John, a patient of mine, came into my office this summer for an audiological evaluation. His main complaint was a loud ringing noise in his ears. This is called tinnitus. He claimed that this “high pitched constant noise was so loud anyone ought to be able to lean over, put their ear next to his and hear it too”. The tinnitus was affecting his work during the day because he worked in a fairly quiet office and was making it very difficult to fall and stay asleep. John told us that he was irritable, short tempered, and just plain ol’ cranky most of the time, because he could not escape from the noise that he had come to focus on constantly.

Tinnitus is a phantom head or ear noise that the person perceives with no outside sound source present. Tinnitus can be in one ear or both. It can be present all of the time or come and go. It can change pitch and loudness. Tinnitus can be very low in volume and difficult to hear unless the environment is quiet and the person stops to “listen for it”. However, others report their tinnitus is extremely loud, making it difficult to hear conversations, television, movies, or even their own thoughts. Some describe the sound as ringing, hissing, buzzing, chirping, frying, cricket/cicada/mosquito insect noises, pulsing, whooshing, and some even hear music. (hopefully a type of music they like!) Tinnitus can begin after noise exposure, head or neck trauma from a car accident/sports injury, ear infection, sinus problems, after taking medications that are toxic to the ear/hearing, certain types of auditory, nerve or facial tumors, jaw misalignments, and even smoking. Sometimes its difficult to remember that anything we put into our body gets into the blood stream and goes through our ear system. Many diseases such as heart disease and diabetes can be associated with tinnitus.

As I am always stressing in my audiology practice: Please wear hearing protection! Everyone in my family laughs at me, but I pass out ear plugs, even at church, if the music gets too loud for my comfort. I wear hearing protection when I cut our lawn, use a blower or hammer, or attend a sports function, because even loud clapping hurts my ears. I feel you should wear hearing protection when using a blow dryer. I’m an audiologist, so it’s my job to be extreme when it comes to protecting the delicate hair cells of the inner ear.

John was fit with two CIC hearing aids with very large venting. He had normal hearing from 250-2kHz, dropping to a mild/moderate high frequency hearing loss from 3-8kHz. With this product we were able to give amplification only from 3-8kHz. It has been only 5 weeks, but John reports no tinnitus while wearing his CICs. I have found over the years that approximately 6 out of 10 hearing aid users report complete freedom or reduction in tinnitus while using their hearing aids. With this in mind, I always want to try this option with an open mind and open venting in the hopes that tinnitus sufferers will find some welcome relief with amplification. At night, when the ringing returns from taking out the hearing aids, we suggested that John use a bedside masker (a device that emits ocean waves, rain, thunder, forest, etc. sounds) with a pillow attachment so that his wife is not in the ocean with him all night long. She appreciates the silence and John loves sleeping “on the beach”.

There has been some encouraging preliminary reports from a major hearing aid manufacturer that some of their latest digital hearing aid technology has actually provided some users several days of relief from tinnitus. These are individuals with no significant hearing loss, but they do have constant moderate to severe tinnitus. Apparently the manufacturer is fitting their product in a manner similar to that of a high frequency hearing loss, using CICs with large venting. Their findings are to be compiled and released sometime in the near future. If shown to be valid, this will a huge step forward for tinnitus sufferers.