Subscribe!

Tinnitus Program

Summary:

In most cases, we’ve found that something can indeed be done for those with tinnitus -- a prevalent and many-times disturbing condition commonly described as "ringing in the ears." Our DigiCare team choreographs and systematizes lifestyle, medical and auditory efforts, helping identify potential contributors, recommending appropriate hearing instruments where applicable, counseling on helpful assistive devises and strategizing personalized biofeedback training. In-depth information follows.

Learn About:

What is Tinnitus?

Tinnitus is an abnormal perception of sound that is unrelated to an external source of stimulation. It has been described as Phantom Auditory Perception and, in some ways, shares similarities with amputees who experience painful sensations from missing appendages.

Tinnitus may:

  • Be intermittent, constant or fluctuant
  • Be mild to severe
  • Vary from a low roaring sensation to a high pitched type of sound
  • Be perceived as very soft to extremely loud
  • Be present in one or both ears

Tinnitus is often referred to as “ringing in the ears,” although some people hear hissing, roaring, whistling, chirping, or clicking. Suffers may have single or multiple types of tones.

Tinnitus is the body’s way of telling us that something is wrong, including acoustic trauma, disease, obstruction, allergy or hearing loss.

By far the most common of the permanent types of tinnitus is called functional or subjective tinnitus, or that which can only be heard by the sufferer. This type of tinnitus is common with some estimates indicating that 95% of cases are of this type. In such cases, the problem usually lies in the delicate inner ear region or even further up into the central auditory pathways.

The other 5% of tinnitus cases are of the type called structural or objective tinnitus.  The sounds of this type of tinnitus can literally be heard by others by means of a probe mic and amplifier.  This type of tinnitus may, in some cases, be treated medically. 

How Many People Suffer From Tinnitus?

Unfortunately, tinnitus is a significant and very common disorder. Approximately 50 million Americans experience the condition to some degree. Recent studies by the American Tinnitus Association (ATA) indicate that up to 25% of the U.S. population experiences some degree of tinnitus, either of an intermittent or constant nature.

Of these some 50 million Americans, about 12 million have tinnitus which is severe enough to seek medical attention. Of those, about two million patients are so seriously debilitated, they cannot function on a “normal,” day-to-day basis.

Patients experiencing severe chronic tinnitus have many characteristics in common with patients suffering from chronic pain. Furthermore, there is a strong correlation between tinnitus severity and a patient’s degree of sleep disturbance, insomnia, anxiety and depression. The symptoms can form a vicious cycle, exacerbating one another.

What are the Causes?

Tinnitus is a symptom of an underlying problem and not a disease in and of itself. Experience tells us that most sufferers of long-term tinnitus exhibit three major causal factors:

  • Auditory Contributors:  The most common cause of tinnitus is exposure to excessively loud noise either a single intense event (acoustic trauma) or long-term noise exposure. Age-related hearing deterioration, or Presbycusis is also a common cause.
  • Medical Contributors:  Many times, these contributors are unresolved or unrecognized disease or injury. They include: food and inhalant allergies, physical trauma to the head or neck, conditions such as hypertension, ear infection, impacted cerumen, reaction to ototoxic drugs & chemicals, thyroid disease, vascular disorders, TMJ disorder, nutritional deficiency, aneurysm, multiple sclerosis, and many others. Prescription and over-the-counter drugs may exacerbate tinnitus.
  • Lifestyle Contributors:  These are casual factors over which only the patient has control. These include obvious dietary and lifestyle contributors, such as smoking, caffeine and high sodium intake, MSG, etc. Also critical, these contributors include lesser recognized factors including dehydration, lack of sleep and stress. In the quest for relief from tinnitus, these contributing factors cannot be ignored. The quest for tinnitus relief is also the quest for excellent overall health.

Our DigiCare Tinnitus Management Program – a Multimodal Approach

First and foremost, rest assured that tinnitus is not “just your imagination,” as some might suggest. The noises the keep you awake and add stress to your life, are just as real and annoying as the static produced on a radio tuned between two stations, a cricket caught behind your couch or a siren that wails all through the night.

Just as frustrating are the many dubious claims of a cure for tinnitus, as if it were one singular condition. In any event, patients we see for the first time nearly always report tremendous frustration and discouragement from searching for reliable answers and professionals who truly care about their particular problem.

Perhaps you’ve been told you must learn to live with the tinnitus or that there’s nothing that can be done to help.  At DigiCare, we do not agree!

Over the last decade, DigiCare has studied and compiled a vast amount of information on tinnitus. We’ve gleaned information from studies undertaken all over the world, and have worked with thousands of tinnitus sufferers nationwide conducting our own research.

As a result, we’ve been fortunate in developing proven assessment and treatment protocols in achieving realistic outcomes for the management of tinnitus. In most cases, we’ve found that something can indeed be done, through an in-depth review of:

  • Factors in your control
  • Factors within your physician’s control
  • Factors within DigiCare’s control
  • And most effectively, a well-balanced, well-strategized combination of all three

At DigiCare, we begin with a formal hearing and tinnitus assessment, including:

  • A thorough case history
  • Comprehensive hearing evaluation, tests and analysis
  • Video otoscopy biomarker investigation
  • Tinnitus pitch and loudness matching
  • A complete evaluation of your auditory status

Our DigiCare Multimodal Tinnitus Management Program utilizes time-tested principles from various schools of thought and models of tinnitus therapy, customized to your particular tinnitus profile and needs. Careful review of any auditory, lifestyle and medical contributors is critical.

Additional tinnitus management tools may include:

  • Hearing aid fitting
  • Noise masking and combination devices
  • Nutritional changes and supplements
  • Various types of therapy and retraining, as appropriate

Each Management Program is tailored specifically to your needs. For more information or answers to specific questions, please do not hesitate to call or email us. 

Hearing Aids and Tinnitus Care

Hearing loss is a co-existing condition for 90% of individuals who have tinnitus. For hearing-impaired patients who meet criteria for amplification, part of our tinnitus management program involves wearing hearing aids or a tinnitus masker.  

Through the use of hearing aid amplification, a combination of low-level, broadband noise is used to achieve the habituation of tinnitus to the point that the patient is no longer aware of their tinnitus, except when they focus their attention on it.  Through this important tinnitus management model, hearing aids become, in essence, a sound therapy tool. 

What Next?

  • Call or email to make an appointment with one of our excellent DigiCare Auditory Rehabilitation Counsellors.
  • Complete the DigiCare Tinnitus Questionnaire provided by our office.
  • Bring a list of any medications, vitamins and minerals you are taking. Include dosage levels and your primary care physician’s name, address and phone number.
  • Bring a brief statement regarding your tinnitus complaint and how it is affecting your life. It can be helpful to jot down notes during the days leading up to your appointment, outlining and recording observations of your day-to-day tinnitus experience.
  • Invite observational input from your spouse or loved-ones. We would like as detailed a description as possible about your tinnitus. We also request that your spouse or loved-one accompanies you on your appointment.
  • Bring copies of any previous audiograms (hearing test results).
  • Bring hearing aid(s) or other assistive devices you may be using or have used in the past.

A Tinnitus Case Study

Q. Dear Dr. Chartrand:

I am 69 years old and have a loud ringing in my ears. I’ve had so many medical tests, including CAT scans and the doctors can find nothing wrong. Why is it that something so disturbing and disruptive to one’s life remains a mystery to the medical profession?

Mr. R. A.

A. Dear Mr. R.A.:

The short answer to your question is that tinnitus (noises in the ear) is not a singular condition, but varies significantly from individual to individual. However, your doctor should have referred you for a complete hearing test to determine if there could be a correlation between the tinnitus and an uncorrected hearing loss. In most cases, the proper fitting and programming of a hearing aid is the most effective remedy of all.

Beginning in 2002, our DigiCare practice began a Tinnitus & Amplification Study, from which we are continually developing “best practice models” for both the medical and audiology professions.

Since our study design may be of benefit in “mystery cases” such as yours, I will outline the program here:

  1. General medical and health history, including available clinical tests, are profiled. In cases where ototoxic medications or pharmacological contraindications appear, we will refer you to your primary care physician for a follow-up review.
  2. Video otoscopy and hearing health history are administered. In this, certain physiological landmarks are observed in light of FDA Red Flag conditions. Again, referral may be warranted.
  3. Nutrition, stress and hydration issues are reviewed as well. Certain foods and substances have been identified in past research as contributive to tinnitus, balance, and deafness.
  4. A complete analysis of your tinnitus (frequency band, intensity, and correlative factors) is made, along with a battery of tests to determine effects of masking, residual inhibition, and auditory reattention.
  5. A complete battery of audiometric tests are then given to determine degree and nature of any existing hearing loss, along with an assessment for amplification.
  6. Follow-up of each of the above is conducted over a 6-8 month period, including hearing aid programming, auditory rehabilitation counseling, and reassessment of tinnitus.

There is a great deal of detail in the study not covered here. But early reports of the effort look very promising with some dramatic results being reported from most participants. But the overriding benefit that has appeared so far is the increasing awareness among health professionals and patients alike that tinnitus does not have to remain a mystery, that there are indeed viable solutions, if applied individually and thoughtfully that can make a difference.

Max S. Chartrand Ph.D.

Learn Even More:

- 0707