Tinnitus is not a psychiatric phenomenon. It is difficult to develop meaningful statistics on the incidence of tinnitus because there has been difficulty arriving at a uniformly accepted precise definition of this phenomenon. If a random sample of the general popualtion is asked whether or not they experience or have experienced "ringing in the ears", approximately 20% will answer affirmatively. Twenty percent of this group finds that the ringing is intrusive. That is ten million people in the United States. One quarter of these, approximately two and half million Americans are disabled from their tinnitus. According to a Heller and Bergman study (1953), if a group of individuals with normal hearing and no history of "ringing in the ears" is placed (one-by-one) in a soundproofed room , more than 90% will report hearing tinnitus within five minutes. It appears that there are two reasons why this group does not complain of tinnitus under normal circumstances. First, typical ambient (environmental) sounds tend to block the perception of tinnitus. Second, if an individual who does not normally hear "ringing in the ears" becomes aware of these sounds, it is likely that the sounds will rapidly disappear because they are not associated with an emotional response. This phenomenon forms part of the basis for "Tinnitus Retraining Therapy," which is a very popular tinnitus treatment method. Treatment Options: Our goal at The Hearing Doctor, Inc is for tinnitus to no longer be an issue in the lives of people with this potentially disabling condition. This goal does not mean that the patient has to "learn to live with tinnitus" or "cope with tinnitus," Learning to live with tinnitus means that the tinnitus sufferer continues to be aware of this annoying stimulus, but deals with it so that he or she can move on with life. Rather, we wish to make tinnitus "like a pair of pants," an entity about which our patients are completely unaware most of the day and even when they are aware of it, it does not bother them. Dr. Marghzar at "The Hearing Doctor" selects an appropriate protocol, based on each individual's neurophysiological, and audiological findings, shown to be effective in over 80% of his patients. Treatment protocols are selected from the following treatment options: Tinnitus Retraining Therapy (Auditory Habituation) - employs the use of broad band "white noise" generators that produce a soft external sound that does not mask the tinnitus while emphasizing an intense informational program ("directive counseling") to neutralize subconsciously negative responses associated with tinnitus. This is the primary mode of treatment used by Dr. Marghzar based on the Jastreboff model of tinnitus. Masking - covers the tinnitus signal with a more acceptable external sound. This method is used for patients with minimal success to TRT (for initial stages of treatment for severe tinnitus) or for patients with previous success with masking. Neuromonics- This is a new technique developed in Australia that uses both counseling and music to reduce the annoyance and perception of tinnitus. It uses a Walkman-like device that patients wear for one hour per day. Some studies show that Neuromonics treatment can significantly help patients in 6 months. The special device was approved by FDA in June of 2005. Cognitive therapy - The way one thinks about his/her tinnitus determines how he/she feels about it. When we modify the response by changing the distorted thought processes commonly associated with tinnitus, patient's emotions toward tinnitus change. This in turn makes the patient notice the annoyance of the tinnitus less than before. Meditation and Relaxation - used to distract the patient from constant monitoring of the tinnitus. This treatment is employed for the type of tinnitus that fluctuates. Distraction and desensitization Exercises - Used to break the vicious cycle of tinnitus and In case of hyperacusis to enhance loudness tolerance.
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