Technology Diminishes Annoying Symptoms

A friend told me recently about the time she asked her husband why there were so many locusts outside. His response was, “What locusts?” That’s when she realized she had developed tinnitus, an affliction that affects about 36 million Americans. Tinnitus is noise in one or both ears that is heard inside the head of the person who has it… the noise can resemble a wide range of sounds, from chirping locusts as my friend hears to high whines, whistling, ringing, or even, as one exhausted new mother described hearing, the whirring sound of slot machines. Most people filter out these internal sounds, but for those with tinnitus, the filtering process is not working properly, so they hear everything. For many people tinnitus is mostly just annoying, but for about seven million Americans the constant racket in their ears is a severe intrusion in their lives.

Thus far there is no cure for tinnitus, but there are several new treatment modalities that can minimize its impact. To get information on these, I called Sujana S. Chandrasekhar, MD, clinical associate professor of otolaryngology at the Mount Sinai School of Medicine in New York City and director of New York Otology. Dr. Chandrasekhar says that current thinking is that most tinnitus is caused by hearing loss. Interestingly, it is our brains, not our ears that do the hearing. The inner ears make noise when components vibrate in response to sound waves, but normally we don’t “hear” this because our brains are paying attention to and processing external sounds. When the brain can no longer hear external sounds at a certain frequency, it processes other sounds — for instance, those produced in the inner ear as tinnitus.

Therefore, Dr. Chandrasekhar explains that the goal of tinnitus therapy is to get the brain of the patient to respond to the inner ear sounds as a ho-hum experience, rather than with fright and panic — as many people do. A new therapy, consisting of a limited number of treatments, called repetitive transcranial-magnetic stimulation (rTMS), involves placing an instrument on the head that transmits a magnetic wave into the brain, which alters neural pathways so that the brain still hears tinnitus sounds, but it doesn’t pay much attention to them. Use has been limited thus far, but results of rTMS are promising, says Dr. Chandrasekhar. However, since rTMS delivers currents to the brain, there may be some risk of seizures.

Another new technique is called Neuromonics Tinnitus Treatment. The Neuromonics device looks like an iPod and patients wear it for at least two hours a day for a two-stage treatment that typically lasts six to eight months. Doctors first identify the frequency and intensity of the tinnitus sound (an audiologist and the patient work together in a soundproof booth to replicate the sound as closely as possible) and then the device is programmed to emit sound that matches it. In the first treatment stage, patients hear music as well as a shower of their particular sound. During the second stage, the music remains but the shower of sound is turned down, allowing the patient to be more aware of his tinnitus during treatment — but by now, the patient’s brain has learned not to allow the tinnitus to be bothersome. It has become associated with pleasant sounds and the patient no longer feels dread or panic because of it — the tinnitus has indeed become ho-hum.

It is important to be evaluated by a doctor who treats tinnitus before beginning treatment. These specialists are called otolaryngologists, or ear-nose-throat specialists, and you can find one near you at the American Academy of Otolaryngology – Head and Neck Surgery site,