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More than 80% of patients manage to stop discomfort from tinnitus and can lead a normal life again
June 26, 2007It is estimated that between 10 and 17% of the population has suffered tinnitus at some time in their lives, according to a number of international studies. Tinnitus is understood as the perception of noise in the ears or inside the head although there is no external source of sound, without any vibratory cochlear activity taking place (which occurs when an external noise is produced). Depending on the intensity of the symptom, the patient may have their everyday life affected. In extreme cases the discomforts may make working routines impossible or negatively affect normal daily life.
Doctor Heitzmann has recommended TRT (Tinnitus Retraining Therapy) treatment - based on the neurophysiological model - for those suffering from tinnitus. She points out that it is a treatment the aim of which is to get the patient to become accustomed to the "noise". To achieve this, therapeutic advice and sound therapy are used. The father of TRT is professor Pawel J. Jastreboff, who has defined tinnitus as a phantom auditory perception perceived only by the person. On applying the neurophysiological model in the University Hospital (of Navarre), Ms Heitzmann concluded that getting used to the tinnitus and thereby, achieving the cessation of discomfort, occurred in between 80 and 84% of patients, including, at times, a higher proportion. It is the treatment that has the highest success rate currently.
Other therapeutic methods, such as pharmacological ones, help to control the effects produced by tinnitus, such as anxiety and stress, but do not solve the problem, itself. Surgical operations have also shown to be of limited application for this disorder.
Various origins
Tinnitus may be triggered by various factors: from a wax plug in the ear or infection in the middle ear, to hearing loss or a benign tumour. Nevertheless, the origin of the problem mostly lies in the ear itself and in the internal auditory passage.
Nevertheless, knowing the possible origin of the tinnitus has not often been helpful in identifying its treatment. Ear specialists must always undertake a diagnosis. But, in the case of tinnitus, the diagnosis is more often than not one of exclusion. The specialist has to discard other pathologies in order to discern if the noises come from the ear itself or not.
On occasions, tinnituss appear accompanied by other manifestations that oblige the intervention of various medical specialists in order to contribute to relieving this symptom. This is why TRT treatment is applied in the most appropriate way in those medical centres equipped for all specialities; in this way, a multidisciplinary treatment of the patient is achieved.
Getting used to noise
With the application of the TRT neurophysiological model, what is important to know about the tinnitus is the manner in which the noise is made, from the peripheral organ (the ear) to the cerebral cortex. There is a series of structures in the central nervous system (CNS) that gives the tinnitus a magnified role. This fact alerts the patient and turn triggers the perception of auditory discomfort, according to Ms Heitzmann. The limbic system, responsible for emotions and learning, is then activated and the autonomous nervous system, which causes the discomfort. It is at these levels that intervention can take place.
This is why the approach proposed by Jastreboff and which we apply at the University Hospital is based on getting the patient to become used to the noise to the point where the tinnitus ceases to be a nuisance.
In this sense, the specialist believes that the disappearance of the tinnitus in itself is not the important thing, given that, on many occasions, we cannot avoid the ear hearing a noise or the auditory canal transmitting it. Dr Heitzmann points out that when we speak of "getting accustomed" to something, we mean ceasing to be conscious of the presence of a stimulus, something which is achieved if we learn to consider it irrelevant or not to take any notice of it. It is something similar to the clothes we wear - normally we are not constantly aware of what we have on and it does not bother us. So, getting used to the noise is synonymous with ceasing to be conscious of the tinnitus when one does not take any notice of it. Or, when notice is taken of it, and so the tinnitus is perceived, it does not cause discomfort or annoyance and is quickly forgotten.
Doctor Heitzmann considers that perceiving a tinnitus does not mean anything of significance, once diagnosed and when it does not present a vital risk to the patient and he or she does not need any other treatment. This is confirmed by the fact that there are many who are aware of tinnitus, but are not at all bothered by them. The well-known experiment by Heller and Bergman in 1953 had already shown that all of us perceive tinnitus in specific situations with no obvious illness involved and, so, in principle, it is a symptom that is frequent and irrelevant.
Therapeutic Advice and Sound Therapy
In working on TRT, Jastreboff showed that the central nervous system (CNS) has an elasticity and capacity for learning. The fact the tinnitus generates annoyance means that the CNS processes it as an important sound. We can teach the system to stop processing it at this level of importance and leave it at a subconscious level. This goal is achieved in two ways: therapeutic advice and sound therapy, fundamental tools in TRT.
Through therapeutic advice, the specialist gives the patient an explanation of what is happening and the cause of the discomfort being triggered, always after undertaking an assessment using questionnaires and clinical records, together with an auditory examination and study and, if deemed necessary, with complementary tests. An overall evaluation of the patient is essential.
The aim of therapeutic advice is to help to minimise the importance of the tinnitus. It involves eliminating the negative significance that makes the sound pass to a conscious level in the patient and cause discomfort. In this way, "disconnecting" the limbic system is achieved and the negative emotion or reaction is eliminated little by little.
Therapeutic advice is carried out over a number of interviews between the specialist and patient. Doctor Heitzmann underlines the importance of these sessions, pointing out that, without these interviews, sound therapy will not produce results.
The second TRT tool, sound therapy, arose from the discovery that, depriving the auditory passage, designed for hearing, of sound, tends to increase the sensitivity of the ear. In such a way that, when a sound - such as a tinnitus - is produced in the passage, it captures it straight away. To avoid this phenomenon, external sound is introduced into the auditory canal, thus reducing the perception of the tinnitus at a cortical level (in order to be less conscious of what there is and distract attention away from the tinnitus by means of this external sound).
Sound therapy, thus aims at helping the patient to get used to the tinnitus, by incorporating external sound in such a way that silence is always avoided. It has various levels of application. On the one hand, all patients are advised to avoid silence at all times, using this external source of sounds. Moreover, some patients require sound generators that emit white (neutral) sound and that have to be inserted in the ears for 8 hours a day, the noise never masking the tinnitus. Other patients with auditory loss need an adaptaiton to the headphones. The application of the therapy must always adapt to the circumstances and needs of each person.
The time estimated in getting the patient accustomed to the tinnitus and the disappearance of the discomfort depends on a number of factors, such as how long the tinnitus has taken to evolve, the psychological profile of the patient, personal circumstances that and other pathologies. All these factors can contribute to the getting used to the acufeno being achieved within a year, a year and a half or two years (the average estimated period) although these times may be longer, due to the factors mentioned. Not achieving the target in this time is thus not considered a failure. To help in the process, monitoring is required involving 5-6 clinical visits over 2 years, although this can vary according to the individual.
Elhuyar Fundazioa
Various origins
Tinnitus may be triggered by various factors: from a wax plug in the ear or infection in the middle ear, to hearing loss or a benign tumour. Nevertheless, the origin of the problem mostly lies in the ear itself and in the internal auditory passage.
Nevertheless, knowing the possible origin of the tinnitus has not often been helpful in identifying its treatment. Ear specialists must always undertake a diagnosis. But, in the case of tinnitus, the diagnosis is more often than not one of exclusion. The specialist has to discard other pathologies in order to discern if the noises come from the ear itself or not.
On occasions, tinnituss appear accompanied by other manifestations that oblige the intervention of various medical specialists in order to contribute to relieving this symptom. This is why TRT treatment is applied in the most appropriate way in those medical centres equipped for all specialities; in this way, a multidisciplinary treatment of the patient is achieved.
Getting used to noise
With the application of the TRT neurophysiological model, what is important to know about the tinnitus is the manner in which the noise is made, from the peripheral organ (the ear) to the cerebral cortex. There is a series of structures in the central nervous system (CNS) that gives the tinnitus a magnified role. This fact alerts the patient and turn triggers the perception of auditory discomfort, according to Ms Heitzmann. The limbic system, responsible for emotions and learning, is then activated and the autonomous nervous system, which causes the discomfort. It is at these levels that intervention can take place.
This is why the approach proposed by Jastreboff and which we apply at the University Hospital is based on getting the patient to become used to the noise to the point where the tinnitus ceases to be a nuisance.
In this sense, the specialist believes that the disappearance of the tinnitus in itself is not the important thing, given that, on many occasions, we cannot avoid the ear hearing a noise or the auditory canal transmitting it. Dr Heitzmann points out that when we speak of "getting accustomed" to something, we mean ceasing to be conscious of the presence of a stimulus, something which is achieved if we learn to consider it irrelevant or not to take any notice of it. It is something similar to the clothes we wear - normally we are not constantly aware of what we have on and it does not bother us. So, getting used to the noise is synonymous with ceasing to be conscious of the tinnitus when one does not take any notice of it. Or, when notice is taken of it, and so the tinnitus is perceived, it does not cause discomfort or annoyance and is quickly forgotten.
Doctor Heitzmann considers that perceiving a tinnitus does not mean anything of significance, once diagnosed and when it does not present a vital risk to the patient and he or she does not need any other treatment. This is confirmed by the fact that there are many who are aware of tinnitus, but are not at all bothered by them. The well-known experiment by Heller and Bergman in 1953 had already shown that all of us perceive tinnitus in specific situations with no obvious illness involved and, so, in principle, it is a symptom that is frequent and irrelevant.
Therapeutic Advice and Sound Therapy
In working on TRT, Jastreboff showed that the central nervous system (CNS) has an elasticity and capacity for learning. The fact the tinnitus generates annoyance means that the CNS processes it as an important sound. We can teach the system to stop processing it at this level of importance and leave it at a subconscious level. This goal is achieved in two ways: therapeutic advice and sound therapy, fundamental tools in TRT.
Through therapeutic advice, the specialist gives the patient an explanation of what is happening and the cause of the discomfort being triggered, always after undertaking an assessment using questionnaires and clinical records, together with an auditory examination and study and, if deemed necessary, with complementary tests. An overall evaluation of the patient is essential.
The aim of therapeutic advice is to help to minimise the importance of the tinnitus. It involves eliminating the negative significance that makes the sound pass to a conscious level in the patient and cause discomfort. In this way, "disconnecting" the limbic system is achieved and the negative emotion or reaction is eliminated little by little.
Therapeutic advice is carried out over a number of interviews between the specialist and patient. Doctor Heitzmann underlines the importance of these sessions, pointing out that, without these interviews, sound therapy will not produce results.
The second TRT tool, sound therapy, arose from the discovery that, depriving the auditory passage, designed for hearing, of sound, tends to increase the sensitivity of the ear. In such a way that, when a sound - such as a tinnitus - is produced in the passage, it captures it straight away. To avoid this phenomenon, external sound is introduced into the auditory canal, thus reducing the perception of the tinnitus at a cortical level (in order to be less conscious of what there is and distract attention away from the tinnitus by means of this external sound).
Sound therapy, thus aims at helping the patient to get used to the tinnitus, by incorporating external sound in such a way that silence is always avoided. It has various levels of application. On the one hand, all patients are advised to avoid silence at all times, using this external source of sounds. Moreover, some patients require sound generators that emit white (neutral) sound and that have to be inserted in the ears for 8 hours a day, the noise never masking the tinnitus. Other patients with auditory loss need an adaptaiton to the headphones. The application of the therapy must always adapt to the circumstances and needs of each person.
The time estimated in getting the patient accustomed to the tinnitus and the disappearance of the discomfort depends on a number of factors, such as how long the tinnitus has taken to evolve, the psychological profile of the patient, personal circumstances that and other pathologies. All these factors can contribute to the getting used to the acufeno being achieved within a year, a year and a half or two years (the average estimated period) although these times may be longer, due to the factors mentioned. Not achieving the target in this time is thus not considered a failure. To help in the process, monitoring is required involving 5-6 clinical visits over 2 years, although this can vary according to the individual.
Elhuyar Fundazioa
Tinnitus Current Events and Tinnitus News RSStudy: The new buzz on detecting tinnitus
It's a ringing, a buzzing, a hissing or a clicking - and the patient is the only one who can hear it. Complicating matters, physicians can rarely pinpoint the source of tinnitus, a chronic ringing of the head or ears that can be as quiet as a whisper or as loud as a jackhammer.
Ultrasound shown to exert remote control of brain circuits
In a twist on nontraditional uses of ultrasound, a group of neuroscientists at Arizona State University has developed pulsed ultrasound techniques that can remotely stimulate brain circuit activity.
National guidelines released for earwax removal
The American Academy of Otolaryngology - Head and Neck Surgery Foundation (AAO-HNSF) will issue the first comprehensive clinical guidelines to help health care practitioners identify patients with cerumen (commonly referred to as earwax) impaction. The guidelines emphasize evidence-based management of cerumen impaction by clinicians, and inform patients of the purpose of ear wax in hearing health.
Zebrafish may help solve ringing in vets' ears
Ernest Moore, an audiologist and cell biologist at Northwestern University, developed tinnitus -- a chronic ringing and whooshing sound in his ears -- twenty years ago after serving in the U.S. Army reserves medical corps.
Overactive nerves in head and neck may account for 'ringing in the ears'
Do your ears ring after a loud concert" Nerves that sense touch in your face and neck may be behind the racket in your brain, University of Michigan researchers say.
Silence may lead to phantom noises misinterpreted as tinnitus
Phantom noises, that mimic ringing in the ears associated with tinnitus, can be experienced by people with normal hearing in quiet situations.
Scientists Search for Brain Center Responsible for Tinnitus
For the more than 50 million Americans who experience the phantom sounds of tinnitus -- ringing in the ears that can range from annoying to debilitating -- certain well-trained rats may be their best hope for finding relief.
New cell culturing method pumps up the volume
In a breakthrough that will likely accelerate research aimed at cures for hearing loss, tinnitus, and balance problems, scientists have perfected a laboratory culturing technique that provides a reliable new source of cells critical to understanding certain inner-ear disorders.
For First Time, Cochlear Implant Restores Hearing To Patient With Rare Genetic Disorder
Researchers at Georgetown University Medical Center and the National Institutes of Health (NIH) have, for the first time, used a "bionic" ear to restore hearing in a patient with von Hippel-Lindau disease. They say this advance offers new hope for individuals with the rare disorder, which can produce non-malignant tumors in ears, as well as in the eyes, brain, and kidneys.
Low-pitch treatment alleviates ringing sound of tinnitus
For those who pumped up the volume one too many times, UC Irvine researchers may have found a treatment for the hearing damage loud music can cause.
More Tinnitus Current Events and Tinnitus News Articles
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Clear Tinnitus - 60 - Capsule by Clear Products Clear Tinnitus A remedy for the ringing, buzzing, humming, roaring and hissing, otherwise known as "Tinnitus". Clear Tinnitus is an all natural herbal product, scientifically formulated to help relieve the effects of tinnitus. This proprietary blend consists of thirteen FDA approved herbs that will not make you drowsy or increase your heartrate. No side effects! All natural ingredients! Clear Tinnitus Ingredients: Puerarie root, platycodon root, angelica root, coix seed, ginger root, ligustici root, peony root, perillia leaf, magnolia flower, notoplerygium root, cinnamon bark, scelellaria root, licorice root. Dosage: Take 1 to 2 capsules 2 times per day. Continue dosage to maintain benefits. Do not exceed 6 capsules per day. Fluid intake should be increased! |
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Tinnitus: Turning the Volume Down (Revised & Expanded) by Kevin Hogan (Author), Jennifer Battaglino (Author) Over 50 million Americans experience some form of tinnitus and there are those who don't realize that the ringing in their ears has a name. Of those 50 million, 12 million are estimated to have severe tinnitus where they seek medical treatment. Approximately two million people are suffering so severely that they cannot make it through their daily activities. Kevin Hogan has a positive approach to health as a definite goal worthy of determination. Kevin experienced tinnitus, and partly because of this, he treats those who suffer from it with respect! He heard the usual, You have to live with it, and he does NOT live with it. In addition he has remolded his profession to help those with tinnitus. This book is a positive example, a helping hand, a light in the darkness.... |
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Lipoflavonoid Caplets - 100 Caplets- NEW FORMULA HD 4930020 by NUMARK LABORATORIES INC. INDICATIONS: Lipoflavonoid helps improve circulation in the inner ear,Lipoflavonoid is recommended by ear doctors as a nutritional supplement to their patients with Menieres Disease (an ailment involving ringing in the ears, loss of hearing, and dizziness). INGREDIENTS: Active Ingredients:Eridictyol Glycoside, Vitamin B6 and B12, Vitamin C, Niacin, Riboflavin, Thiamine, Bioflavonoids, Choline, Inositol, and Pantothenic Acid. Inactive Ingredients:Dibasic Calcium Phosphate, Microcrystalline Cellulose, Croscamellose Sodium, Stearic Acid, Hydroxypropyl, Methylcelluose, Magnesium Stearate, Pharmaceutical Glaze, Polyethylene Glycol, Silica, Titanium dioxide, ethyl Vanillin, FD&C yellow 6, (sunset yellow), FD&C red 40 lake, FD&C blue 1 lake. DIRECTIONS: Adults and children 12 years or older:... |
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Tinnitus Retraining Therapy: Implementing the Neurophysiological Model by Pawel J. Jastreboff (Author), Jonathan W. P. Hazell (Author) Tinnitus and oversensitivity to sound are common and hitherto incurable, distressing conditions that affect a substantial number of the population. Pawel Jastreboff's discovery of the mechanisms by which tinnitus and decreased sound tolerance occur has led to a new and effective treatment called Tinnitus Retraining Therapy (TRT). Audiologists, ENT specialists, psychologists and counsellors around the world currently practise this technique, with very high success rates. TRT, the treatment developed by the authors from the model, has already proved to be the most effective and most widely practised worldwide. This book presents a definitive description and justification for the Jastreboff neurophysiological model of tinnitus, outlining the essentials of TRT, reviewing the research... |
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Arches Tinnitus Relief Formula by Arches Natural Products, Inc Arches Tinnitus Relief Formula® (TRF) uses clinically proven natural herbal & mineral ingredients for the reduction of tinnitus. The real truth is that there is no cure for tinnitus. But for the majority of those who try TRF there is real relief. Over 30 placebo based clinical studies have shown the ingredients used in TRF effective in reducing tinnitus noise. TRF is recommended by thousands leading US Ear, Nose & Throat doctors (ENT) to their patients with tinnitus who tell them to take TRF for at least 100 days (4 bottles) to determine total its effectiveness and total reduction of tinnitus noise. Arches Tinnitus Relief Formula is endorsed by Michael Seidman, MD, inner ear specialist and leading US tinnitus authority. Dr. Seidman is director of the Tinnitus Center for a major US... |
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Natural Relief from Tinnitus by Paul Yanick (Author) |
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NaturalCare RingStop for Ringing and/or Buzzing in Ears, Capsules, 60-Count Bottle by NaturalCare RingStop helps relieve symptoms of ringing and buzzing in the ears, ear noise and sensitivity to sound. This maddening noise is called tinnitus, and some people hear buzzing, hissing, roaring, whistling, chirping or clicking. This homeopathic formula comes in easy-to-swallow capsules, and includes ginkgo, special Chinese herbs, and key vitamins and minerals. |
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Tinnitus: Questions and Answers by Jack A. Vernon (Author), Barbara Tabachnick Sanders (Author) A brief book focusing on the most frequently asked questions regarding to ringing in the ears. Uses an easy to follow "question and answer" format. Covers causes and treatments with an optimistic tone. Includes a glossary. Tinnitus patients have questions that most often their doctors and audiologists can't answer. The disorder is not taught in medical schools and a single frontrunner of a treatment has not emerged. Tinnitus patients typically do not know where to go for help. Thousands resort to chatting on the Internet about their condition. Thousands of others have written to the American Tinnitus Association and to Dr. Jack Vernon for help, compassion, wisdom and answers. This book is a reflection of Dr. Vernon's 30-year dedication to this problem. His optimism for... |
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Tinnitus -60C Clear Products 60 Capsules by Clear Products CLEAR TINNITUSTM, contains a unique proprietary blend of thirteen herbs, scientifically formulated to work in combination with active homeopathic ingredients to provide temporary relief of tinnitus. Benefits and Features: - Provides temporary relief from the symptoms of tinnitus. - Contains specific homeopathic remedies traditionally used to relieve the symptoms of Tinnitus. - Safe for individuals with heart problems and does not increase heart rate. - Does not make you drowsy. - Easy to swallow capsules. - Users of Clear Tinnitus have felt a reduction of noise within a week and the daily recommended dose will need to be maintained for continued benefit. - No side effects. - Time tested Chinese herbs used in Traditional Chinese Medicine for thousands of years. ... |
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