TinnitusTinnitus

ObjectivesObjectives

• Tinnitus:o Definitiono Effectso Causeso Diagnosiso Treatment

Audiology and Hearing HealthAudiology and Hearing Health

• Jewell Baggett-Strehlau, Au.D.• 31 years of experience• Provides diagnostic and tinnitus treatment

services• Has personal experience of tinnitus from an

airbag deployment

“….over 50 million Americans experience tinnitus…”1

1American Tinnitus Association

Pronunciation of TinnitusPronunciation of Tinnitus

Tinnitus can be pronounced one of two ways.

Tin-NIGHT-us

TIN-it-us

DefinitionDefinition

“A sensation of noise (as a ringing or roaring) that is caused by a bodily condition….”

My ears whistle and buzz continually, day and night...such a condition is truly frightful.

-Beethoven 1801

Merriam Webster

EffectsEffects

He who lives in harmony with himself lives in harmony with the universe.

- Marcus Aurelius(Roman emperor 161 to 180)

• Loss of Inner Silence• Emotional Upset and Panic• Sleep Disturbance• Weak and Vulnerable feelings

EffectsEffects

Reading in a silent atmosphere is a common technique used to help release tension and ‘tune-out’ the busyness of everyday hustle and bustle.Tinnitus makes it difficult to enjoy a peaceful atmosphere. The condition is an imposition and interferes with a variety of normal daily activities.

CausesCauses• External Ear • Middle Ear

• Inner Ear • Central Ear • Auditory Pathways

Causes – Outer EarCauses – Outer Ear

• Blockage• Reverberations and awareness to body’s breathing

• Impacted Wax• Disturbance of the ear drum

• Debris• Loose hair or foreign debris disturbs ear drum

Causes – Middle EarCauses – Middle Ear• Pulsatile Tinnitus

• May be completely synchronized with heartbeat• Plugging canal increases intensity• ‘Objective’ – clinician can listen in using stethoscope

• Vascular Tumor (paraganglioma)• Erode bones surrounding inner ear

Causes – Middle EarCauses – Middle Ear• Infections

• Excess fluid from blockage of Eustachian tube

• Otosclerosis• Abnormal bone growth

• Muscle Spasms• Stapedius muscle• Non-pulsating• Objective

Causes – Inner EarCauses – Inner Ear• Noise Trauma• Medications

• Ototoxic drugs

• Ménière's Disease• Aging- Presbycusis

Cause – Central Auditory PathwaysCause – Central Auditory Pathways• Tumors

• Brainstem or cerebellopontine tumors• Benign in nature, but proximity to nerve or blood vessel is the issue

• Vascular Loop in Brainstem• Hearing and balance nerves happen to coil near the nerve• Debatable

TreatmentTreatment• No Silver Bullet for Tinnitus• Many Causes = Many Treatments• Surgery – Tumors

• Mixed Results

• Medications• Inner Ear Disease

• Dietary Restriction• Sodium Restriction

Treatment – Music and TherapyTreatment – Music and Therapy

• Induce relaxation• Muscle relaxation• Slowing heart rate• Decreased blood pressure

Most common and effective of the self-help treatments

Treatment – AudiologistTreatment – AudiologistTinnitus is commonly associated with sensory or neural hearing lossYour Audiologist is the best resource for Tinnitus diagnosis and treatment.

Treatment – AudiologistTreatment – AudiologistTests to attempt to measure tinnitus• Tinnitus Loudness: level of loudness that matches the tinnitus• Pitch Matching: frequency that best matches the pitch of the tinnitus

Treatment – Sound TreatmentTreatment – Sound Treatment• Attention and Distraction

• Only focus on one thing at a time

• Habituation• Body’s ability to ‘tune out’ signal

• Masking• Oldest treatment• Cover the sound

Treatment – Hearing InstrumentsTreatment – Hearing InstrumentsNinety percent of patients with severe tinnitus experience some hearing loss…• Overall sound is decreased

• Tinnitus unaffected thus it is overstated • Hearing instruments decrease tinnitus

• 50% express reduction (Surr et al., 1985)• Built in maskers

Oregon Health Science University

Treatment – Hearing InstrumentsTreatment – Hearing Instruments

Tonotopic map• Frequency coding of brain

• Areas around damaged frequency ‘turn-up’ to compensate

Hearing Instruments can help bring the damaged areas back to normal levels.

TinnitusTinnitus

Tinnitus has many different causes.Due to the high correlation of hearing loss and tinnitus, hearing instruments can help to mitigate the symptom of Tinnitus.

First Step!First Step!

If you experience any signs of Tinnitus, the first step is to schedule a screening with your AudigyCertified® Professional!AudigyCertified® Professional!