Tinnitus Frequently Asked Questions
These questions and answers are reproduced from a workshop conducted by Dr’s Pawel and Margaret Jastreboff, neuroscientists who developed Tinnitus Retraining Therapy (TRT). Western Hearing Services audiologists are all trained in tinnitus assessment and application of Tinnitus Retraining Therapy.
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What is Tinnitus?
Tinnitus refers to any sound heard in the head or ears for which there is no corresponding outside sound. Most tinnitus is reported as sounding like ringing, whistling, humming, cicadas, buzzing, static or the ocean etc. In most cases tinnitus is reported as sounding like it is in both ears and the main cause is noise exposure. Tinnitus can cause depression, anxiety and sleep disturbance however the good news is tinnitus can be treated and relieved.
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Medical Management
Medical management consists of making a diagnosis as to the cause and providing an explanation to the patient. It involves taking a history of noise exposure, previous ear problems, head trauma, illness and drugs used in the past, examination of the head, neck and ears and an accurate audiogram. If an unexplainable asymmetrical hearing loss is found a CT or MRI scan to exclude an acoustic neuroma may be required.
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What happens at an appointment?
Your tinnitus assessment appointment will take 60 to 90 minutes. During that time a comprehensive history will be taken by your Audiologist. You will have your ears examined and a number of tests will be conducted including otoscopy, impedance audiometry, measurements of the outer hairs cells in the cochlea as well as hearing and speech testing. You may then be guided through tinnitus pitch and loudness matching and tests of sound tolerance. Your Audiologist will discuss the results with you in detail and explain why the tinnitus has become a problem and what can be done to treat it. If, during your assessment your audiologist detects anything to suggest that there may be an underlying medical condition you will be sent with a letter explaining the results to your general practitioner.
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What does treatment involve?
Our statistics show that in half of the cases we see all that is needed is an explanation of the mechanisms involved in tinnitus and a check of the hearing and tinnitus and a discussion of any concerns you may have. You will receive instruction on the best way to modify your day / night sound envronment to effectively habituate (eliminate from your conscious thought)to the tinnitus. If necessary some high frequency hearing devices or tinnitus instruments to subdue the tinnitus (so it reaches a point where its easily habituated) may be recommended.
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Prevention is better than cure – the importance of hearing protection
Whilst we have had overwhelming success treating noise induced hearing loss and tinnitus, prevention is better than cure. Hearing protection, conservative exposure to sound and regular hearing assessments are the only way to prevent damage and the subsequent distress that tinnitus can cause.
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How do you treat tinnitus?
Our treatment is called Tinnitus Retraining Therapy, but other names such a habituation-oriented therapy, tinnitus treatment based on neurophysiological model, and “Dr Jastreboffs treatment” are used as well. It involves an extensive audiological evaluation, several counselling sessions, the use of external sound, and frequently the use of sound devices. It does not involve any surgery or drugs.
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What does retraining therapy mean?
We try to retrain the subconscious parts of the brain to ignore the sound of your tinnitus and to achieve the state in which you are not aware of and/or annoyed by your tinnitus.
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What kind of audiological tests are performed?
The tests include an audiogram and several specific tests which will allow us to evaluate whether you have tinnitus and/or hyperacusis, and to what degree. The tests begin with low levels of sound and gradually get louder, therefore, none of the tests will be painful. If your tinnitus is not present on the day of the testing, it will NOT influence the possibility of success with the treatment.
