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All About Tinnitus
with patient testimonials
Tinnitus (ringing in the ears) is a common problem for AN patients. It can cause significant suffering in some cases:
For me the worst, the very worst, long term aspect of AN has been my tinnitus. On rare occasion it had soared up to the volume of a vacuum cleaner or leaf blower. In other periods it fluctuated with head movement. Thank goodness it has stabilized for many months now. It is about the loudness of a tea kettle in the next room, but the pitch and volume are constant, and I have learned to tune it out most of the time. I was not able to tune it out when the noise fluctuated. It may not sound like much, but I have heard of people considering suicide over tinnitus... All I can say for me is that once in a while I dream a beautiful dream that I am in a still, deep forest, and it is silent. Just silent. I wake up from those dreams with a deep and persistent sense of longing.
Tinnitus may get better after AN treatment...
I had the experience that continuous tinnitus led to my diagnosis with an AN. Since my surgery, the tinnitus has disappeared. This was not an expected result of the surgery, but I certainly am happy about it!
Or it may get worse
After my surgery the tinnitus in the deaf ear got worse. It is not unusual for someone who suddenly loses the hearing in an ear to have tinnitus dramatically increase.
FSR was what I chose... I had 28 treatments. Each session had four arcs. Total administered radiation was 50.4 GY. My hearing comprehension has greatly improved, BUT I have ringing in my ear since the 26th treatment which is very loud. It sounds like crickets made up of two different tones and is as loud as the noise inside a car driving down the highway with the windows opened doing about 60 mph... It really doesn't bother me too much, I just tend to ignore it and along with it I seem to ignore folks talking to me as well. Once my attention is gotten, I have no problem hearing and paying attention.
The frustration of tinnitus can induce emotional problems
My tinnitus is what I would consider mild, but it annoys the heck out of me. I really have a hard time when other repetitive noises are occuring or if my kids and their friends are being loud. Which seems funny to me, because of being deaf in one ear. You would think I could tolerate more noise. I have heard a lot of people say that they get used to the tinnitus. I'm beginning to wonder how long it is going to take. It doesn't seem to be getting any easier.
Your "good" ear may be affected, too
I have chronic tinnitus as a result of AN. At one point, I heard the tinnitus from both ears and had the fear that I might have developed a tumor on the other side, too. This prompted me to get an MRI, which showed the non-AN side clear of any tumors. Audiology confirmed normal hearing in the non-AN ear. In discussing this with my neurotologist and audiologist, I was informed that tinnitus can work that way -- your brain can "assign" the location of the tinnitus to the other ear on occasion, with the result that the tinnitus sounds like it is coming from there.
Many things can aggravate it
All NSAIDs (Non-Steroidal Anti-Inflammatory Drugs, of which aspirin and ibuprofen are examples) seem to have tinnitus as a side effect that is generally dose-dependant (meaning the more of it you take the greater the effect). In controlled clinical studies with ibuprofen (Motrin), between 1% and 3% of patients reported tinnitus, according to information provided by McNeil Consumer Products, who makes the stuff. For perspective, between 3 and 9% reported dizziness, nausea, and a rash, and 4-16% reported some sort of gastro-intestinal disturbance (which is about half of what an equivalent dose of aspirin seems to cause.)
When I take aspirin, my ears ring consistently after about the 3rd dose, or so. Ibuprofen doesn't seem to affect me nearly as much. The problem always goes away when I quit taking the medication. The ringing is in both of my ears, so I doubt there is any relationship to my AN.
I have recently started taking Celebrex for tendonitis so I believe this may be the reason for my increased tinnitus. I guess I need to decide whether the tendonitis is worse than the tinnitus.
Caffeine can aggravate it, too:
I called my friend that is a Beltone hearing aid specialist and he said that caffeine usually will cause the tinnitus to increase.
So can a cold:
I have mild tinnitus, and have noticed that when I get a stuffy head as from a cold, it seems much worse. At those times my balance is also worse. The tinnitus also varies up and down for reasons I can not attitubte to any known factor.
Diet and tiredness are also a factor:
I think the tinnitus was aggravated by foods containing salt and/or monosodium glutamate, and maybe chocolate. I also found it helpful to avoid getting too tired -- the tinnitus bothered me more and I was less able to cope with it when I was tired.
Noise can make it flare up; ear plugs can be very helpful
When booking your flight, ask the person to seat you away from the engines on all legs of your journel, and/or bring ear plugs. Loud noises can exacerbate tinnitus, and I have found that the drone of the plane's jet engines leaves my AN ear roaring.
In my case, using earplugs definitely helps prevent the tinnitus from flaring up as a result of being in a loud environment. I always use earplugs for loud-noise chores like lawn mowing, wet-vac jobs, etc. In addition, when I'm riding my motorcycle (motor scooter, actually), I use plugs if the duration of the ride will be longer than, say, half an hour; below that, the helmet provides enough ear protection that my tinnitus doesn't flare significantly.
It's acually the good ear that needs the plugs more, even though the tinnitus is in the bad ear:
When I am in a known noisy place, such as a sports arena, I always use an ear plug in my good ear. This helps cut down the tinnitus effect in my deaf ear quite a lot. I also try and use an ear plug when I blow dry my hair --. the hair dryer is a real tinnitus maker -- and I always use an ear plug when I mow the lawn or do yard work that I know will be noisy.
Masking device may be the answer
William Shatner is one of tinnitus sufferers; he got tinnitus from an explosion on a Star Trek movie and was very bothered from it. He was treated at the University of Maryland Tinnitus & Hyperacusis Center by Dr. Pawel Jastreboff and was very happy with the results. His treatment consisted of wearing a device in his ear that generated "white noise" to mask the sound of the tinnitus. More extensive information can be found using the first couple of links in our index below. The phone number for the Center is (410) 328-1279 or (800) 492-5538 (outside Maryland); the contact email address is tinnitus@smail.umaryland.edu.
Dr. Pawel J. Jastreboff, the doctor who treated Mr. Shatner, is now Director of the Emory Tinnitus & Hyperacusis Center in Atlanta, Georgia. There is also a Tinnitus and Hyperacusis Centre in London UK, headed by Jonathan Hazell FRCS, who works in collaboration with Professor Jastreboff.
At night, a fan or an air filter will do
Some simple commonplace devices, such as room fans or air filters, can also be used to generate the "white noise" that masks tinnitus. It is better to use something that has a constant sound, with no information content, rather than a radio on low or one of those "relaxation" tapes or CDs. The idea is to have some sound going on that has minimal information content so you can hear it but not be stimulated by it:
When my tinnitus kept me awake at night, my audiologist recommended an air filter. I plugged it into an outlet in my bedroom, and it worked well for me. However, I found that there was a fine line between loud enough to mask the tinnitus and so loud it annoyed me. You can also tune a radio to a place between stations so you get static.
I've had tinnitus for years and years. I use a sound machine that has a rain sound on it. Works great. The key is picking a sound that works for you. Radio white noise doesn't work for me because it bothers me; waves bother me too. Actually, I like the sound of a Hankscraft humidifier vaporizer for the best tinnitus masking, but vaporizors don't work in my high humidity city.
The single thing that helped the most, at least in terms of being able to sleep decently, was to run a fan in my bedroom as a masker. I sleep with a box fan going in my room every night. The low hum drowns out my tinnitis... Now I find, I'm so used to the humming from the fan, I can't sleep without it.
Magnetic fields look promising
Transcranial magnetic stimulation (TMS) may eventually be a useful therapy for AN patients with tinnitus.
A new study of people who had been troubled with tinnitus for years was presented in September 2003 at the annual meeting of the American Academy of Otolaryngology Head and Neck Surgery in Orlando. Researchers from the University of Regensburg in Germany used TMS to reduce tinnitus in more than half of the participants. Although the reduction was slight, it was enough to improve their quality of life. Six months later, the improvement had not diminished.
TMS involves placing a magnetic coil just above the person's head in a position that corresponds with the area of hyperactivity. In the new study, the area of brain hyperactivity for tinnitus sufferers was precisely pinpointed using sophisticated brain scans. Before the therapy, all of the participants had a sham five-day treatment. They were not aware that no actual magnetic field was being created, and none responded to the fake treatment. Then they underwent the half-hour magnetic procedure every day for five days, with seven of the participants reporting a reduction in the rushing, or ringing, sound they heard. "They were able to sleep and concentrate much better than before the treatment," says study co-author Dr. Tobias Kleinjung.
Herbal remedies can also help
I had AN microsurgery in July 1997 and have been battling terrible problems with tinnitus. In addition to the ringing, I get wooshing sounds, too. Stress and sleep deprivation seem to make the problem worse. Seems to me that nobody has clear answers to this bothersome problem (which you probably know already). I have been taking Ginko Biloba coupled with Gingerroot and Siberian Ginseng. Believe it or not, it has worked wonders. My tinnitus has not disappeared, but it's now possible for me to clearly hear the television or someone speaking to me without that annoying sound drowning everything out.
Research on Gaze Evoked Tinnitus
Gaze evoked tinnitus superimposes a 'pitch' or 'tone' kind of tinnitus on top of the background noise static type tinnitus.
Mine evolved into what is termed "gaze evoked tinnitus." In addition to the regular background noise tinnitus -- which is worse in my deaf ear -- I also perceive varying 'tones' when my eyes move.
I have a very high pitch whistle on the treated side. Evidently some of us are able to control the volume by moving the jaw or eyes. Dr. Richard Salvi at the U. of Buffalo is doing research, using PET scans to identify what part of the brain is activated when the noise is loudest and when it is less intense. With his colleague Dr. Lockwood, they have done tremendous, ground-breaking research in this area. Their preliminary study was published in Neurology, Jan 1998; volume 50 no. 1, pages 114-20.
Treatment for tinnitus has been difficult due to lack of knowledge on its etiology. Researchers discovered an atypical link existing between the patients' auditory and limbic systems which can also be related to emotional impairment. They discovered that the hippocampus was activated in tinnitus patients but not in control subjects and that the pathological condition was the auditory counterpart of the phantom limb pain.
Science News (Vol 153, No. 4, January 24, 1998, page 53), contains a really nice summary of Dr. Salvi's test and the findings. Your local library most likely carries Science News. It is written for broad spectrums of people to read. Highlights are these:
PET scans showed...changed blood flow, an indicator of neural activity, to certain regions of the brain -- mainly an area of the temporal lobe associated with hearing. In three of the patients, who had tinnitus only in the right ear, blood flow changes showed up on the left side of the brain. Blood flow also increased somewhat in the hippocampus, a part of the brain that controls emotions... The findings suggest that sound, even in one ear, is processed on both sides of the brain, whereas the tinnitus arose on one side only. The result indicates that "this form of tinnitus is not cochlear" because a disturbance arising in the ear would register on both sides of the brain... Just as some amputees feel pain in a limb they no longer have, people with tinnitus experience sounds they don't actually hear. "We think that tinnitus may be a sort of sensory analog to phantom limb pain," Lockwood says. Although the brain appears to be largely " hard-wired" for sensory input, it "is capable of undergoing some fairly substantial reorganization, especially in altered sensory perception." The researchers also consider activation of the hippocampus unusual. In the control group [no tinnitus] PET scans showed no hippocampal activation.
American Tinnitus Association (ATA)
a non-profit organization dedicated to supporting research and educational activities
relating to the treatment and cure of tinnitus. They have many suggestions for dealing
with the noise.
CCCD
Tinnitus FAQ Homepage
Maintained by the Coast Community College District in Costa Mesa, California, USA, this
website is provided by the CCCD as a resource for understanding tinnitus.
Tinnitus Online Community
An Internet website supporting a "small but terrific" online community of people
with tinnitus, communicating through newsgroups, chats and e-mail.
Tinnitus
entry in the Healthopedia
Includes information on symptoms, tests, treatments, etc.
A book about Tinnitus
A book entitled Tinnitus: Treatment and Relief by Jack A. Vernon of Oregon Health
Sciences University is widely available in libraries, bookstores, and on the internet
(such as Amazon); it is under $21 for the hardcover edition. The author maintains
that tinnitus can be treated and he writes about the most frequently used procedures for
the relief of tinnitus. Here is a patient review:
The variety of topics covered--medication, depression, masking, habituation, ginkgo, etc.-- indicates that Dr. Vernon wanted this book to be a comprehensive guide to treatment... As a tinnitus sufferer myself, this book was a indispensable tool in trying to understand what I was up against.
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