TINNITUS
Speaker: Amit Gosalia, AuD
President of Audiology Practice Standards Organization

 
 
 
 

CME MEETING WEDNESDAY, MAY 1, 2019
Spice Affair, Beverly Hills

 

Topic: TINNITUS

Speaker: Amit Gosalia, AuD

President of Audiology Practice Standards Organization

 

ANATOMY OF THE EAR

Whereas the Pinna of the ear collects and funnels sound waves towards the ear canal, it is the collective effort of the tympanic membrane and the middle ear bones that transmit the auditory signal to the cochlea, where the vibrating cilia orchestrate sound through the 8th cranial nerve  and the auditory cortex of the brain.

 

DEFINITION

The perception of hearing a noise, usually ringing or buzzing, without a viable source of the noise, is known as tinnitus.

 

EPIDEMIOLOGY

In the US, there are about 50-55 million people having some degree of tinnitus.

10 million are serious. 2 million have debilitating tinnitus. 40 million do not seek any help.  it is more prevalent in males who historically work in noisy environments.

There is a correlation between hearing loss and tinnitus in direct proportion. 

One of the reasons for patients not seeking advice is owing to poor medical advice from physicians who discourage the patients by stating that there is no treatment for the condition.

 

EFFECTS

In severe cases there is extreme disturbance with lack of sleep and lack of concentration.

It is caused by multiple factors including including trauma and chemotherapy, particularly the cis platinum compounds. It also accompanies vertigo and Meniere’s disease. It becomes louder when one is stressed and fatigued. 

 

80% of tinnitus is amplified in a quiet environment.

 

MANAGEMENT

There is no definitive cure for tinnitus, but a patient can be managed to reduce the deleterious effects of the malady. 

 

Medication to correct depression, anxiety and insomnia helps. 

Since hearing loss amplifies tinnitus, it os imperative to correct hearing deficiencies with appropriate hearing devices. 

 

Trial and error has led to the production of soft white noise, that drowns any sound perception of tinnitus. 

 

There are essentially no medications to correct the condition.  However, there are anecdotal effects of medications on the market. The Lipo-flavinoids are touted as a treatment but no research backs this. The homeopathic product Quietus has no proven effect. 

 

90% of tinnitus cases have hearing loss. Using the proper hearing devices after careful evaluation, impacts tinnitus as well.

 

Retraining a person to accept the back ground noise helps when abetted by reducing stress, ands alteration of ones life style.  

COURSE OF ACTION

Noise is defined as an increased neural activity. The correction of neural activation and training the brain to focus on real, meaningful noise  helps in deciphering sound with a source rather than focus on tinnitus sound perception.

 

Back-ground noises like chirping (white noise) or hissing (Purple noise) relegate the annoying sounds to the background. There is resultant improvement in communication, and the brain’s disregard for the unwanted noise.

 

CONCLUSION

 

Seeking the help of an audiologist, and correcting hearing loss are helpful tools. Encouragement to a patient halves the perception of a problem. The emphasis that tinnitus is a symptom makes it more likely to be managed.

 

PARVIN D. SYAL MD