Tinnitus Slide Show - Clinical Perspective

Research has revealed a lot of new information in the past twenty years.

This slide show gives you an outline of the types of Tinnitus and various treatments that have been studied in clinical research situations.

My experience is not included within the content of the slide show. I share it here to fill in some of the knowledge gaps that I wish I had filled in many years ago.

Maybe you will discover something helpful here too.

Tinnitus

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Is It Tinnitus? Meniere's? Or Imagination?

Even today people often think the ringing in one's ears is "all in your head" or just plain imagination. They are wrong. You must understand that it is real and believe in yourself if you are to learn how to handle life WITH tinnitus or Meniere's Disease.

It is not an easy task. Many ear, nose and throat specialists will still tell you it is just something you have to live with. And with no further ado and no further testing essentially give you the "brush off".

What a wonder it was to find an aging physician who was testing patients to try and assess how bad their tinnitus or Meniere's condition was, rather than just tell them to go cope with it. His office was very low tech, his audiologist had all the high tech equipment. The waiting room was full.

With just a handful of questions this physician had a ready analysis of the severity of the patient's tinnitus - self-reported. With a series of audiology tests that went beyond the average hearing test, he was able to review the charts and identify particular tones that were mimicked or similar to external sounds. Armed with this information he was able to make suggestions for lifestyle and diet changes, some of which are common knowledge now.

What was new for me was his suggestion of trying a masking device that would deliver the tones comparable to the ones inside the patient's head, thus teaching the brain to accommodate for the sound. All of this was self - taught by this little old man in his tiny office with historic equipment which he used daily. No, I shall not reveal his name here.

I share the tale because it is true. There are mavericks out there. This fellow had a particular pre-conception of what would work and he looked for ways to assess patients to determine whether his approach could help them. If yes, he kept them as patients and continued to work with them. If not, he suggested the basic lifestyle changes, offered practical coping strategies and advised them what to do if things got worse.

I have always held him in high regard. Even though he could not help me reduce my tinnitus, he was able to tell me that clearly in that first appointment. I gave him and his audiologist some new ideas that I had about coping strategies and they gave me suggestions for lifestyle and dietary changes that actually did improve my overall health. Isn't that what physicians are supposed to do?

As I left that office on that remarkable day, I looked around at the people who were waiting in simple wooden chairs. I realized that except for one child, I was the youngest person in the room. It made me wonder if it was that odd for people under 60 to have tinnitus. The answer to that is no, it is not that odd.

What IS unusual is having a patient seek help before they reach around 60 years old or so. That is an interesting anectodal observation on my part. I sought help because I knew my tinnitus was serious enough that it was having adverse effects in my work and social life. I believed in my empirical knowledge and ignored the casual "brush off" that I had received from 5 other ENTs before I found this man.

So, do not give up. Listen and trust your personal experience. It is not necessary to be the antagonist with the uneducated physicians who simply tell you to "live with it". Nor is it necessary to be the Victim and stay stuck because no one believes you have anything wrong happening inside your head.

By the way we were able to rule out Meniere's Disease quickly because my occasional bouts of dizziness and vertigo were exactly that. Occasional.

Tinnitus Centers and Clinics

If you have serious tinnitus and it is interfering with your work and life you may find relief from one of several specialized clinics that work with tinnitus all the time.

There are 3 that I know from personal contact and experience.

• The Tinnitus and Hyperacusis Center in Georgia which heralds the now well known Jastreboff method of retraining the leading and at times controversial neurophysiological approach. I described my ear situation in a phone interview with Dr. Pawel Jastreboff a few years ago. While 80% of their clients indicate significant improvement, that is surely affected by the screening process for their treatment. We decided that my tinnitus would not be likely to respond well to their program. I explained that I had been coping independently for decades as my tinnitus worsened. I sought relief not more coping advice, which I could readily give out if anyone ever asked.

• One in Oregon - The Oregon Hearing Research Center has a focus on TRT- Tinnitus Retraining Therapy and management. They specialize in therapies derived from the Jastreboff approach.

• The Shea Clinic in Memphis Tennesee where I finally found relief in 2008. Since 1926 the Shea family and staff have specialized in ear, nose and throat disorders. Often their work was pioneering and inventive and controversial. Since they treat tinnitus to provide relief for the patients rather than focus on research for a cure their entire approach is different.

The Shea Clinic pioneered surgical intervention and inner ear perfusion more than twenty years ago and has had excellent results with thousands of patients using their procedures.
Keep in mind this is the only clinic on this list that does employ surgical methods, that I know of. It will require you to stay overnight nearby and return for follow up care the following day. Unless they have made changes in the process since my visit.

In recent years there has been considerably more research and many more treatment centers for tinnitus and other hearing and balance disorders and conditions.

• One in Denver Colorado that leads the way with the new Neuromonics approach and Lyric hearing devices. Neuromonics in short refers to a treatment that delivers sounds to the patient to match the sounds perceived internally, in effect a highly sophisticated and personalized masking device.

• The Silverstein Institute in Florida with its emphasis on Meniere's Disease has a strong emphasis on research since 1979 and a strong focus on retraining whether via neuromonics or other therapies. Generally treating tinnitus as a symptom and teaching people how to cope with it.

• A few in California which also focus on re-training and habituation. In other words helping the patient get accustomed to the sounds. Often tinnitus is referred to as a symptom rather than a condition.

Each one takes a different approach to evaluating and then treating tinnitus patients. All of them are viable professional centers.

You have heard the saying "different strokes for different folks"
and here that is most certainly true.