Tinnitus
Understanding Ringing in the EarsAffects 70-85% hearing impaired
people
Anatomy of the ear
What is Tinnitus ?
Tinnitus is a symptom
not a disorder / disease
• Hearing loss
• Medical disorders
• Drugs Diazpam -valium
When brain hears
tinnitus – produces stress
hormones
Regardless cause- high
correlation with hearing
loss
Peripheral hearing loss –
less stimulation to brainincrease brain activitybrain compensating for
hearing loss.
Humming, ringing,
buzzing., continuous,
periodic, different pitch,
loudness variation
Brain has ability to ignore
Tinnitus
Assessing a patient with Tinnitus
Hearing test
Tinnitus
matchingTinnitus handicap
questionaire
• Pure tones
• Speech tests
• Pressure of middle ears
• Pitch
• Loudness
• Duration
• Patients reaction to tinnitus
Management of patient with Tinnitus
Counselling and education
Sound therapy
Hearing aidsstimulating brain
reducing tinnitus
Takes attention
away from tinnitus
Reduces quiet time
Reduces sound
noise ratio
Sound Therapy
Hearing aidsonly therapy
recommended
for most
patients
Broadband and
narrow band
sound
generators –
tinnitus
maskers
Environmental
soundsprogrammed
into hearing
aids
Music therapyprogrammed
into hearing
aids
Music Therapy
Induces
relaxationstimulates
part of brain
releasing
mood
hormones
and tinnitus
• Slow music and non changing soothing effect
• High pitches and fast music causes excitement
• Repetitive music pleasant –
active listening
• Non repetitive music – passive
listening
Music and Stress
People use
music without
thinking
Carefully
selected music
helps tinnitus
Changes vicious
cycle of stress
Set program in
hearing aid with
Zen tones.
Different Zen
tones catering
individual needs
Invokes passive
listening
Binaural
stimulation
necessary
Programming the Hearing Instrument
Need remote or
program button
First program –
master programgeneral listening
Second programZen with
microphone on
music in
background while
amplifying speech
Third programZen only –
meditating and
quiet times.
Cure for Tinnitus ?
No Cure
Goal is
alter
patients
reaction to
Tinnitus
Habituation
Acceptance
– no
danger
Improve
quality of
life