Being a doctor for Hearing and Balance, one of the most common complaints that I see in my practice is that of buzzing in the ears, known in medical lingo as tinnitus. Of course, what we English speaking doctors call Medical Lingo is chiefly words originating from Latin. In this case Tinnitus takes origin from the latin word Tinnire, which translates to "Tinkle or Ringing".
Our body is used to all sorts of sound, from those noisy tube-light chokes to background buzzing of refrigerators, motor sounds from pumps, jet engines flying over head and sundry. Almost everybody adapts to those sounds. Why then, do the same individuals present as patients when they hear an internal ringing or buzz in their ears, even if the volume is significantly lower than outside ambient noise?
To answer this, a lot of research has been undertaken into the field, and the answers that we now have are astonishing.
Fact #1 : There is little correlation between the loudness of tinnitus sound and its effects.
Patients with softer tinnitus can be greatly disturbed by it and people with really loud tinnitus can sometimes not be bothered about it at all. Researchers didn't expect to find this info. In the past, the sole criteria of documenting severity of tinnitus used to be a loudness match (try to figure out how loud a patient hears his tinnitus), but since loudness did not always mean severity, this attempt therefore does not give as much clinical information to the doctor as he/she had expected it to.
Fact #2 : The Symptoms Tinnitus causes aren't truly auditory
Tinnitus does not cause decline in hearing. A patient who has tinnitus isn't more likely to develop a hearing problem than somebody without tinnitus and in fact, most often than not, tinnitus is not a marker for a disease.
Fact #3 : The Limbic System has more to do with Tinnitus than the Auditory Cortex
I like using latin words. I am sorry. Part of the medical training. Anyway, this is the most exciting point about tinnitus, and the most important one when we plan treatment.
Here's the backstory for Fact #3 : Long time ago, evolution was shaping the mind to be what it is today. The common point in many higher life forms (us included) is the Limbic System, or the emotional system. All senses that we have (eyes, ears, touch, etc) have connections to the Emotional System and the Rational System. We evolved to take all decisions based on emotions, and use the rational mind only after it has been trained. In a nutshell, often when people can't decide between the heart and the mind, the limbic system is the heart, and the rational brain is the mind.
In the case of tinnitus, at the onset the sufferer is curious. He/she wants to know what this sound is and why are they hearing it. The rational brain tries, but can't explain, because it is unlike anything else that the rational mind has experienced. So there's a blank. The patient then asks the emotional brain, and since the emotional brain is trained to save the animal from predators and risks, it thinks the tinnitus sound to be a threat, a warning or a disease. Once the patient establishes the sound as a threat, it is difficult to let go of that sound, and there are all sorts of negative emotions that cloud the patient's mind, such as anxiety, stress and occasionally depression.
Often this forms a two way reaction, with tinnitus increasing stress, and stress (from office/home/anywhere else) increasing tinnitus.
Treatment:
There are treatments aimed at reducing the sound, and there are treatments aimed at reducing the emotional upsets that tinnitus causes. We have had very little success in the first, but amazingly the second treatment has had as high success rates as 80% in multi-centric trials in India and abroad.
Tinnitus Re-training Therapy is based on the Neuro-physiological Model of tinnitus, the one with the limbic system. The principle is to re-train the brain into taking tinnitus as just another sensation, much like touch. Just as one doesn't feel one's footwear, or the clothes on one's body unless their mind goes to that, the tinnitus sufferer doesn't feel the tinnitus unless they want to. This is possible when the patient stops taking tinnitus as a threat and takes it only as another sensation. To help in this, a specific treatment plan is followed which uses counselling, sound therapy and brain pasticity to make the tinnitus sufferer let go of their tinnitus.
For more information on the program and how it can help somebody you know, write an email to me at contact@primehearing.com
Our body is used to all sorts of sound, from those noisy tube-light chokes to background buzzing of refrigerators, motor sounds from pumps, jet engines flying over head and sundry. Almost everybody adapts to those sounds. Why then, do the same individuals present as patients when they hear an internal ringing or buzz in their ears, even if the volume is significantly lower than outside ambient noise?
To answer this, a lot of research has been undertaken into the field, and the answers that we now have are astonishing.
Fact #1 : There is little correlation between the loudness of tinnitus sound and its effects.
Patients with softer tinnitus can be greatly disturbed by it and people with really loud tinnitus can sometimes not be bothered about it at all. Researchers didn't expect to find this info. In the past, the sole criteria of documenting severity of tinnitus used to be a loudness match (try to figure out how loud a patient hears his tinnitus), but since loudness did not always mean severity, this attempt therefore does not give as much clinical information to the doctor as he/she had expected it to.
Fact #2 : The Symptoms Tinnitus causes aren't truly auditory
Tinnitus does not cause decline in hearing. A patient who has tinnitus isn't more likely to develop a hearing problem than somebody without tinnitus and in fact, most often than not, tinnitus is not a marker for a disease.
Fact #3 : The Limbic System has more to do with Tinnitus than the Auditory Cortex
I like using latin words. I am sorry. Part of the medical training. Anyway, this is the most exciting point about tinnitus, and the most important one when we plan treatment.
Here's the backstory for Fact #3 : Long time ago, evolution was shaping the mind to be what it is today. The common point in many higher life forms (us included) is the Limbic System, or the emotional system. All senses that we have (eyes, ears, touch, etc) have connections to the Emotional System and the Rational System. We evolved to take all decisions based on emotions, and use the rational mind only after it has been trained. In a nutshell, often when people can't decide between the heart and the mind, the limbic system is the heart, and the rational brain is the mind.
In the case of tinnitus, at the onset the sufferer is curious. He/she wants to know what this sound is and why are they hearing it. The rational brain tries, but can't explain, because it is unlike anything else that the rational mind has experienced. So there's a blank. The patient then asks the emotional brain, and since the emotional brain is trained to save the animal from predators and risks, it thinks the tinnitus sound to be a threat, a warning or a disease. Once the patient establishes the sound as a threat, it is difficult to let go of that sound, and there are all sorts of negative emotions that cloud the patient's mind, such as anxiety, stress and occasionally depression.
Often this forms a two way reaction, with tinnitus increasing stress, and stress (from office/home/anywhere else) increasing tinnitus.
Source: wikimedia commons : Blausen.com staff.
Treatment:
There are treatments aimed at reducing the sound, and there are treatments aimed at reducing the emotional upsets that tinnitus causes. We have had very little success in the first, but amazingly the second treatment has had as high success rates as 80% in multi-centric trials in India and abroad.
Tinnitus Re-training Therapy is based on the Neuro-physiological Model of tinnitus, the one with the limbic system. The principle is to re-train the brain into taking tinnitus as just another sensation, much like touch. Just as one doesn't feel one's footwear, or the clothes on one's body unless their mind goes to that, the tinnitus sufferer doesn't feel the tinnitus unless they want to. This is possible when the patient stops taking tinnitus as a threat and takes it only as another sensation. To help in this, a specific treatment plan is followed which uses counselling, sound therapy and brain pasticity to make the tinnitus sufferer let go of their tinnitus.
For more information on the program and how it can help somebody you know, write an email to me at contact@primehearing.com
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