STORY BY

Anissa Anderson Orr

 

Tinnitus

When Silence Becomes Deafening

“Peace and quiet” is rare for people with tinnitus. Constant buzzing fills the nighttime silence, interrupting sleep. High-pitched ringing hijacks the brain’s attention from work or study. Tinnitus can sound like a radio that can’t tune in to a station. And the human brain can’t tune out from the static.

Even worse, the noise of tinnitus is always there.

The inner noise is distracting and bothersome, making it difficult for people with the condition to work or live a normal life, says Nabil Al-Muhtaseb, director of the Audiology Hearing, Tinnitus and Balance Clinic at The University of Texas Health Science Center at Houston (UTHealth). The sounds of tinnitus range from a mild ringing or buzzing to a high-pitched, insistent whine, depending on the severity. The noise is often worse at night, when homes are most quiet.

For many years, people with tinnitus just had to live with the constant noise.

“When I was in medical school 30 years ago, they used to tell us, ‘There is nothing we can do for tinnitus,’” says Muhtaseb, one of the few physicians-turned-audiologists. “Over the last 10 to 15 years, we have developed many ways of managing hearing loss and tinnitus in particular.”

Oh the noise, noise, noise, noise!

Ever leave a raucous rock concert with ringing in your ears? That’s tinnitus. You are hearing your brain trying to make sense of the sounds around you. However, the nerves in your ears—damaged by the loud music—can’t process those sounds. So you hear ringing instead.

Muhtaseb compares a person with tinnitus to someone who has lost his toes, but still feels sensation in them—a phenomenon known as phantom limb syndrome. The toes act as the transmitter to the brain.

“When he loses his toes, he has lost the transmitter, but the brain cells, which used to identify that feeling, have not died,” Muhtaseb says. The same is true with tinnitus, he says. The brain cells remember sounds, but the nerves are damaged, so the patient hears them as ringing or buzzing. “Now these sounds become strange to the patient,” he says.

The music fan’s hearing will likely return to normal a few hours after the concert. But sustained exposure to loud sounds—such as loud music, factory sounds, or combat noise—may cause lasting tinnitus.

Such was the case for Charles Williams who fired 106 rifles as a trainee in the Marine Corps Reserve in the late 60's.

“It was the loudest thing I ever heard in my life, and my ears were left ringing,” he says, describing the rifle’s retort. In his later career with the Occupational Health and Safety Administration (OSHA), he learned how noise affected hearing and how to protect workers from excess noise exposure. Based on his experience, and an assessment at the UTHealth Audiology Clinic, Williams now believes his exposure to loud noises during his military service is the likely cause of his tinnitus—a “high-frequency ringing sound” that bothers him when his surroundings are quiet.

“Right now, if I don’t use the [drone of] TV at night, the ringing is sometimes so loud it keeps me from going to sleep,” Williams says.

Distracting the brain

Giving the brain something else to do helps distract it from tinnitus. For patients with milder forms of tinnitus, white noise in the background helps.

“I advise some patients, if they have a fan in the room, just to turn it on low and it will produce a humming sound to mask over the tinnitus, especially when they go to bed.” Muhtaseb says, adding he also advises his patients to buy or download albums with nature sounds or classical music to play when they have episodes of tinnitus. The peaceful sounds help mask the noise. Muhtaseb also prescribes an-iPod-like device designed specifically to mask the sounds of tinnitus, called Neuromonics. The FDA-approved device plays music embedded with tinnitus sounds, programmed to match the frequency, volume and intensity of the tinnitus sounds that are bothering them. Treatment lasts six months on average.

Patients listen to the music every day for a prescribed number of hours—while jogging, doing housework or working. The idea behind Neuromonics, is that by listening to the music masking the tinnitus sounds, the person with tinnitus becomes used to that sound, and doesn’t pay attention to it anymore. The device works on scientific data that brain cells learn to adjust to the sounds of tinnitus. We unconsciously ignore the sounds in our environment all the time, Muhtaseb says.

“If I ask you right now to direct your attention to the sound of the air conditioner, you will hear it,” he says. “But before I mentioned it, you probably never even noticed it.”

Hearing aids help

Hearing aids designed for people with high-frequency hearing loss—called open ear canal hearing aids—also help eliminate tinnitus. Muhtaseb likes this treatment method because it improves his patients’ communication and understanding and, “when they are wearing their hearing aid, they don’t hear their tinnitus, and they hear more sounds from outside, so their brain cells are more occupied by the sounds they did not hear before.”

Seemingly gone, but not forgotten

All treatments for tinnitus mask the condition, but the tinnitus doesn’t go away.

“It may come back, because tinnitus is like a headache,” Muhtaseb says. “Sometimes under stressful circumstances, your headache may come back. The same happens with tinnitus. Under certain circumstances, it may come back, under stress or sudden exposure to loud noises.”

In Williams’ case, the former soldier, businessman and current grandfather, hopes new treatments for tinnitus might grant him some peace in his retirement. Based on recommendations from his assessment at the UT Audiology Clinic, he is getting a hearing aid to mask the high-frequency ringing he hears, and to improve his hearing.

For many of the years he suffered with tinnitus, “I was not aware of any treatment for it,” Williams says. “I had been hoping that they would be coming up with some remedy, but it was just a long shot frankly. I am hopeful that it (the hearing aid) will improve my quality of life and makes things better for me.”

If you would like to make an appointment with the UTHealth Audiology Clinic please visit the patient information site or call 713-486-5000.

For all other health matters regarding the ear, nose or throat and head and neck surgery, please visit the patient site for the Department of Otorhinolarngology and Head&Neck Surgery.

 

 

Last Updated: 10-05-2011

 

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