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07.03.2014

Tinnitus masking therapy, tinnitus medication treatment - Within Minutes

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There is considerable evidence that many forms of tinnitus are caused by central changes that may occur after peripheral lesions. Auditory stimulation is one of the most employed therapeutic methods for tinnitus, and one of the most beneficial. Hearing aids designed for people with tinnitus and hearing loss provide amplification that facilitates auditory stimulation to ameliorate tinnitus.
Implantable hearing aids are now used by many people, which made it possible to assess their efficacy in tinnitus treatment.
Other devices can be used for tinnitus management for immediate relief before a more complete sound therapy can be initiated. Sound stimulation has its beneficial effect on most forms of tinnitus by activating neural plasticity, which requires time to develop. The specific guidelines on hearing aid device adaptation are crucial for an effective auditory stimulation of tinnitus-affected patients. The most frequent causes of tinnitus seem to be cochlear damage, as almost all individuals with tinnitus have hearing loss. Auditory stimulation is one of the most employed therapeutic methods and one of the most beneficial for patients suffering from tinnitus [32].
The most suitable hearing aids for sound therapy are the open-ear hearing aids [38, 39], which have a mini speaker placed at the entrance of the ear canal. Besides sound generators and acoustic prostheses, other devices that are not specifically designed for treatment of tinnitus can be used for tinnitus management. Clinical studies [29, 34, 35] have shown that not only do hearing aids improve hearing ability, but they can also reduce or suppress tinnitus.
For instance, in a study carried out in 1999 [44], 50% of hearing aid wearers experienced relief from tinnitus, with a median improvement of 10% after only 6 weeks from the first application.
Favoring the ability to listen to tinnitus according to Jastreboff’s neurophysiologic hypothesis. Improving communication and reducing the discomfort often reported by patients as sounds and voices covered by tinnitus. Stimulating the auditory nervous system in a normal way and not only with tinnitus (phantom sounds). The role of the therapist should not be limited to the technical aspects of hearing aids and their application, but should aim at developing an empathic and confident relationship with the individual patient. The introduction of the so-called open-ear hearing aids helped overcome some of these problems, allowing application of hearing aids to individuals with mild hearing loss, such as many individuals with tinnitus have.
Optimal results in management of tinnitus are not only obtained with the application of technologically advanced hearing aid devices but, most of all, with their adjustment to the individual person’s needs and through patient counselling. The exact cause of tinnitus isn’t known, although there are known causes that can trigger or enhance it. Neuromonics Tinnitus Treatment is a FDA-cleared, patented, and clinically-tested treatment that has been shown to help reduce long-term tinnitus disturbances.
The first step in fitting a patient with a Neuromonic device is to do an assessment of their hearing and tinnitus profile. The Sound Oasis Sleep Sound Therapy System S-650-02 delivers unmatched therapeutic sound experience specifically developed for Tinnitus Relief. The Sound Oasis® Ear Therapy sound card provides advanced sound therapy to help tinnitus sufferers mask and manage their tinnitus at home or work. Your Sound Oasis® advances the science of sound therapy by incorporating clinically proven sound therapy sounds developed by Dr. Tinnitus, a condition that causes people to hear sounds such as ringing in the ears even when all is quiet, afflicts at least 10 percent of American adults. The time it takes for sound stimulation to reduce an individual’s tinnitus varies and may require a 6- to 8-month time frame.
Especially regarding treatment with sound, it is important to know if tinnitus is caused by pathology of the ear or the auditory nervous system. These central changes could ultimately result in the emergence of an aberrant neural activity that could induce tinnitus. Such therapy has no noticeable side effects and may be administered through simple devices [33].
Unfortunately, hearing aids currently available are not able to amplify sounds with a frequency above 6–7 kHz, a range of hearing that is often impaired in individuals with tinnitus; for this reason, ordinary hearing aids may be less efficient in compensating for lost auditory stimulation. These results were confirmed by subsequent studies, which extended the investigation to individuals who had tinnitus and mild hearing loss [34, 45].


Only a comprehensive evaluation may allow the therapist to have an accurate picture, in order to tailor the most appropriate and effective therapeutic plan. For example, sound environment generators are mostly indicated during night rest in patients affected by mild tinnitus. The parameters are crucial for auditory stimulation achieving maximal benefits on tinnitus.
In fact, even partial occlusion of the auditory canal may cause unease of use and may even increase tinnitus perception. Open-ear hearing aids also provide a stimulation mainly in the frequency region of the tinnitus pitch. In fact, many tinnitus patients are sensitive to amplification, which sometimes requires less gain and maximum output than in patients who do not have tinnitus. Patients are generally able to fully understand the volume regulation procedure and to safely carry it out, but often more than one round of counselling is necessary and analog scales should be used to track the intensity of both tinnitus and therapeutic sound. Each single patient must be listened to, counselled, and informed throughout therapy planning and during follow-up. Tonndorf J (1987) The analogy between tinnitus and pain: a suggestion for a physiological basis of chronic tinnitus.
Norena AJ and JJ Eggermont (2003) Changes in spontaneous neural activity immediately after an acoustic trauma: implications for neural correlates of tinnitus.
Norena A, C Micheyl, S Chery-Croze et al (2002) Psychoacoustic characterization of the tinnitus spectrum: implications for the underlying mechanisms of tinnitus.
Puel JL, J Ruel, M Guitton et al (2002) The inner hair cell synaptic complex: physiology, pharmacology and new therapeutic strategies.
Moffat G, K Adjout, S Gallego et al (2009) Effects of hearing aid fitting on the perceptual characteristics of tinnitus.
Norena AJ and JJ Eggermont (2006) Enriched acoustic environment after noise trauma abolishes neural signs of tinnitus. Han BI, HW Lee, TY Kim et al (2009) Tinnitus: characteristics, causes, mechanisms, and treatments.
Jastreboff PJ and JWP Hazell (2004) Tinnitus retraining therapy: implementing the neurophysicological model. Del Bo L, U Ambrosetti, M Bettinelli et al (2006) Using open-ear hearing aids in tinnitus therapy. Van de Heyning P, K Vermeire, M Diebl et al (2008) Incapacitating unilateral tinnitus in single-sided deafness treated by cochlear implantation. Holgers KM and BE Hakansson (2002) Sound stimulation via bone conduction for tinnitus relief: a pilot study.
Surr RK, JA Kolb, MT Cord et al (1999) Tinnitus Handicap Inventory (THI) as a hearing aid outcome measure.
Henry JA, TL Zaugg and MA Schechter (2005) Clinical guide for audiologic tinnitus management II: treatment.
Molini E, M Faralli, C Calenti et al (2009) Personal experience with tinnitus retraining therapy. Sheldrake JB, JWP Hazell and RL Graham, (1999) Results of tinnitus retraining therapy, in Proceedings of the sixth International Tinnitus Seminar, Cambridge UK September 5th-9th 1999, J Hazell, Editor. Ito M, K Soma and R Ando (2009) Association between tinnitus retraining therapy and a tinnitus control instrument.
Instead of just masking the tinnitus while the patient wears the device, it re-trains the brain to filter out the tinnitus sound, allowing for decreased tinnitus disturbance for the patient. Then the audiologist orders the device that is customized to the patient’s hearing and tinnitus profile. Thompson's sounds represent the most advanced approach to tinnitus therapy sounds that anyone has ever attempted with fixed pre-recorded sound tracks. There is now considerable evidence that most forms of tinnitus are caused by changes in the central nervous system after peripheral lesions [3, 4]. The increase in use of implantable hearing aids during recent years has made it possible to assess their efficacy for treatment of tinnitus. Conversely, these devices may be useful for immediate relief before a more complete sound therapy is started.
However, patients with disturbing tinnitus and without subjective hearing impairments benefit from custom sound generators, which should be worn at least 8 h during the daytime, in combination with an environment generator during night rest.
The open-ear hearing aids, thus, provide important advantages, such as sound enrichment, that reduce tinnitus by activating the neural plasticity.


During TRT therapy, the correct balance between sound stimulation and amplification can be determined with in situ instruments after some weeks of use [52]. This enables therapists to fully understand their patient’s problems and to solve them to the greatest extent through a proper selection of prosthetic devices and finding the optimal settings. Some patients notice benefit when they use hearing aids and some gain relief when they use a device called a tinnitus masker. For treatment of tinnitus, it is important to distinguish between these two models, as they imply different therapeutic strategies.
This strongly argues against a peripheral origin of tinnitus encountered in human subjects (related to peripheral damages).
In case sound enrichment should be required all day long (and tinnitus is not associated to hearing loss), “custom” ear level sound generators may be suitable. Custom sound generators are both useful for total masking therapy [36] and for partial masking therapy, according to tinnitus retraining therapy (TRT) [37] (Picture 2). The Combi devices represent the most innovative and efficient therapeutic tools for tinnitus and hearing loss, because they can combine auditory stimulation in impaired hearing areas with either partial or total tinnitus masking [40, 41]. Implantable middle-ear prostheses provide better sound therapy for some patients with tinnitus than traditional hearing aids [42], probably because they provide amplification in a wider frequency range and because of the “naturalness of the amplification”. Sound generators should be adjusted to the frequency of the tinnitus in order to activate the auditory nerve close to tinnitus frequency.
The large variability of the requirements for tinnitus patients regarding amplification has prevented adaptation of an uniform formula that is suitable for all tinnitus patients.
A new device has been made available that is a tinnitus retraining therapy called Neuromonics.
In fact, the peripheral model suggests that the aberrant neural activity is responsible for tinnitus perception. Audiometric test results do not usually reflect variations in tinnitus and thus, are not valid measures of relief [48]; tests, therefore, do not need to be periodically repeated. It is also important not to underestimate the hearing of one’s own voice which often causes difficulties in the understanding of speech, as well as being unpleasant for the individual and may cause a sensation of “closure” that can worsen tinnitus. Individuals with tinnitus often benefit from having the option of noise reduction switched off or turned down. This treatment uses the fact that the brain is able to be retrained on what auditory sounds it focuses on to allow for a reduced tinnitus disturbance. Finally, changes in the pattern of spontaneous discharge (increase in firing rate and synchrony), consistent with the psychoacoustic properties of tinnitus [4], have been observed after acoustic trauma [3, 27]. For individuals with hearing loss, open-ear hearing aids are suitable [34, 35], as well as tinnitus control combination instruments (Combi), which combine a prosthesis and a sound generator. Cochlear implants can provide input to the auditory nervous system that can reduce tinnitus in many individuals, both in those with severe hearing loss and in individuals with good hearing on one ear who have severe tinnitus referred to that side [43].
Cerebral plasticity requires some time to develop, and the needed duration of therapy may, therefore, vary from patient to patient [49]. In the selection of hearing aids, all elements that can cause a patient’s discomfort and increase the perception of tinnitus must be taken into account, including cosmetic aspects.
The tones are customized for each patient based on that person's specific level of tinnitus, although the reprieve is temporary, experienced only when the Serenade is in use.Reports of tinnitus are rising because of widespread use of personal entertainment and communication devices, particularly in children, according to researchers at the University of California at Irvine's Hearing Research Center, where Serenade was first developed.
A recent study [6] has shown that salicylate-induced tinnitus may be caused by activation of NMDA receptors expressed in the synapses of cochlear hair cells and dendrites of spiral ganglion neurons.
Optimal relief from tinnitus may require a 6- to 8-month therapy using hearing aids and sound generators [50, 51]. In a paper published online in April by the Journal of the Association for Research in Otolaryngology, the researchers, who describe tinnitus as a "brain disorder," said their device was most effective when the volume was set at a level just softer than the sounds produced by tinnitus (pdf).
If tinnitus was normally caused by increased activation of NMDA receptors, a possible therapeutic approach that could suppress such “peripheral tinnitus” would be inactivating NMDA receptors [6, 7].
Once the treatment is completed, periodic use of the device is recommended to ensure that the tinnitus relief continues. Tinnitus is also the most common disability among Afghanistan and Iraq war veterans, according to the U.S.



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