There Are Treatments That Work!
Unfortunately, many people with tinnitus have wrongfully been told there is nothing that can be done about their tinnitus and that they must learn to live with its presence. This is not true and is actually negative reinforcement that can make people who experience tinnitus become people who suffer from tinnitus. The treatments discussed below can offer improvement to most people who live with or suffer from tinnitus. These treatment options are not for everyone and frequently multiple options are used simultaneously.
Device Centered Treatments Offered at This Office
If you are diagnosed with a hearing loss it needs to be treated to have successful treatment outcomes with any tinnitus treatment plan. If the hearing loss is left untreated your tinnitus treatment can be as much as 50% less effective. Hearing loss decreases the background neural activity that happens in normal hearing people, making the tinnitus one of the most prominent signals to the brain. Hearings aids naturally increase the background neural activity by correcting the hearing loss and therefore increasing any potential treatment outcome. For some people simply using hearing aids provides enough improvement that there is no need for them to pursue other forms of treatment.
Neuromonics is a sound therapy approach that uses a specific device that produces customized sounds based on your audiological profile. This treatment, has been proven and validated over the last 14 years treating thousands of tinnitus sufferers worldwide. Clinical research shows that the treatment is successful in over 90% of patients. The device treats the cause of the tinnitus, not the symptom and therefore gives long-term benefit. The device is used for at least 2 hours a day during your quiet activities such as reading, relaxing and even at work for some patients. You typically achieve immediate relief within 0-2 weeks of starting treatment and the tinnitus continues to improve throughout the treatment. This treatment process typically takes 6 months but may take up to 8 to 10 months and some patients see improvement much sooner. A listening demonstration can be done by your Doctor of Audiology at Hearing and Balance Institute of the Rockies, Inc. so you know what to expect using this device.
Serenade® by Sound Cure uses sound therapy technology developed at the University of California, Irvine by lead researcher and Professor of Otolaryngology, Fan-Gang Zeng PhD. You are tested with special software and the results downloaded into the Seranade device. The sounds available for therapy are S-Tones™, custom narrowband stimuli, and broadband sounds. The narrowband and broadband noise are like those used in traditional sound therapy. S-Tones™ use sinusoidal amplitude modulated signals customized to your tinnitus which can produce synchronized robust neural activity in the auditory cortex. This can offer immediate relief. Long-term relief requires a standard long-term tinnitus treatment program similar to all sound treatment programs. The level of the S-Tones™ is much softer than the level of the tinnitus to lower the perception of tinnitus.
Inhibitor (Ultrasonic Wave Treatment)
The Inhibitor emits ultrasonic waves from a handheld device. The treatment takes about 60 seconds and patient who experience results see them immediately. Results can range from a decrease in the volume of the tinnitus to full suppression of the tinnitus. The time the improvement lasts differs from person to person. It may only be minutes or last days. The Inhibitor can be demonstrated by your Doctor of Audiology at Hearing and Balance Institute of the Rockies, Inc. so together you can determine if this is a treatment option for you.
Over the years a number of tinnitus maskers have been made and dispensed. They have become much less popular among audiologist because most people become non users within about six months of purchasing the devices. Most maskers are built with the intention of setting the masking noise loud enough that the tinnitus is not heard. This works well for a while but when the masking device is not worn the tinnitus is usually still present. Additionally, over time the volume of the masking noise has to be increased as the volume of the tinnitus can increase.
Other Treatment Options
Sound generators come in all sorts of sizes and shapes. Sound generators are not meant to be used as tinnitus maskers. Their job is to provide background sound to increase the background neural activity in the auditory pathway. Sound generators also have a variety of sounds that can be made. Some devices have very customized sounds specific to your hearing loss and others are very generic sounds. In most cases using a sound generator without further therapy will provide some help but to obtain the full benefit TRT should accompany their use.
Electrical stimulation, in theory, holds great hope for tinnitus treatment. However, practical results have not lived up to these hopes. One of the largest issues with electrical stimulation is electrode placement. The closer the electrode is placed to the source of the tinnitus the better the outcome has been. Due to this issue typically only the profoundly deaf who are cochlear implant candidates are candidates for current research trails. Further research in this area is bound to be a great focus of tinnitus research in the next few years.
Many medications have been studied as to their effect on tinnitus. However, when the results of these studies have been compared to the placebo effect there has yet to be a medication that performs better than placebo effect. Most medications that come close to performing as well as the placebo effect they typically tend to come with severe side effects and are unsafe to take long term. Pharmacological treatments of tinnitus continue to be investigated. If a successful medication is found, it will have to be safe to take long term with minimal side effects since it will likely not permanently eliminate the tinnitus but only suppress it while on the medication.
Many medications have been used to decrease the emotional side effects that tinnitus can create such as anxiety, depression and sleep issues. Treating these issues with medications should be done cautiously since some of the medications can cause or increase tinnitus. Benzodiazepines are some of the most commonly prescribed drugs for these types of issues. However, tinnitus is one of the known withdrawal side effects for benzodiazepines. While on a benzodiazepine the medication has no effect on tinnitus, only during the withdrawal of the medication.
Therapy Based Treatments (not offered at this office)
Tinnitus Retraining Therapy (TRT)
Tinnitus Retraining Therapy is specific therapy that focuses on habituating to the tinnitus. This specific therapy approach is based off of the neurophysiologic model of tinnitus and involves cognitive training and sound therapy. Tinnitus Retraining Therapy is the most effective approach to treating abnormal sound tolerance levels. If you have sound tolerance issues and tinnitus they must be treated before the tinnitus is addressed. Tinnitus Retraining Therapy is not an immediate solution. For some people it may take up to 18 months before the full effect of the therapy is seen.
Sound therapy can mean a number of things and a lot of different treatment options incorporate some form of sound with therapy. The basics of sound therapy is that sound is used to help increase the neural background activity so that the tinnitus is not the most prominent sound you hear. This can be accomplished by using a hearing aid, sound generators, the Neuromonics device (see picture at bottom of page), or a tinnitus masker. Most people with tinnitus notice that they don’t notice their tinnitus as much if they have a fan on or the radio playing. They are in essence creating a simple form of sound therapy.
There is no research to support the theory that behavior modification therapy will decrease tinnitus. This therapy approach is only used to address the emotional issues that result from tinnitus. However, just as relaxation techniques can help when paired with another treatment approach, psychological support can be helpful.
Sleep therapy may not directly address tinnitus, however if the presence of tinnitus makes falling asleep or staying a sleep difficult a number of sleep strategies can be helpful. It is also important to note that the lack of sleep can certainly lead to increased tinnitus. Depending on your medical history there is a chance your Doctor of Audiology at Hearing and Balance Institute of the Rockies, Inc. will recommend a sleep study be conducted.
Temporo Mandibular Joint Dysfunction (TMJ)
About 20% of tinnitus patients can modify the sound and volume of their tinnitus by applying or manipulating force through their jaw. Many dental clinics advertise TMJ treatment as a treatment for tinnitus. In select cases TMJ treatment can be an effective option but it is often not the only treatment that is included in a treatment plan.
Stress Management (we will incorporate several forms of stress management into your therapy)
Tinnitus can start or increase when stress is high. Most tinnitus sufferers find that as they manager their stress they notice a decrease in the prevalence and annoyance of their tinnitus. Some great stress management activities are exercise (exercise can in some cases temporarily increase tinnitus, especially if you are not used to working out), massage therapy, acupuncture, aroma therapy, meditation, biofeedback, hypnotherapy and simply relaxing.
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