Question:

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.

Answer:

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.

Our practice is currently in the midst of the Tinnitus & Amplification 2002 Study, from which we are 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.

The study is open, of course, to all who desire to be a part of it. So you may consider this an invitation to participate.