Tinnitus

Understanding Ringing in the Ears- Affects 70-85% hearing impaired people

Anatomy of the ear

What is Tinnitus ?

Tinnitus is a symptom not a disorder / disease • Hearing loss• Medical disorders• Drugs Diazpam -valium

Regardless cause- high correlation with hearing

loss

Peripheral hearing loss – less stimulation to brain- increase brain activity- brain compensating for

hearing loss.

Brain has ability to ignore Tinnitus

Humming, ringing, buzzing., continuous,

periodic, different pitch, loudness variation

When brain hears tinnitus – produces

stress hormones

Assessing a patient with Tinnitus

• Pure tones• Speech tests• Pressure of middle ears

Hearing test

• Pitch• Loudness• Duration

Tinnitus matching-

• Patients reaction to tinnitusTinnitus handicap questionaire

Management of patient with Tinnitus

Sound therapyHearing aids-

stimulating brain reducing tinnitus

Takes attention away from tinnitus Reduces quiet time Reduces sound

noise ratio

Counselling and education

Sound Therapy

Hearing aids- only therapy

recommended for most patients

Broadband and narrow band

sound generators –

tinnitus maskers

Environmental sounds-

programmed into hearing

aids

Music therapy- programmed into hearing

aids

Music Therapy

• Slow music and non changing - soothing effect

• High pitches and fast music - causes excitement

• Repetitive music pleasant – active listening

• Non repetitive music – passive listening

Induces relaxation- stimulates

part of brain releasing

mood hormones

and tinnitus

Music and Stress

People use music without

thinking

Carefully selected music helps tinnitus

Changes vicious cycle of stress

Set program in hearing aid with

Zen tones.

Different Zen tones catering

individual needs

Invokes passive listening

Binaural stimulation necessary

Programming the Hearing Instrument

Need remote or program

button

First program – master

program- general listening

Second program- Zen with

microphone on music in

background while amplifying speech

Third program- Zen only –

meditating and quiet times.

Cure for Tinnitus ?

No Cure

Goal is alter

patients reaction to

Tinnitus

Habituation

Acceptance – no danger

Improve quality of

life