Many people with tinnitus find lack of sleep to be their greatest problem. Most people do not know that our quality and pattern of sleep naturally change as we get older. When we are young we may need anything between seven and nine hours of sleep per night, but as we get older we may feel refreshed after only five or six. Also older people do not typically sleep as deeply as younger adults.
If we wake up very frequently during the night, we may be under the impression that we have not slept at all. However true insomnia is very rare and most people find they have slept more than they thought. However many people do experience periods where they have difficulty getting to sleep and this may cause or make anxiety worse.
Approximately 50% of people with tinnitus report difficulty in sleeping, because they find their tinnitus keeps them awake. People are also sometimes under the false impression that their tinnitus wakes them up during the night. What's more likely is that someone thinks their tinnitus has woken them because they hear it as soon as they wake up. Anyone worrying about their tinnitus during these awakenings will also stay awake longer.
Sound therapy is one way of dealing with this problem. By introducing a low level of sound into the bedroom (such as white noise, the sound of the radio tuned in between stations) you provide an additional sound for your brain to listen to.
The following tips may also be used to encourage natural sleep:
Try relaxation exercises. Classes and tapes are widely available.
Go to bed when you feel sleepy, not just because it is a certain time.
Get up at the same time every day.
Try to limit the amount of caffeine (found in tea, coffee, cola and chocolate) and nicotine you take late at night as these are stimulants.
Keep your room at a temperature that is neither too cold nor too hot.
Don’t read or watch television in bed before trying to go to sleep, these will only make you feel more alert.
'Wind down' for at least an hour before bedtime – have a warm bath (not too hot), milky drink or listen to some relaxing music.
Friday, March 30, 2007
Thursday, March 29, 2007
Supplements may help hearing loss
A U.S. study says a combination of anti-oxidants and minerals may help prevent hearing loss.
Researchers at the University of Michigan found that guinea pigs who were given an anti-oxidant-mineral combination were protected from hearing damage for days after exposure to loud noise, the university said in a release.
The report says the findings could lead to the development of a nutrition bar that would protect soldiers from battle-related hearing loss.
Guinea pigs were given high doses of vitamins A, C, and E and magnesium one hour before noise exposure and continued as a once-daily treatment for five days.
Josef M. Miller, a professor in the Department of Otolaryngology at the UM Medical School is the senior author of the study, published online in the journal Free Radical Biology and Medicine. He has launched a startup company, OtoMedicine, that is developing the vitamin-and-magnesium formulation.
"Ultimately, we envision soldiers would have a nutritional bar with meals and it would give them adequate daily protection," said Miller.
Researchers at the University of Michigan found that guinea pigs who were given an anti-oxidant-mineral combination were protected from hearing damage for days after exposure to loud noise, the university said in a release.
The report says the findings could lead to the development of a nutrition bar that would protect soldiers from battle-related hearing loss.
Guinea pigs were given high doses of vitamins A, C, and E and magnesium one hour before noise exposure and continued as a once-daily treatment for five days.
Josef M. Miller, a professor in the Department of Otolaryngology at the UM Medical School is the senior author of the study, published online in the journal Free Radical Biology and Medicine. He has launched a startup company, OtoMedicine, that is developing the vitamin-and-magnesium formulation.
"Ultimately, we envision soldiers would have a nutritional bar with meals and it would give them adequate daily protection," said Miller.
Tuesday, March 27, 2007
Treatments for Tinnitus
Biofeedback
Useful as a stress reduction tool, biofeedback may help some people.
Accupuncture
May provide temporary relief to some people. One contributor reports significant relief that enabled him to avoid the heavy-duty anti-depressants that his Western physician had prescribed.
Stress Reduction
Many people say their tinnitus is more active when they're tired and stressed out. Get a good night's sleep and avoid unnecessary stress.
Hearing Aids
Some people with severe tinnitus may benefit from hearing aids that bring normal speech sounds above the background tinnitus sounds. In addition to amplification, hearing aids may be useful as maskers when they also introduce white noise into the sound stream.
Cranial Sacral Therapy
There is anecdotal evidence of help for tinnitus through cranial sacral therapy by osteopaths and chiropractors.
Electrical Stimulation
Various electrode placements with various vol frequencies may provide some relief. External, ear canal, transtympanic, middle ear, and cochlear electrodes have all been tried. Side effects may include pain, and alterations to sense of ssmell. In one study of electrical stimulation on the round window, 3 out of 5 patients experienced some relief when frequencies of 40 Hz or less were applied.
Surgically Severing the Auditory Nerves
An Eighth Nerve section is the treatment of last resort. You will be totally deaf. But beware - if your tinnitus originates somewhere inside the brain, you will be totally deaf AND still have tinnitus. A prominent American tinnitus specialist says this surgery should never be done for tinnitus, since he knows of patients whose tinnitus INCREASED to suicidal levels afterward.
Hyperbaric Oxygen Therapy
This treatment is supposed to be beneficial when the tinnitus is thought to be due to a lack of oxygen for the hearing mechanism. It may be more effective for recent onset cases rather than long-term ones.
Useful as a stress reduction tool, biofeedback may help some people.
Accupuncture
May provide temporary relief to some people. One contributor reports significant relief that enabled him to avoid the heavy-duty anti-depressants that his Western physician had prescribed.
Stress Reduction
Many people say their tinnitus is more active when they're tired and stressed out. Get a good night's sleep and avoid unnecessary stress.
Hearing Aids
Some people with severe tinnitus may benefit from hearing aids that bring normal speech sounds above the background tinnitus sounds. In addition to amplification, hearing aids may be useful as maskers when they also introduce white noise into the sound stream.
Cranial Sacral Therapy
There is anecdotal evidence of help for tinnitus through cranial sacral therapy by osteopaths and chiropractors.
Electrical Stimulation
Various electrode placements with various vol frequencies may provide some relief. External, ear canal, transtympanic, middle ear, and cochlear electrodes have all been tried. Side effects may include pain, and alterations to sense of ssmell. In one study of electrical stimulation on the round window, 3 out of 5 patients experienced some relief when frequencies of 40 Hz or less were applied.
Surgically Severing the Auditory Nerves
An Eighth Nerve section is the treatment of last resort. You will be totally deaf. But beware - if your tinnitus originates somewhere inside the brain, you will be totally deaf AND still have tinnitus. A prominent American tinnitus specialist says this surgery should never be done for tinnitus, since he knows of patients whose tinnitus INCREASED to suicidal levels afterward.
Hyperbaric Oxygen Therapy
This treatment is supposed to be beneficial when the tinnitus is thought to be due to a lack of oxygen for the hearing mechanism. It may be more effective for recent onset cases rather than long-term ones.
Monday, March 26, 2007
Protect your hearing!
Short-term exposure to loud noises, such as explosions, fireworks, or jet engines can cause hearing loss. But so can longer-term exposure to noises that aren't so loud. Even listening to your MP3 player too loud or too long can damage your hearing.
The loudness of a sound is measured in decibels (dB). Sounds that are louder than 85 dB can cause hearing loss. The higher the decibels, the shorter the amount of time you can be exposed to the sound before hearing loss occurs. For example, 8 hours at 85 dB causes as much damage as 4 hours at 88 dB, 2 hours at 91 dB, or just 15 minutes at 100 dB. The Canadian Centre for Occupational Health and Safety recommends ear protection for people exposed to sounds of 85 dB or higher. Otherwise, you risk permanent hearing loss.
Some of your daily activities may be noisier than you think! Here are the decibel ratings of some common sounds:
firecracker: 150 dB
ambulance siren or airplane taking off: 120 dB
nightclub: 120 dB
movie theatre: up to 117 dB
rock concert: 110-125 dB
listening to music with headphones: 105-120 dB if the volume is cranked up to the maximum setting (earbuds, such as those found with popular music-listening devices like MP3 and CD players, can add 6-9 dB to the volume)
motorcycle: 95 dB
noisy restaurant or heavy traffic in the city: 85 dB
riding in a car: 70 dB
normal conversation: 60 dB
fridge humming: 40 dB
whispering: 30 dB
Here's how to protect yourself from noise-related hearing loss:
Wear ear protection (ear plugs or ear muffs) if you'll be exposed to sounds over 85 dB. Generally, a sound is too loud if you can't hear a person talking 1 metre (3 feet) away.
If your workplace is noisy, wear the recommended ear protection all the time! If you have questions about ear protection on the job, contact the Canadian Centre for Occupational Health and Safety.
Follow the 60-60 rule for your personal music device (such as your MP3 or CD player): listen at 60% of the maximum volume for up to 60 minutes per day. Any more than this can lead to permanent hearing loss. And be careful you don't turn up the sound too high when you're in noisy surroundings, such as public transit.
Check it out!Some medical conditions, such as ear infections, can lead to hearing loss if not treated. And other causes of hearing loss, such as earwax and damaged eardrums, can be treated to improve hearing. Have regular medical check-ups to find health conditions and nip them in the bud. The Canadian Hearing Society recommends a hearing test every 2 years, or more often if you have concerns about your hearing.
Watch out for the "what"?Keep an ear out for the early signs of hearing loss. Read "Could you be losing your hearing?" to learn what to listen for. If you notice these signs, talk to your doctor or audiologist about having a hearing test. Getting help early can stop some types of hearing loss from getting worse and help you cope with others.
The loudness of a sound is measured in decibels (dB). Sounds that are louder than 85 dB can cause hearing loss. The higher the decibels, the shorter the amount of time you can be exposed to the sound before hearing loss occurs. For example, 8 hours at 85 dB causes as much damage as 4 hours at 88 dB, 2 hours at 91 dB, or just 15 minutes at 100 dB. The Canadian Centre for Occupational Health and Safety recommends ear protection for people exposed to sounds of 85 dB or higher. Otherwise, you risk permanent hearing loss.
Some of your daily activities may be noisier than you think! Here are the decibel ratings of some common sounds:
firecracker: 150 dB
ambulance siren or airplane taking off: 120 dB
nightclub: 120 dB
movie theatre: up to 117 dB
rock concert: 110-125 dB
listening to music with headphones: 105-120 dB if the volume is cranked up to the maximum setting (earbuds, such as those found with popular music-listening devices like MP3 and CD players, can add 6-9 dB to the volume)
motorcycle: 95 dB
noisy restaurant or heavy traffic in the city: 85 dB
riding in a car: 70 dB
normal conversation: 60 dB
fridge humming: 40 dB
whispering: 30 dB
Here's how to protect yourself from noise-related hearing loss:
Wear ear protection (ear plugs or ear muffs) if you'll be exposed to sounds over 85 dB. Generally, a sound is too loud if you can't hear a person talking 1 metre (3 feet) away.
If your workplace is noisy, wear the recommended ear protection all the time! If you have questions about ear protection on the job, contact the Canadian Centre for Occupational Health and Safety.
Follow the 60-60 rule for your personal music device (such as your MP3 or CD player): listen at 60% of the maximum volume for up to 60 minutes per day. Any more than this can lead to permanent hearing loss. And be careful you don't turn up the sound too high when you're in noisy surroundings, such as public transit.
Check it out!Some medical conditions, such as ear infections, can lead to hearing loss if not treated. And other causes of hearing loss, such as earwax and damaged eardrums, can be treated to improve hearing. Have regular medical check-ups to find health conditions and nip them in the bud. The Canadian Hearing Society recommends a hearing test every 2 years, or more often if you have concerns about your hearing.
Watch out for the "what"?Keep an ear out for the early signs of hearing loss. Read "Could you be losing your hearing?" to learn what to listen for. If you notice these signs, talk to your doctor or audiologist about having a hearing test. Getting help early can stop some types of hearing loss from getting worse and help you cope with others.
Saturday, March 24, 2007
Drugs for Tinnitus
Anti-Depressants, Tranquilizers,and Muscle Relaxants
Anti-drepressants are drugs used to prevent or relieve mental depression. Tranquilizers are drugs that promote tranquility by calming, soothing, quieting, or pacifying without drpressant effects. Muscle relaxants are drugs that reduce tension in the muscle.
Many tinnitus sufferers become depressed from having to deal with the constant noise. Treating the depression may make the tinnitus seem less severe. But beware that certain ototoxic anti-depressants may worsen tinnitus. SSRI anti-depressants may temporarily worsen tinnitus for the first few weeks, but risk fewer side-effects as compared to the older tricyclic drugs.
Tricyclic anti-depressants, such as Nortriptyline and benzodiazepines, such as Alprazolam (Xanax) were used in one study in which some people reported improvement.
Possible reasons:
Patients just think they feel better (placebo effect).
Since these drugs are central nervous system depressants, auditory responsiveness diminishes.
Tinnitus is stress-related - i.e. muscle tension in neck & jaw restricts blood and lymph flow.
Anti-drepressants are drugs used to prevent or relieve mental depression. Tranquilizers are drugs that promote tranquility by calming, soothing, quieting, or pacifying without drpressant effects. Muscle relaxants are drugs that reduce tension in the muscle.
Many tinnitus sufferers become depressed from having to deal with the constant noise. Treating the depression may make the tinnitus seem less severe. But beware that certain ototoxic anti-depressants may worsen tinnitus. SSRI anti-depressants may temporarily worsen tinnitus for the first few weeks, but risk fewer side-effects as compared to the older tricyclic drugs.
Tricyclic anti-depressants, such as Nortriptyline and benzodiazepines, such as Alprazolam (Xanax) were used in one study in which some people reported improvement.
Possible reasons:
Patients just think they feel better (placebo effect).
Since these drugs are central nervous system depressants, auditory responsiveness diminishes.
Tinnitus is stress-related - i.e. muscle tension in neck & jaw restricts blood and lymph flow.
Friday, March 23, 2007
Alcohol drug improves ringing in ears
While it may not sound like a drug for ear troubles, researchers believe acamprosate (Campral), a medication used for alcohol dependence treatment, is actually effective at improving ringing in the ears.
In a small study, two Brazilian doctors found that taking Campral led to a decline in symptoms of tinnitus, a disorder that results in ringing or noises in the ear.
Out of 50 patients, some provided with Campral and others with a placebo (an inactive fake medication), more than 80% of those who took Campral said their tinnitus problems lessened.
About half of the group taking Campral said their symptoms decreased by nearly 50%.
"That's a very significant decrease," note Dr. Andréia Aparecida de Azevedo and Dr. Ricardo Rodrigues Figueiredo, lead authors of the study, which will be presented at the Annual Meeting of the American Academy of Otolaryngology - Head and Neck Surgery.
People taking the placebo did not show significant improvement.
Both groups observed were asked to quantify their tinnitus on a scale of 1 to 10 over the course of 30, 60 and 90 days.
The researchers note that age, gender, hearing level and the type of tinnitus suffered from did not make any difference in the effectiveness of the treatment.
As for the reasons why an alcohol-treatment medication is effective for tinnitus, the researchers note that Campral is able to affect both auditory pathways and the central nervous system.
The investigators do emphasize their study was quite small and more research is needed.
In a small study, two Brazilian doctors found that taking Campral led to a decline in symptoms of tinnitus, a disorder that results in ringing or noises in the ear.
Out of 50 patients, some provided with Campral and others with a placebo (an inactive fake medication), more than 80% of those who took Campral said their tinnitus problems lessened.
About half of the group taking Campral said their symptoms decreased by nearly 50%.
"That's a very significant decrease," note Dr. Andréia Aparecida de Azevedo and Dr. Ricardo Rodrigues Figueiredo, lead authors of the study, which will be presented at the Annual Meeting of the American Academy of Otolaryngology - Head and Neck Surgery.
People taking the placebo did not show significant improvement.
Both groups observed were asked to quantify their tinnitus on a scale of 1 to 10 over the course of 30, 60 and 90 days.
The researchers note that age, gender, hearing level and the type of tinnitus suffered from did not make any difference in the effectiveness of the treatment.
As for the reasons why an alcohol-treatment medication is effective for tinnitus, the researchers note that Campral is able to affect both auditory pathways and the central nervous system.
The investigators do emphasize their study was quite small and more research is needed.
Thursday, March 22, 2007
50 million!
Otolaryngologist Jay Piccirillo, M.D., of Washington University School of Medicine in St. Louis, says at least 50 million Americans have tinnitus. "There is no drug that we can give them. There is no surgery that we can do or device that we can put in the ear to cure the tinnitus."
But there is help for people with sleep problems as a result of their tinnitus. A new study shows melatonin lessens the ringing and significantly improves sleep.
"I would definitely think that patients with tinnitus who are having problems sleeping should consider melatonin," Dr. Piccirillo said.
Another small study shows injecting Botox around the ear might also help. Dr. Piccirillo is also studying a procedure called transcranial magnetic stimulation (TMS) -- where a magnetic device stimulates certain areas in the brain. Early studies are promising.
LaJeunesse was in a study on melatonin to help the ringing and her sleep. "I had more energy in the mornings," she said. "I woke up more refreshed than I had been, and that was wonderful."
Dr. Piccirillo says other sufferers could easily get the same benefit, since melatonin is available over the counter. Though all three methods are showing success in helping lessen the ringing, he says there is still no cure for tinnitus. He says seeking help from a professional hearing expert is the best first step to take. Other medications, like anti-anxiety drugs, are also used for tinnitus with some success.
But there is help for people with sleep problems as a result of their tinnitus. A new study shows melatonin lessens the ringing and significantly improves sleep.
"I would definitely think that patients with tinnitus who are having problems sleeping should consider melatonin," Dr. Piccirillo said.
Another small study shows injecting Botox around the ear might also help. Dr. Piccirillo is also studying a procedure called transcranial magnetic stimulation (TMS) -- where a magnetic device stimulates certain areas in the brain. Early studies are promising.
LaJeunesse was in a study on melatonin to help the ringing and her sleep. "I had more energy in the mornings," she said. "I woke up more refreshed than I had been, and that was wonderful."
Dr. Piccirillo says other sufferers could easily get the same benefit, since melatonin is available over the counter. Though all three methods are showing success in helping lessen the ringing, he says there is still no cure for tinnitus. He says seeking help from a professional hearing expert is the best first step to take. Other medications, like anti-anxiety drugs, are also used for tinnitus with some success.
Wednesday, March 21, 2007
What is available?
What vitamins are available for treating tinnitus?
Niacin
Lecithin
Zinc
Magnesium
What herbs are available for treating tinnitus?
Gingko Biloba
What other treatments are available for tinnitus?
Surgery
Biofeedback
Accupuncture
Stress Reduction
Hearing Aids
Cranial Sacral Therapy
Electrical Stimulation
Surgically Severing the Auditory Nerves
Hyperbaric Oxygen Therapy
Feedback Therapy
Auditory Integration Training
Sound Therapy
Hypnotherapy
Homeopathic Remedies
Temporomandibular Disorder and Coexisting Tinnitus
Niacin
Lecithin
Zinc
Magnesium
What herbs are available for treating tinnitus?
Gingko Biloba
What other treatments are available for tinnitus?
Surgery
Biofeedback
Accupuncture
Stress Reduction
Hearing Aids
Cranial Sacral Therapy
Electrical Stimulation
Surgically Severing the Auditory Nerves
Hyperbaric Oxygen Therapy
Feedback Therapy
Auditory Integration Training
Sound Therapy
Hypnotherapy
Homeopathic Remedies
Temporomandibular Disorder and Coexisting Tinnitus
Tuesday, March 20, 2007
Refresher
Tinnitus (ti-NIGHT-us or TIN-i-tus) is the perception of sound in the absence of a corresponding external sound. It can be perceived in one or both ears or in the head. Tinnitus is the Latin word for "ringing", and usually it is described as a ringing noise, but in some patients it takes the form of a buzzing, hissing, humming, or whistling sound, ticking, clicking, roaring, "crickets," tunes, or songs. It has also been described as a "whooshing" sound, as of wind or waves.
Tinnitus is not itself a disease, but an unwelcome symptom resulting from a range of underlying causes, including ear infections, foreign objects or wax in the ear, and injury from loud noises, as may have been experienced by war veterans (bombardments, shelling, etc.). Tinnitus is also a side-effect of some oral medications.
Tinnitus is not itself a disease, but an unwelcome symptom resulting from a range of underlying causes, including ear infections, foreign objects or wax in the ear, and injury from loud noises, as may have been experienced by war veterans (bombardments, shelling, etc.). Tinnitus is also a side-effect of some oral medications.
Monday, March 19, 2007
Mechanisms of Subjective Tinnitus
The inner ear contains thousands of minute hairs which vibrate in response to sound waves. Receptor cells (hair cells) in turn send signals to the brain, which are interpreted as sound. Although receptor cells can be regenerated from the adjacent supporting Deiters cells after injury in birds, reptiles, and amphibians, in mammals it is believed that they can be produced only during embryogenesis. Although mammalian Deiters cells reproduce and position themselves appropriately for regeneration, they have not been observed to transdifferentiate into receptor cells except in tissue culture experiments. Therefore, if these hairs become damaged, through prolonged exposure to excessive decibel levels, for instance, then deafness to certain frequencies occurs. In tinnitus, they may falsely relay information at a certain frequency that an externally audible sound is present, when it is not.
The mechanisms of subjective tinnitus are often obscure. While it is not surprising that direct trauma to the inner ear can cause tinnitus, other apparent causes (e.g., TMJ and dental disorders) are difficult to explain. Recent research has proposed that there are two distinct categories of subjective tinnitus: otic tinnitus, caused by disorders of the inner ear or the acoustic nerve; and somatic tinnitus, caused by disorders outside the ear and nerve, but still within the head or neck. It is further hypothesized that somatic tinnitus may be due to "central crosstalk" within the brain, as certain head and neck nerves enter the brain near regions known to be involved in hearing.
source- Wikipedia
The mechanisms of subjective tinnitus are often obscure. While it is not surprising that direct trauma to the inner ear can cause tinnitus, other apparent causes (e.g., TMJ and dental disorders) are difficult to explain. Recent research has proposed that there are two distinct categories of subjective tinnitus: otic tinnitus, caused by disorders of the inner ear or the acoustic nerve; and somatic tinnitus, caused by disorders outside the ear and nerve, but still within the head or neck. It is further hypothesized that somatic tinnitus may be due to "central crosstalk" within the brain, as certain head and neck nerves enter the brain near regions known to be involved in hearing.
source- Wikipedia
Thursday, March 15, 2007
Drugs available
Here is a list that I found truly useful. It links to information on the different drugs used to treat tinnitus.
What drugs are available for treating tinnitus?
Anti-Depressants, Tranquilizers, and Muscle Relaxants
Alprazolam (Xanax)
Klonopin
Anti-Convulsants
Intravenous Lidocaine
Tocainide Hydrochloride
Histamine
Anti-Histamine
Meclizine
DMSO
Vinpocetine and Vincamine
Hydergine
Sodium Fluoride
Vasodilators
Diuretics
Betahistine Hydrochloride (SERC)
Caroverine
Carbogen
What drugs are available for treating tinnitus?
Anti-Depressants, Tranquilizers, and Muscle Relaxants
Alprazolam (Xanax)
Klonopin
Anti-Convulsants
Intravenous Lidocaine
Tocainide Hydrochloride
Histamine
Anti-Histamine
Meclizine
DMSO
Vinpocetine and Vincamine
Hydergine
Sodium Fluoride
Vasodilators
Diuretics
Betahistine Hydrochloride (SERC)
Caroverine
Carbogen
Wednesday, March 14, 2007
Action for Tinnitus Research
Recent surveys and anecdotal evidence highlights the poor treatment that tinnitus sufferers receive from the NHS. The main problem for GPs is not one of diagnosis. That is easy. However, the problem is that there are insufficient secondary care services: from consultants to support services. The service is inconsistent. Some GPs give basic advice and support, while others neither have the time nor the knowledge to give even that... ATR is calling for the National Institute for Health and Clinical Excellence (NICE) to offer national, consistent guidelines for identifying and dealing with tinnitus. The campaign, which is being backed by Dr Nick Palmer MP, encourages everyone to get involved: healthcare professionals, patients, carers, and the public. Make a big difference to tinnitus sufferers in the UK! Suggest Tinnitus as a topic to be investigated by NICE. Completing the NICE form The NICE website form is easy enough to complete. It may take you ten minutes, however it is worth the effort! It asks for your name, email address, role i.e. patient, healthcare worker etc., location, and whether you are responding as an individual or organisation. Please answer from your perspective and your own knowledge. However to help you, here are some tips to make it easier to complete the form. The detail you need to complete: Topic suggestion: consistent guidelines for identifying and dealing with tinnitus Clinical or public health area suggestion most closely applies to? Ear and nose Specific illness or condition suggestion aims to treat or prevent: Tinnitus Aspect(s) of this illness/condition or behaviour suggestion focus on? Tick the following: Investigation/assessment, Diagnosis/identification, Referral, Individual treatment, Management/pathway of care, Service delivery What group(s) of patients or the general public does your suggestion apply to? 10% of the UK population – across all demographics - who have tinnitus Where is the care associated with your suggestion given? Primary care Why you think there is a need for guidance on your suggestion in the NHS? Variation in prescription/practice, Inappropriate use/practice, Variation in access to treatment/care Other information about you that is relevant to your topic suggestion? Provide information from your persepctive, i.e. I am a tinnitus sufferer, I am a GP with tinnitus patients Statement on the extent and quality of the evidence base: Only complete is you have insight and information Data protection section: answer in terms of your own experience. Thank you for taking the trouble to complete the form… Action for Tinnitus Research
Tuesday, March 13, 2007
More causes of Subjective Tinnitus
chemotherapy drugs:
bleomycin
cisplatin
mechlorethamine
methotrexate
vincristine
loop diuretics:
bumetanide
ethacrynic acid
furosemide
others:
chloroquine
quinine
mercury
lead
neurologic disorders:
multiple sclerosis
head injury
skull fracture
closed head injury
whiplash injury
temporomandibular joint disorder
metabolic disorders:
thyroid disorder
hyperlipidemia
vitamin B12 deficiency
psychogenic disorders:
depression
anxiety
other disorders:
fibromyalgia
bleomycin
cisplatin
mechlorethamine
methotrexate
vincristine
loop diuretics:
bumetanide
ethacrynic acid
furosemide
others:
chloroquine
quinine
mercury
lead
neurologic disorders:
multiple sclerosis
head injury
skull fracture
closed head injury
whiplash injury
temporomandibular joint disorder
metabolic disorders:
thyroid disorder
hyperlipidemia
vitamin B12 deficiency
psychogenic disorders:
depression
anxiety
other disorders:
fibromyalgia
causes of subjective Tinnitus
Tinnitus can have many different causes, but most commonly results from otologic disorders - the same conditions that cause hearing loss. The most common cause is noise-induced hearing loss, resulting from exposure to excessive or loud noises. Ototoxic drugs can cause tinnitus either secondary to hearing loss or without hearing loss, and may increase the damage done by exposure to loud noise, even at doses that are not in themselves ototoxic.
Saturday, March 10, 2007
Objective Tinnitus
In a minority of cases, a clinician can perceive an actual sound (e.g., a bruit) emanating from the patient's ears. This is called objective tinnitus. Objective tinnitus can arise from muscle spasms that cause clicks or crackling around the middle ear. Some people experience a sound that beats in time with the pulse (pulsatile tinnitus). Pulsatile tinnitus is usually objective in nature, resulting from altered blood flow or increased blood turbulence near the ear (such as from atherosclerosis or venous hum), but it can also arise as a subjective phenomenon from an increased awareness of blood flow in the ear. Rarely, pulsatile tinnitus may be a symptom of potentially life-threatening conditions such as carotid artery aneurysm or dissection .
Thursday, March 8, 2007
Effective treatments for objective and subjective tinnitus
Effective treatments include:
Objective tinnitus:
Gamma knife radiosurgery (glomus jugulare)
Shielding of cochlea by teflon implant
Botulinum toxin (palatal tremor)
Propranolol and clonazepam (arterial anatomic variation)
Subjective tinnitus:
Drugs and nutrients
Avoidance of caffeine, nicotine, salt
Avoidance of or consumption of alcohol
Zinc supplementation (where serum zinc deficiency is present)
Acamprosate Etidronate or sodium fluoride (otosclerosis)
Lignocaine or anticonvulsants (usually in patients responsive to white noise masking)
Carbemazepine
Melatonin (especially for those with sleep disturbance)
Sertraline Acupuncture and Chinese herbal medicine
Wednesday, March 7, 2007
Prevention of Tinnitus
Because tinnitus and hearing loss can be permanent conditions, precautionary measures are advisable. If a ringing in the ears is audible after exposure to a loud environment, such as a rock concert or work place, it means that damage is being done. Prolonged exposure to noise levels as low as 70 dB can result in damage to hearing. If it is not possible to limit exposure, earplugs or ear defenders should be worn. For musicians and DJs, special musicians' earplugs can lower the volume of the music without distorting the sound and can prevent tinnitus from developing in later years.It is also important to check medications for potential ototoxicity. Ototoxicity can be cumulative between medications, or can greatly increase the damage done by noise. If ototoxic medications must be administered, close attention by the physician to prescription details, such as dose and dosage interval, can reduce the damage done.
Tuesday, March 6, 2007
iPod addiction
For iPod users, a budding problem
By Mary Brophy Marcus, Special to USA TODAY
Seattle-based builder and author Pete Nelson blasts his iPod to drown out the sound of his power tools when he works. He cranks it up when he skis and even listens to the portable music player while working at his computer."I'm having a love affair with my iPod," says Nelson, whose wife, 15-year-old daughter and 13-year-old twin sons all have iPod addictions.
They're like millions of other Americans who listen to their MP3s for hours each day.
Apple has sold more than 40 million iPods since they hit the market in 2001. Last year, 14 million were snatched up in the fourth quarter alone. Those figures don't include purchases of iRiver, Sony and other brands of MP3 players.
But lately it seems a backlash may be brewing against MP3 players with claims that the gadgets, which typically are used with dime-sized, disc-shaped earphones called ear buds, can cause hearing loss:
• Last month, a Louisiana man filed a federal lawsuit against Apple claiming iPods cause hearing damage.
• Rep. Edward Markey, D-Mass., wrote a letter to the director of the National Institute on Deafness and Other Communication Disorders in January, calling for a review of the scientific information on the effect of portable music players on hearing loss. He also asked for recommendations to help consumers avoid potential damage from MP3 players.
• In France, the government has set a limit of 100 decibels in MP3 players, and Apple has made adjustments. Company executives, when contacted for this report, declined to comment on the maximum volume an American-sold iPod can reach.But independent testing showed that maximum volumes hovered in the 120-decibel range, about the level of a jet plane taking off, says audiologist Brian Fligor, a hearing expert at Children's Hospital Boston.
According to the deafness institute, almost 28 million Americans have hearing loss. One-third have damage because of loud noise.
Very few documented cases of noise-induced hearing loss are tracked to long-term use of handheld stereos alone, but more research is needed, Fligor says.
Fligor is researching safe-listening levels in MP3s. He and colleagues published a study in 2004 that determined safe-listening levels with portable music players such as the Sony Walkman; the study found that one hour a day at about 60% volume was safe. Preliminary results of the MP3 study show figures in the same ballpark, he says.
Hearing loss is preventable
If it's not healthy, why give listeners the option to pump it up to 120 decibels? Pure pleasure, Fligor says.
"There are just some songs you want to rock out on," says iPod user and Texas musician Bob Schneider, 40, who has been performing for 17 years and concedes he probably has some hearing damage. "At this stage of the game, I still play the music pretty loud. I can still hear pretty well, but that might be a whole different story when I'm 60."
By then, it might be too late for Schneider or families such as the Nelsons who sometimes listen to their MP3s more than three hours a day.
Using earphones for hours at high volumes basically causes "shock and awe" to delicate hair-like cells deep within the inner ear that help the brain process sound, says Ron Eavey, director of pediatric otolaryngology at Massachusetts Eye and Ear Infirmary. After years of abuse, those structures won't function anymore, he says.
Nelson, 43, is concerned about hearing loss and already experiences ringing in the ears, called tinnitus, which is a symptom of damage. But he says he has no plans to cut back on his MP3 use.
Noise-induced hearing loss is preventable, says Pam Mason, an audiologist with the American Speech and Hearing Association in Rockville, Md.
Mason suggests dishing out the cash for a good pair of earphones. Sound-isolating earphones made by companies such as Future Sonics, Shure and Etymotic reduce ambient noise outside the ears so that listeners don't have to pump up the volume as high.
"People think if they listen at a lower volume, they won't get the same quality of sound. But good headphones actually allow you to hear more detailed nuances in the music without the high frequencies that do damage," says Marty Garcia, founder of Philadelphia-based Future Sonics.
Boston-based Bose and other companies sell another option: noise-canceling headphones. Battery-driven, they cover the entire outer ear and work by picking up ambient noise outside the headphones and then emitting a counter frequency that cancels out the incoming noise. This technology also allows a user to reduce the volume on his MP3 because there is little outside noise to overcome.
No two people are alike, so it's difficult to predict who will develop hearing loss, experts say.
But if you have tinnitus, find that noises sound muffled, experience temporary hearing loss after a loud concert or have difficulty hearing someone 3 feet away, you need to get your hearing tested.
Apple and other MP3 player manufacturers can help listeners by reducing volume levels, experts say. But in the end, it is up to the user. Says Harvard's Eavey: "It's like using sunblock to prevent skin cancer. Ultimately, iPod users need to make the right choices to avoid hearing loss."
By Mary Brophy Marcus, Special to USA TODAY
Seattle-based builder and author Pete Nelson blasts his iPod to drown out the sound of his power tools when he works. He cranks it up when he skis and even listens to the portable music player while working at his computer."I'm having a love affair with my iPod," says Nelson, whose wife, 15-year-old daughter and 13-year-old twin sons all have iPod addictions.
They're like millions of other Americans who listen to their MP3s for hours each day.
Apple has sold more than 40 million iPods since they hit the market in 2001. Last year, 14 million were snatched up in the fourth quarter alone. Those figures don't include purchases of iRiver, Sony and other brands of MP3 players.
But lately it seems a backlash may be brewing against MP3 players with claims that the gadgets, which typically are used with dime-sized, disc-shaped earphones called ear buds, can cause hearing loss:
• Last month, a Louisiana man filed a federal lawsuit against Apple claiming iPods cause hearing damage.
• Rep. Edward Markey, D-Mass., wrote a letter to the director of the National Institute on Deafness and Other Communication Disorders in January, calling for a review of the scientific information on the effect of portable music players on hearing loss. He also asked for recommendations to help consumers avoid potential damage from MP3 players.
• In France, the government has set a limit of 100 decibels in MP3 players, and Apple has made adjustments. Company executives, when contacted for this report, declined to comment on the maximum volume an American-sold iPod can reach.But independent testing showed that maximum volumes hovered in the 120-decibel range, about the level of a jet plane taking off, says audiologist Brian Fligor, a hearing expert at Children's Hospital Boston.
According to the deafness institute, almost 28 million Americans have hearing loss. One-third have damage because of loud noise.
Very few documented cases of noise-induced hearing loss are tracked to long-term use of handheld stereos alone, but more research is needed, Fligor says.
Fligor is researching safe-listening levels in MP3s. He and colleagues published a study in 2004 that determined safe-listening levels with portable music players such as the Sony Walkman; the study found that one hour a day at about 60% volume was safe. Preliminary results of the MP3 study show figures in the same ballpark, he says.
Hearing loss is preventable
If it's not healthy, why give listeners the option to pump it up to 120 decibels? Pure pleasure, Fligor says.
"There are just some songs you want to rock out on," says iPod user and Texas musician Bob Schneider, 40, who has been performing for 17 years and concedes he probably has some hearing damage. "At this stage of the game, I still play the music pretty loud. I can still hear pretty well, but that might be a whole different story when I'm 60."
By then, it might be too late for Schneider or families such as the Nelsons who sometimes listen to their MP3s more than three hours a day.
Using earphones for hours at high volumes basically causes "shock and awe" to delicate hair-like cells deep within the inner ear that help the brain process sound, says Ron Eavey, director of pediatric otolaryngology at Massachusetts Eye and Ear Infirmary. After years of abuse, those structures won't function anymore, he says.
Nelson, 43, is concerned about hearing loss and already experiences ringing in the ears, called tinnitus, which is a symptom of damage. But he says he has no plans to cut back on his MP3 use.
Noise-induced hearing loss is preventable, says Pam Mason, an audiologist with the American Speech and Hearing Association in Rockville, Md.
Mason suggests dishing out the cash for a good pair of earphones. Sound-isolating earphones made by companies such as Future Sonics, Shure and Etymotic reduce ambient noise outside the ears so that listeners don't have to pump up the volume as high.
"People think if they listen at a lower volume, they won't get the same quality of sound. But good headphones actually allow you to hear more detailed nuances in the music without the high frequencies that do damage," says Marty Garcia, founder of Philadelphia-based Future Sonics.
Boston-based Bose and other companies sell another option: noise-canceling headphones. Battery-driven, they cover the entire outer ear and work by picking up ambient noise outside the headphones and then emitting a counter frequency that cancels out the incoming noise. This technology also allows a user to reduce the volume on his MP3 because there is little outside noise to overcome.
No two people are alike, so it's difficult to predict who will develop hearing loss, experts say.
But if you have tinnitus, find that noises sound muffled, experience temporary hearing loss after a loud concert or have difficulty hearing someone 3 feet away, you need to get your hearing tested.
Apple and other MP3 player manufacturers can help listeners by reducing volume levels, experts say. But in the end, it is up to the user. Says Harvard's Eavey: "It's like using sunblock to prevent skin cancer. Ultimately, iPod users need to make the right choices to avoid hearing loss."
Monday, March 5, 2007
Tinnitus in Songs
Peter Framptom - based on lyrics to Show me the way - "I wonder how you're feeling....there's ringing in my ears....and no one to relate to...cept the sea (?)Who can I believe in?I feel so ....."Robert Plant - Stairway to Heaven - "You´re head is humming and it won´t go in case you don´t know..."Bob Dylan - Call Letter Blues - "My ears are ringing, ringing like empty shells... (2x) Well, it can't be no guitar player.Must be...convent bells"Nine Inch Nails - Something I Can Never Have - (Trent Reznor from the album Downward Spiral) "I still recall the taste of your tears. Echoing your voice just like the ringing in my ears."Nine Inch Nails - The Becoming - (Trent Reznor) "I can try to get away but I've strapped myself in. I can try to scratch away the sound in my ears. I can see it killing away all of my bad parts. I don't want to listen but it's all to clear. Hiding backwards inside of me I feel so unafraid. Annie, hold a little tighter I might just slip away. It wont give up. It wants me dead. Goddamn this noise inside my head [8x] "The Young Fresh Fellows / The Minus 5 - Little Bell - (from the album Because We Hate You / Let the War Against Music Begin) - an ode to tinnitus?Garbage - Push It - "This is the noise that keeps me awake, my head explodes and my body aches"U2 - Staring At The Sun - "...There's an insect in your ear, if you scratch it won't disappear, its gonna itch and burn and sting, you wanna see what the scratching brings...waves that leave me out of reach, breaking on your back like a beach, will we ever live in peace? as those that can't do, often have to preach, to the ones, staring at the sun..."Francis Rossi/Status Quo - from 1998 single Burning Bridges - "I can't escape this ringing in my ears..." Bob Seger - Turn the Page - "Later in the evening as you lie awake in bed, with the echo from the amplifiers ringing in your head." Blondie - Fan Mail - (written by James Destri from the album Plastic Letters) "Beat on my Fender through my Gemini II. Play to the posters on the wall in my room. Thought I was crazy when I thought about you. And the bells in my ears kept ringing, In my ears bells are ringing..." The Nitty Gritty Dirt Band - Hillbilly Hollywood - (Jim Photoglo, Vince Melamed) "I played some bars where you never wanna go. From Oklahoma City down to Tupelo. My ears would be ringing like an old fire bell when I'd lay me down in some cheap motel." Wilco - Heavy Metal Drummer - (Lyrics by Jeff Tweedy from the album Yankee Hotel Foxtrot) - "Classical music blasting masks the ringing in my ears." Mr. Bungle - Slowly Growing Deaf - Written by Faith No More lead singer Mike Patton - "To my ears the greatest sin, feel a bit like Beethoven... No one is listening, yet ears are ringing."
Saturday, March 3, 2007
Famous People with Tinnitus-Part 6
Jimmy Savile - "It doesn't bother me in the slightest," he told Michael Church. "It reminds me of all the girls I've known, and all the discos. I'm very happily ensconced with this friend inside my head." Source from: news.independent.co.uk
Michael Church - "I acquired my own tinnitus in the stupidest possible way: on the rifle range at Catterick army camp, while training as an officer cadet. St Albans School in the late Fifties was a grotesquely spartan place, where ear-defenders were unheard of (my fellow victim Stephen Hawking improvised earplugs from blotting paper, and the doctor had to dig them out). After a noisy afternoon with a Bren firing 12 inches from my left ear, I returned home deafened, and though my hearing eventually returned (minus the high frequencies), I was left with a loud hiss. (Yes, I should have sued both the school and the MoD, but 16-year-olds don't have time for such niceties.)" Source from: news.independent.co.uk
Francis Rossi - lead singer and guitarist for the band Status Quo.
Mick Ronson - David Bowie's guitarist, had tinnitus in the ear that was closest to his speaker column.
Hansi Kursch - lead singer and bass player for the band Blind Guardian. Kursch actually lost all hearing on one side, and then suffered tinnitus in the same ear. source from DynamiteMetal.com
Jarmo Miettinen - Rhythm guitar & vocals for the band Status Quiz
Todd Rundgren - Musician
Trent Reznor - Nine Inch Nails
James Destri - keyboardist who wrote "Fan Mail" by Blondie on the album Plastic Letters
Roger Miller - "Mission of Burma...Its career cut short by guitarist Roger Miller’s mounting tinnitus... Miller’s never shaken his condition, but now wears firingrange headphones so that Burma’s full sonic experience--high decibel levels are a key component in the band’s music--can be unleashed upon the crowd." Source from: http://www.fortunecity.com/banners/interstitial.html?http://www.avguide.com/film_music/music/musicreviews/tas148/148_pop_caps.jsp
Richard Pleasance - guitarist for Boom Crash Opera, took time off in 1990 from touring with this band due to tinnitus. Source from: http://www.fortunecity.com/banners/interstitial.html?http://www.vh1.com/artists/az/pleasance_richard/bio.jhtml
Danny Elfman - Oingo Boingo, film scores/composer. Touring took a major toll on his hearing and he still suffers from tinnitus. "The last five or six years I was in the band, my instincts were telling me I was doing myself a lot of harm - and I was right. I really should have gotten out sooner than I did, and I'm incredibly regretful that I didn't because I'm paying the price for it now." Source from: OCRegister
Steve Lukather - guitarist/song writer for Toto, developed tinnitus sometime in the 1980's. "Yes I have tinnitus, what a drag. I wear earplugs now 'cause of it. I found that it was all the years wearing headphones that did me in more than live playing. I used to have the real expensive plugs, but I found some 2 dollar ones that work just as good and you don't feel bad losing them, hahaha. My hearing is damaged though. I always have to say "WHAT???", hahaha. Be careful guys, this could happen to you!"
Friday, March 2, 2007
Pulsatile tinnitus sounds are tinnitus sounds that are synchronous with your heartbeat. Thus, pulsatile tinnitus is generally related somehow to the blood flowing in the blood vessels in your neck and head—close enough to your ears that you can hear them.
Although pulsatile tinnitus sounds are rhythmic pulsing sounds in time with your heart beat, they have a number of variations. For example, they may be drumming, beating, pounding, throbbing, pulsating or fluttering sounds. They may have single beats, or they may have biphasic beats (like the clip-clop of a horse). They may even make swishing, swooshing or whooshing sounds (to name some of them).
Here are some of the more common causes of pulsatile tinnitus. You may have what is called a glomus tumor. Glomus tumors occur in about 12% of diagnosed cases of pulsatile tinnitus. A glomus tumor is a non-cancerous mass of intertwined blood vessels growing near your ear. The blood pulsating through them could be causing your pulsatile tinnitus.
If you had a glomus tumor, perhaps it could also be pressing on something causing your pain. I don’t have a clue, of course—but a good ENT doctor (not all are good as you have found out) or a good vascular surgeon should be able to figure out what is going on, and whether it needs further investigation or treatment or not.
Another common cause of pulsatile tinnitus is “Benign Intracranial Hypertension” syndrome or BIH. BIH accounts for about 39% of all diagnosed cases of pulsatile tinnitus. BIH is increased pressure of the fluid that bathes your brain. This syndrome includes headaches and blurred vision among other things.
Pulsatile tinnitus could also be the result of Carotid Artery Disease (CAD) which accounts for 17% of all diagnosed cases of pulsatile tinnitus. With CAD, the “gunk” in your arteries (to use a fancy medical term—which is sure easier to spell than “atherosclerotic build-up of cholesterol”) reduces the space inside the arteries in your neck leading to turbulent blood flow which you hear as pulsatile tinnitus.
Although pulsatile tinnitus sounds are rhythmic pulsing sounds in time with your heart beat, they have a number of variations. For example, they may be drumming, beating, pounding, throbbing, pulsating or fluttering sounds. They may have single beats, or they may have biphasic beats (like the clip-clop of a horse). They may even make swishing, swooshing or whooshing sounds (to name some of them).
Here are some of the more common causes of pulsatile tinnitus. You may have what is called a glomus tumor. Glomus tumors occur in about 12% of diagnosed cases of pulsatile tinnitus. A glomus tumor is a non-cancerous mass of intertwined blood vessels growing near your ear. The blood pulsating through them could be causing your pulsatile tinnitus.
If you had a glomus tumor, perhaps it could also be pressing on something causing your pain. I don’t have a clue, of course—but a good ENT doctor (not all are good as you have found out) or a good vascular surgeon should be able to figure out what is going on, and whether it needs further investigation or treatment or not.
Another common cause of pulsatile tinnitus is “Benign Intracranial Hypertension” syndrome or BIH. BIH accounts for about 39% of all diagnosed cases of pulsatile tinnitus. BIH is increased pressure of the fluid that bathes your brain. This syndrome includes headaches and blurred vision among other things.
Pulsatile tinnitus could also be the result of Carotid Artery Disease (CAD) which accounts for 17% of all diagnosed cases of pulsatile tinnitus. With CAD, the “gunk” in your arteries (to use a fancy medical term—which is sure easier to spell than “atherosclerotic build-up of cholesterol”) reduces the space inside the arteries in your neck leading to turbulent blood flow which you hear as pulsatile tinnitus.
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