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23.08.2014

Tinnitus ringing noise, hearing loss ppt - Review

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Tinnitus is a ringing or swishing noise in one or both ears that originates inside the ear or head.
The Audiology Department at Great Hills ENT offers a wide variety of therapy options for those with tinnitus. Constant noise in the head -- such as ringing in the ears -- rarely indicates a serious health problem, but it sure can be annoying.
Tinnitus (pronounced tih-NITE-us or TIN-ih-tus) is sound in the head with no external source.
Almost everyone has had tinnitus for a short time after being exposed to extremely loud noise. While there's no cure for chronic tinnitus, it often becomes less noticeable and more manageable over time.
Most people who seek medical help for tinnitus experience it as subjective, constant sound, and most have some degree of hearing loss. Tinnitus can arise anywhere along the auditory pathway, from the outer ear through the middle and inner ear to the brain's auditory cortex, where it's thought to be encoded (in a sense, imprinted).
Most tinnitus is "sensorineural," meaning that it's due to hearing loss at the cochlea or cochlear nerve level.
Musculoskeletal factors — jaw clenching, tooth grinding, prior injury, or muscle tension in the neck — sometimes make tinnitus more noticeable, so your clinician may ask you to tighten muscles or move the jaw or neck in certain ways to see if the sound changes. Tinnitus that's continuous, steady, and high-pitched (the most common type) generally indicates a problem in the auditory system and requires hearing tests conducted by an audiologist. Your general health can affect the severity and impact of tinnitus, so this is also a good time to take stock of your diet, physical activity, sleep, and stress level — and take steps to improve them.
If you're often exposed to loud noises at work or at home, it's important to reduce the risk of hearing loss (or further hearing loss) by using protectors such as earplugs or earmuff-like or custom-fitted devices.
In addition to treating associated problems (such as depression or insomnia), there are several strategies that can help make tinnitus less bothersome. There is no FDA-approved drug treatment for tinnitus, and controlled trials have not found any drug, supplement, or herb to be any more effective than a placebo. Not all insurance companies cover tinnitus treatments in the same way, so be sure to check your coverage.
Tinnitus is the perception of sound within the human ear in the absence of corresponding external sound. Tinnitus is not itself a disease but a symptom resulting from a range of underlying causes. However, if you experience a noise that no one else hears and it doesn’t go away, please contact our office and schedule an appointment with one of our providers. For many, it's a ringing sound, while for others, it's whistling, buzzing, chirping, hissing, humming, roaring, or even shrieking. When hair cells are damaged — by loud noise or ototoxic drugs, for example — the circuits in the brain don't receive the signals they're expecting.
Things that cause hearing loss (and tinnitus) include loud noise, medications that damage the nerves in the ear (ototoxic drugs), impacted earwax, middle ear problems (such as infections and vascular tumors), and aging.


One of the most common causes of tinnitus is damage to the hair cells in the cochlea (see "Auditory pathways and tinnitus").
Pulsatile tinnitus calls for a thorough evaluation by an otolaryngologist (commonly called an ear, nose, and throat specialist, or ENT) or neurotologist, especially if the noise is frequent or constant. You may also be able to reduce the impact of tinnitus by treating depression, anxiety, insomnia, and pain with medications or psychotherapy. CBT uses techniques such as cognitive restructuring and relaxation to change the way patients think about and respond to tinnitus. Masking devices, worn like hearing aids, generate low-level white noise (a high-pitched hiss, for example) that can reduce the perception of tinnitus and sometimes also produce residual inhibition — less noticeable tinnitus for a short time after the masker is turned off. Other treatments that have been studied for tinnitus include transcutaneous electrical stimulation of parts of the inner ear by way of electrodes placed on the skin or acupuncture needles, and stimulation of the brain using a powerful magnetic field (a technique called repetitive transcranial magnetic stimulation, or rTMS). Causes include ear infections, foreign objects or wax in the ear, nose allergies that prevent (or induce) fluid drain and cause wax build-up, and injury from loud noises.
But now the Neuromonics Tinnitus Treatment lets you relieve these symptoms and reclaim your life. Some medications (especially aspirin and other nonsteroidal anti-inflammatory drugs taken in high doses) can cause tinnitus that goes away when the drug is discontinued. This stimulates abnormal activity in the neurons, which results in the illusion of sound, or tinnitus. Tinnitus can also be a symptom of Mnire's disease, a disorder of the balance mechanism in the inner ear. She or he will also ask you to describe the noise you're hearing (including its pitch and sound quality, and whether it's constant or periodic, steady or pulsatile) and the times and places in which you hear it. If you have age-related hearing loss, a hearing aid can often make tinnitus less noticeable by amplifying outside sounds.
The aim is to habituate the auditory system to the tinnitus signals, making them less noticeable or less bothersome. Tinnitus is also a side-effect of some oral medications, such as aspirin, and may also result from an abnormally low level of serotonin activity.
The Audiology Department at Great Hills ENT is proud to provide the latest in tinnitus therapy to the greater Austin, TX area. In rare cases, tinnitus may be caused by a tumor on the nerve in the ear that sends signals to the brain, known as an acoustic neuroma. Many people can hear their heartbeat — a phenomenon called pulsatile tinnitus — especially as they grow older, because blood flow tends to be more turbulent in arteries whose walls have stiffened with age. Your clinician will review your medical history, your current and past exposure to noise, and any medications or supplements you're taking.
The main components of TRT are individual counseling (to explain the auditory system, how tinnitus develops, and how TRT can help) and sound therapy.
Individual studies have reported improvements in as many as 80% of patients with high-pitched tinnitus.
In two small trials, rTMS compared with a sham procedure helped improve the perception of tinnitus in a few patients.


Pulsatile tinnitus may be more noticeable at night, when you're lying in bed, because more blood is reaching your head, and there are fewer external sounds to mask the tinnitus. The resulting electrical noise takes the form of tinnitus — a sound that is high-pitched if hearing loss is in the high-frequency range and low-pitched if it's in the low-frequency range. Tinnitus can be a side effect of many medications, especially when taken at higher doses (see "Some drugs that can cause or worsen tinnitus").
A device is inserted in the ear to generate low-level noise and environmental sounds that match the pitch, volume, and quality of the patient's tinnitus.
In a Cochrane review of the one randomized trial that followed Jastreboff's protocol and met the organization's standards, TRT was much more effective in reducing tinnitus severity and disability than a technique called masking (see below).
Many people worry that tinnitus is a sign that they are going deaf or have another serious medical problem, but it rarely is. If you notice any new pulsatile tinnitus, you should consult a clinician, because in rare cases it is a sign of a tumor or blood vessel damage. This kind of tinnitus resembles phantom limb pain in an amputee — the brain is producing abnormal nerve signals to compensate for missing input. For patients with hearing loss, state-of-the-art hearing aids and tinnitus treatment solutions are available. This past August, I visited SUNY Buffalo, which houses one of the major clinical and research centers for the evaluation and study of tinnitus. Stocking thought that I might have suffered noise trauma during a youth spent on the New York City subways. Moreover, since much of the New York subway system is underground, the noise reverberates in the tunnels, unlike in Boston, where many of the trains are above ground and noise dissipates, or in Paris, where several metro lines run on rubber wheels. Tinnitus can be temporary, caused by excess wax, an infection of the inner ear, or the toxic effects of drugs like aspirin (which appears to weaken the neural signals from the ear to the brain) or those used to treat cancer. Some people with normal hearing develop spontaneous tinnitus when placed in total silence; this is believed to be a response of the auditory cortex to the abnormal absence of all ambient sounds.
With the recent proliferation of MP3 players, rates of hearing loss and tinnitus may rise sharply in the coming years. A recent European Union study has projected that as many as ten million Europeans may be at risk of developing severe hearing loss as they age; and, according to the American Academy of Audiology, noise-induced hearing loss affects about one out of every eight children in the United States.
Although my eardrums functioned well, Stocking said, the last two tests showed signs common to hearing loss at high frequencies, usually owing to age and noise trauma. First, a normal rat that served as a control was caged under the canopy and the entire apparatus was placed inside an acoustic chamber, into which Lobarinas delivered a steady noise with a narrow frequency range.



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