In the first week of October, nurses Jan and Fiona attended a Tinnitus Workshop run by Hearing Support Christchurch. Two guest speakers, Dr Grant Searchfield (Tinnitus Specialist from Auckland University) and Rosemary Mannering (Physiotherapist - Stress Management), provided some excellent insight on tinnitus and treatments for it. Jan has written the following blog post to report back on what was covered during this workshop. 

What is Tinnitus?

Tinnitus is a symptom that usually indicates a problem or change in the hearing system. It is experienced as noises or ringing in the ears or head when no such external physical noise is present. The sounds vary from person to person and include hissing, clicking, whistling, buzzing, grinding and roaring. Some people hear the sounds in just one ear and others hear the sounds in both ears.

It can be temporary, or it can be chronic and persistent. For many people who have tinnitus, the sounds are just a nuisance, but for others tinnitus can affect their ability to sleep, concentrate, work, and relax.

The Causes of Tinnitus

Tinnitus is a change in the normal processing of background noise and begins with a change in the ear.

Things that may cause changes in the hearing system include:

• Ear blocked by wax

• Middle ear infection or Eustachian tube problems

• Damage to hair cells - due to excessive or cumulative noise exposure or the normal ageing process

• Damage to the neurons of the hearing nerve - from head and neck injuries

• Stress

• Raised blood pressure

• Drugs

The brain tries to make sense of these changes and can make the brain reorganise itself and turn-up its internal volume control. Instead of rejecting tinnitus as meaningless, the brain thinks it is a sound.

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Who gets Tinnitus?

Although tinnitus is often associated with hearing loss, children and adults with good hearing can also experience tinnitus. Many people with hearing loss never suffer tinnitus.

Other factors that can be important predictors of tinnitus or affect the condition are:

• Personality - memories, thoughts, emotions

• Environment - time of day, exercise, stimulants, social venue, work, home

• Social Factors - relationships, values, beliefs, customs

Treatment

Although there is no cure for tinnitus, there are some very effective treatments and therapies available to help you manage your symptoms.

Sound Therapy

Sound as a therapy can be used in a number of ways:

• To interfere with  tinnitus; to mask it

• To assist relaxation

• To change the brain’s over-attention away from the tinnitus to normal sound. Training the brain to do this can lead to adaptation.

Masking

Masking is the use of a different sound from the tinnitus. 

• Masking can interfere with the tinnitus by making the hearing system too busy to listen to it

• Choosing the right sound is more important than the loudness of the sound. The sound has to be interesting so that your brain wants to concentrate on it

• Some people find that tuning a radio between FM stations helps, because of the static or white noise produced. There are devices available that can play different masking sounds, such as rainfall, ocean or surf

• Your doctor, hearing therapist or audiologist can make recommendations that are right for you

Relaxation

Stress can exacerbate tinnitus or cause it. Listening to music or other sounds that you like, can help with relaxation. Audiologists, hearing therapists and other trained people can help you understand what is happening and teach you a range of coping techniques. This includes information on stress management strategies, how to get to sleep, creating good work habits, sounds for relaxing, sound therapy and training for the brain.

Adaptation

The idea is that over time, your brain will get used to hearing an external, non-threatening sound and will learn to ignore the tinnitus. If the brain is trained in this way, over time the tinnitus will fade into the background. In a recent trial of hearing aids with sound therapy, it was found that the longer that people persisted with these, the better their tinnitus became.

New ideas on the horizon

• 3D sound  - this improves the effect of masking, by making the masking sound cover the location of the tinnitus

• Hearing aids with nature sounds  - A usual masking sound made through a hearing aid is a hissing sound, but recent research has found while both sounds worked, the nature sounds continued to improve the tinnitus and were more successful over time

• Trans-cranial current stimulation - this is a battery connected to wires and placed on the head with a very low-level current. When placed on the head above places which maybe causing tinnitus, the tinnitus can be turned off

• New Drugs - Work is continuing on drugs to try and improve the effects of sound therapy and other research involves trialling drugs that make the tinnitus go away

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