INFORMATION ON TINNITUS
Demystifying Buzzing in the Ear
The Answers You Need
WHAT IS TINNITUS ?
Simply put tinnitus is an auditory phantom perception. It is a feeling of ringing, buzzing or humming in the ear/s or the head. Tinnitus may be subjective, meaning it might be heard only to the individual, or it can be objective, in which case it can be heard by others as well.
When describing to the doctor, one should note :
If it is heard occasionally or all the time
Does it change in character or volume
Is it pulsatile ( like beating of the heart)
Is it associated with decreased hearing
Factors that make it better or worse
CAN IT BE NORMAL TO HEAR TINNITUS?
In 1953, two scientists placed 80 university students with normal hearing & no tinnitus in a sound proof booth. After 5 minutes, they were asked if they heard any sounds while they were in the test room. The students assumed they were undergoing a hearing test, but in reality they were exposed to absolute silence for 5 minutes.
93% of them reported that they heard buzzing or pulsating sounds; very similar to those experienced by tinnitus sufferers. This simple experiment proves that almost everyone can detect the electrical activity in the hearing pathway. Different people perceive it differently. About 85% people who hear tinnitus don’t find it intrusive or anxiety provoking.
CAN TINNITUS BE LINKED WITH HEARING LOSS ?
Hearing loss causes a decrease in sounds reaching the brain. To compensate for this, the brain tries to pick up as much information from the hearing nerve as it can. In a way, this is similar to what happens with the eyes in a dark room, where they become sensitive to even very low levels of light because the brain is trying to see very hard. In case of the ears, the extra strain to hear opens up/ relaxes the brain’s sound filtering mechanism & it starts picking up the baseline electrical activity in the nerves, which in turn can be perceived as tinnitus.
WHY IS TINNITUS SO DISTRESSING?
Tinnitus is one of the sounds that has the potential to elicit a strong emotional response. Prima facie this is because the brain considers tinnitus to be a threat, often because of various false notions surrounding it. Some may wrongly feel it to be sign of a permanent hearing loss, or that it indicates the possibility of a tumour in the brain. A lot of patients who visit our practice have been incorrectly led to believe that tinnitus cannot be cured, or it may continue to increase in volume.
At times these fears are enhanced by inconsiderate professional advise. The body reacts to tinnitus as it would to danger. There is an increase in heart rate, while all activities associated with pleasure are suppressed. For a few, the emotional cortex starts releasing stress hormones in response to even low levels of tinnitus which leads to feelings of anger, anxiety & frustration. Some tinnitus suffers develop a two way pathway, where in not only does tinnitus lead to an increase in negative emotions, but a bad mood for any reason whatsoever may in turn make tinnitus worse. This forms a vicious cycle which adds to the feeling of distress.
DOES EVERYONE FIND TINNITUS BOTHERSOME?
Experiments have proven that a majority of people can detect the background electrical activity present in the hearing nerve. Some of them never take notice of this sound, just as most of us don’t/ can’t see our nose despite it being in the field of vision.
Of those who do detect/ notice tinnitus, most do not find it bothersome. On the other extreme, there are some who develop a phobic reaction to their tinnitus, very similar to that of snakes, spiders, height etc. The phobic state can produce extreme emotional upset in the presence of continuous tinnitus sound, making it difficult to enjoy life while perceiving tinnitus.
Tinnitus Re-training Therapy (TRT)
WHAT IS TINNITUS RETRAINING THERAPY
TRT is a method aimed at habituating the body reactions induced by tinnitus, & habituating the perception of the tinnitus signal itself. The goal is to re-train the patient’s brain so they treat tinnitus the way they treat the sound of a refrigerator in their kitchen; a sound which they normally are not aware of, but when they do hear it, it is not bothersome. This method re-trains the reflexes involving the connections between the auditory & emotional cortex & re-trains the subconscious part of the auditory pathway to block the tinnitus signal.
TRT consists of two components: intensive one-on-one re-training counselling and sound therapy, most frequently with the use of sound generators, following a specific habituation protocol. Tinnitus is not masked during TRT, as one can never habituate to a signal one cannot detect. In fact the act of masking tinnitus may increase its loudness once the masking noise is taken away. This does not happen with a customised Tinnitus Retraining Therapy based programme which is tailored specifically as per individual tinnitus levels.
TRT offers significant reduction in tinnitus in about 80% of cases, a claim corroborated by many multi-centric studies in various parts of the world. Provided the specifics of the therapy are followed, TRT is the best chance against the menace of tinnitus that modern medicine has to offer.