Tinnitus and Decreased Sound Tolerance Assessment and Management
Tinnitus, or ringing in the ears, is a very common symptom experienced by up to 80% of the population.
As tinnitus is often associated with hearing loss or with conditions of the ear, a full tinnitus assessment will include not only a comprehensive medical and audiological case history but also a full diagnostic hearing test as well as a subjective review of the tinnitus itself (such as pitch and loudness matching, masking affects etc.) Following assessment, your audiologist may recommend you visit an Ear, Nose and Throat Specialist to determine if there is any underlying otological pathology that requires medical treatment.
There has recently been a lot of research on tinnitus which has revolutionised its long term management in those who find it distressing or disturbing. Understanding the importance of the brain and the sub-conscious pathways in maintaining and emphasising the tinnitus signal is especially important in managing the condition.
Tinnitus Retraining Therapy (TRT) is considered one of the most successful approaches to tinnitus management. It is based on neurophysiology and the theory that tinnitus is experienced by the whole population, but the majority of people do not hear it as it is not important for the brain to monitor the sound. This theory is also based around the fact that the brain is capable of suppressing familiar but unimportant noises (e.g. the motor of your fridge) but emphasize sounds that mean danger or that are important (e.g. if your fridge breaks down and makes a strange noise).
The goal of TRT is to retrain the brain to suppress the tinnitus in the same way as these familiar but unimportant sounds are suppressed by retraining the auditory, limbic and autonomic nervous systems to process the tinnitus sound in a neutral way, removing the reaction to the tinnitus and enabling it to become less noticeable – a process called habituation.
What is Involved with TRT
Education and Counselling:
One-on-one education and counselling takes into account individual circumstances and case history to enable each patient to understand the neurophysiological theory of how tinnitus is generated and how the habituation process is achieved.
Sound therapy is an important component of TRT. This is the appropriate use of environmental sounds to facilitate the retraining process.
For those patients with hearing loss, the fitting of hearing aids is strongly recommended as auditory deprivation can exacerbate tinnitus. For those with normal hearing, other noise generators or devices such as appropriately used iPods may be used to stimulate the auditory pathways and allow the habituation process to take place.
Cognitive Behavioural Therapy (CBT)
Cairns Audiology Group works closely with local Psychologists to provide appropriate options for Cognitive Behaviour Therapy the aim of which is to reduce the patient’s distress caused by the tinnitus and to assist with the habituation process. Changing negative thought processes may help reduce tinnitus distress, annoyance, severity and awareness. CBT helps the person to challenge negative thoughts about the tinnitus and break the cycle of distress.
Click here for more information on Tinnitus and Decreased Sound Tolerance