment

Question 5

What are some factors that make tinnitus worse?

Answer 5

• Stress
• noise exposure
• fatigue
• certain medications
• diet
• monitoring tinnitus
• Internet surfing about tinnitus

Question 6

What makes tinnitus better?

Answer 6

• Information and education
• management strategies
• tinnitus treatment via acoustic or sound therapy

Question 7

Sources of tinnitus

Answer 7

• Phantom sound
  
  • phantom pain that brain is expecting to get something and when it isn’t getting it, it is recreating it
• Damaged or missing hair cells
  
  • distortion or noise produced

-perception of a “brain hum” due to kiss or hearing for sounds outside the head

Question 8

How does tinnitus become intrusive? Aka what happens in the brain that makes it become a problem for some people?

Answer 8

A connection has developed in their brain between the neural tinnitus sound and two systems in the brain which makes it intrusive and unable to be out in the background/ignored.

The brain thinks that tinnitus is a threat to the system and caused stress which brings attention to the tinnitus.

Question 9

What does reaction to a sound depend on?

Answer 9

The context–> not how loud the context is but rather how strong the correlation is

Example: air conditioner in hotel (snake vs. nothing)

Question 10

What are some treatment options for tinnitus?

Answer 10

• Environmental sound (white or pink noise sound generator)
• hearing aids
• Neuromonics Tinnitus Treatment
• Tinnitus Activities Treatment
• cognitive behavioral therapy (CBT)

Question 11

How do hearing aids help with tinnitus?

Answer 11

They increase neuronal activity by directly activating the IHCs as soon as sounds are loud enough. (AKA decrease random neuronal activity)

Amplification of speech and ambient sound may reduce tinnitus audibility and awareness. (AKA provide sound enrichment by making ambient sounds audible and enabling patient to use low level sound and hear it)

Amplification may remove hearing loss as a driver of neural compensation mechanisms such as gain adaptation.

Improved ease of communication which reduces stress which reduces tinnitus. (aka improve ease of listening and decrease stress)